title: Autochthonous lyme borreliosis in humans and ticks in Korea.
abstract: OBJECTIVE
  This study aimed at finding epidemiological and clinical features of autochthonous Lyme borreliosis in humans through epidemiological investigations and identifying its vectors and pathogens through analysis of ticks.
  
  
  METHODS
  Epidemiological investigations, including review of the retrospective medical records and patient interviews, were conducted in two cases that occurred in 2012. To identify the vectors and pathogens, ticks were collected between September 23 and October 6, 2012 from the area where the tick bite in the first patient occurred. The ticks were classified, and polymerase chain reaction (PCR) tests and cultures were performed.
  
  
  RESULTS
  The first patient, a 46-year-old female, visited a forest in Gangwon province, which was 900 m above sea level, where the tick bite occurred. Two weeks after the tick bite, erythema migrans (12 × 6 cm(2) in size) appeared on the site of tick bite, along with fever, chill, fatigue, myalgia, and arthralgia on shoulders, knees, and hips. The second patient, a 44-year-old male, visited a mountain in Gangwon province, which was 1200 m above sea level, where a tick bite occurred. One month after the tick bite, erythema migrans appeared at the site of the tick bite, along with fatigue, myalgia, and arthralgia on the right shoulder and temporomandibular joint. Indirect fluorescent antibody testing and Western blotting were carried out in these two cases for diagnosis, and positive findings were obtained. As a result, Lyme borreliosis could be confirmed. To estimate the pathogens and vectors, the ticks were collected. A total of 122 ticks were collected and only two species, Haemaphysalis japonica and Haemaphysalis flava, were identified. PCR and culture were performed on ticks. However, Borrelia burgdo rferi sensu lato was not isolated from any collected ticks.
  
  
  CONCLUSIONS
  This study is significant to confirm Lyme borreliosis officially at first by the national surveillance system, although identification of the mites and pathogens failed.
authors.affiliation: Division of Epidemic Intelligence Service, Korea Centers for Disease Control and Prevention, Osong, Korea .
authors.forename: Shinje
authors.initials: S
authors.lastname: Moon
authors.forename: Jin
authors.initials: J
authors.lastname: Gwack
authors.forename: Kyu Jam
authors.initials: KJ
authors.lastname: Hwang
authors.forename: Donghyuk
authors.initials: D
authors.lastname: Kwon
authors.forename: Suyeon
authors.initials: S
authors.lastname: Kim
authors.forename: Yoontae
authors.initials: Y
authors.lastname: Noh
authors.forename: Jongyul
authors.initials: J
authors.lastname: Roh
authors.forename: E-Hyun
authors.initials: EH
authors.lastname: Shin
authors.forename: Kyungjin
authors.initials: K
authors.lastname: Jeong
authors.forename: Wonseok
authors.initials: W
authors.lastname: Seok
authors.forename: Seung-Ki
authors.initials: SK
authors.lastname: Youn
keywords: Borrelia burgdorferi; Ixodes; Lyme borreliosis; Lyme disease; tick