title: Seroepidemiological investigation of lyme disease and human granulocytic anaplasmosis among people living in forest areas of eight provinces in China.
abstract: OBJECTIVE
  Lyme disease and Human granulocytic anaplasmosis are tick-borne diseases caused by Borrelia burgdorferi and Anaplasma phagocytophilum respectively. We have investigated infection and co-infection of the two diseases in the population of forest areas of eight provinces in China by measuring seroprevalence of antibodies against B. burgdorferi and A. phagocytophilum.
  
  
  METHODS
  Forest areas in 8 provinces were chosen for investigation using whole sampling and questionnaire survey methods. 3 669 serum samples from people in the forest areas were tested for the presence of antibodies by indirect immunofluorescent assay (IFA).
  
  
  RESULTS
  Seroprevalence against B. burgdorferi was 3% to 15% and against A. phagocytophilum was 2% to 18% in the study sites in the 8 provinces in China. We also found co-infection of B. burgdorferi and A. phagocytophilum in 7 of the 8 provinces (the exception being the Miyun area in Beijing). The seroprevalence for both B. burgdorferi and A. phagocytophilum was significantly higher among people exposed to ticks than among people who were not exposed to ticks.
  
  
  CONCLUSIONS
  We conclude that both pathogens are endemic in the forest areas in the eight provinces, but the prevalence of B. burgdorferi and A. phagocytophilum differs between the provinces.
authors: National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, State Key Laboratory for Infectious Disease Prevention and Control, Beijing 102206, China.
authors: Qin
authors: Q
authors: Hao
authors: Zhen
authors: Z
authors: Geng
authors: Xue Xia
authors: XX
authors: Hou
authors: Zhen
authors: Z
authors: Tian
authors: Xiu Jun
authors: XJ
authors: Yang
authors: Wei Jia
authors: WJ
authors: Jiang
authors: Yan
authors: Y
authors: Shi
authors: Zhi Fei
authors: ZF
authors: Zhan
authors: Guo Hua
authors: GH
authors: Li
authors: De Shan
authors: DS
authors: Yu
authors: Hua Yong
authors: HY
authors: Wang
authors: Jian Guo
authors: JG
authors: Xu
authors: Kang Lin
authors: KL
authors: Wan
mesh_terms: D000293:Adolescent; D000328:Adult; D041081:Anaplasma phagocytophilum / Q000472:pathogenicity; D000712:Anaplasmosis / Q000097:blood* / Q000453:epidemiology; D000818:Animals; D025065:Borrelia burgdorferi / Q000472:pathogenicity; D002648:Child; D002681:China; D060085:Coinfection; D005260:Female; D006801:Humans; D008193:Lyme Disease / Q000097:blood* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D016036:Seroepidemiologic Studies; D017282:Tick-Borne Diseases / Q000097:blood / Q000453:epidemiology; D014197:Trees; D055815:Young Adult
keywords: Anaplasma phagocytophilum; Borrelia burgdorferi; Co-infection; Residents of forest areas