title: Seroprevalence and seroconversion for tick-borne diseases in a high-risk population in the northeast United States.
abstract: OBJECTIVE
  To determine the prevalence of serologic reactivity, the 1-year incidence of seroconversion, and the frequency of multiple infections, and their associations with symptoms in a group of volunteers at high risk for tick-borne infections in New York state.
  
  
  METHODS
  We performed a seroepidemiologic study of Lyme borreliosis, 2 of the ehrlichioses, Rocky Mountain spotted fever, and babesiosis among 671 participants who lived or worked in a high-risk area (mainly in eastern Long Island, New York) for tick-borne diseases. Sera were collected in the winters of 1994 and 1995. Signs and symptoms of tick-borne disease were monitored monthly by mail and telephone. Lyme borreliosis serologies were done by enzyme-linked immunosorbent assay and Western blot. Rocky Mountain spotted fever serologies were initially screened using Dip-S-Ticks, followed by specific indirect immunofluorescence. Ehrlichiosis serologies were determined by epifluorescent microscopy, as were antibodies to Babesia microti.
  
  
  RESULTS
  Of the 671 participants, 88 (13%) had antibodies to > or = 1 tick-borne organisms, including 34 (5% of the total) with antibodies to Borrelia burgdorferi. Twenty-seven participants had evidence of exposure to B. burgdorferi at baseline. Seven participants (1%) seroconverted during the course of the study, 5 of whom were symptomatic for Lyme borreliosis. Antibodies to spotted fever group rickettsiae were seen in 28 participants (4%), 22 of whom were positive at baseline and 6 of whom seroconverted during the observation period. None of the seropositive patients had any symptoms or signs of infection. Twenty-four participants (3%) had serologic evidence of exposure to Ehrlichia (all but one to Ehrlichia equi); 5 (0.7%) seroconverted during the observation period, including 3 subjects who were asymptomatic. Antibodies to B. microti were seen in 7 participants (1%), including one asymptomatic seroconversion during the year of observation. There was evidence of possible dual infection in 5 patients.
  
  
  CONCLUSIONS
  In a high-risk population, there was evidence of exposure to 5 tick-borne pathogens; however, many infections were asymptomatic, and coinfections were rare.
authors.affiliation: North Shore-Long Island Jewish Health System, Division of Clinical Research, The Long Island Campus for the Albert Einstein College of Medicine, New Hyde Park, New York, USA.
authors.forename: E
authors.initials: E
authors.lastname: Hilton
authors.forename: J
authors.initials: J
authors.lastname: DeVoti
authors.forename: J L
authors.initials: JL
authors.lastname: Benach
authors.forename: M L
authors.initials: ML
authors.lastname: Halluska
authors.forename: D J
authors.initials: DJ
authors.lastname: White
authors.forename: H
authors.initials: H
authors.lastname: Paxton
authors.forename: J S
authors.initials: JS
authors.lastname: Dumler
mesh_terms: D001404:Babesiosis / Q000453:epidemiology / Q000276:immunology; D015153:Blotting, Western; D016873:Ehrlichiosis / Q000453:epidemiology / Q000276:immunology; D004797:Enzyme-Linked Immunosorbent Assay; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000453:epidemiology / Q000276:immunology; D008297:Male; D009511:New England / Q000453:epidemiology; D012306:Risk; D012373:Rocky Mountain Spotted Fever / Q000453:epidemiology / Q000276:immunology; D016036:Seroepidemiologic Studies; D017282:Tick-Borne Diseases / Q000453:epidemiology* / Q000276:immunology*