title: Clinical and serological one-year follow-up of patients after the bite of Ixodes ricinus ticks infected with Borrelia burgdorferi sensu lato.
abstract: BACKGROUND
  The risk of developing Lyme borreliosis (LB) after the bite of a Borrelia (B.) burgdorferi sensu lato (s.l.) infected tick in Romania is unknown.
  
  
  METHODS
  The present prospective study, performed in 2010-2011 in a hospital in Romania, has followed-up clinical and serological outcome of patients that presented with B. burgdorferi positive Ixodes (I.) ricinus bite. A second group of patients, including age, sex and residence-matched individuals bitten by B. burgdorferi negative ticks, was followed-up as a control group. The subjects' outcome was evaluated one year after the tick bite.
  
  
  RESULTS
  Forty-three out of 389 ticks detached from patients were positive by hbb Real-Time PCR (RT-PCR) for B. burgdorferi s.l. (mainly B. afzelii, but also B. garinii, B. burgdorferi sensu stricto, B. spielmanii/B. valaisiana and B. lusitaniae). Twenty patients bitten by B. burgdorferi positive ticks and twenty matched control patients returned for the one year follow-up. Two patients from the B. burgdorferi positive group developed clinical manifestations of acute LB (erythema migrans) and 5 patients seroconverted (two from the B. burgdorferi positive group and three from the B. burgdorferi negative group). Borrelia afzelii was identified in ticks collected from persons that developed erythema migrans (EM). Comparing the two groups of patients, no statistical significant differences were found regarding presence of clinical symptoms or seroconversion.
  
  
  CONCLUSIONS
  No outcome differences were found between the group of patients bitten by B. burgdorferi positive ticks and the group of patients bitten by B. burgdorferi negative ticks.
authors.affiliation: a Department of Infectious Diseases , Iuliu Haţieganu University of Medicine and Pharmacy , Cluj-Napoca , Romania.|b Clinical Hospital of Infectious Diseases , Cluj-Napoca , Romania.|c Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine , University of Agricultural Sciences and Veterinary Medicine , Cluj-Napoca , Romania.|d National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority , Oberschleißheim , Germany.
authors.forename: Violeta T
authors.initials: VT
authors.lastname: Briciu
authors.affiliation: b Clinical Hospital of Infectious Diseases , Cluj-Napoca , Romania.
authors.forename: Mirela
authors.initials: M
authors.lastname: Flonta
authors.affiliation: a Department of Infectious Diseases , Iuliu Haţieganu University of Medicine and Pharmacy , Cluj-Napoca , Romania.|b Clinical Hospital of Infectious Diseases , Cluj-Napoca , Romania.
authors.forename: Doina F
authors.initials: DF
authors.lastname: Ţăţulescu
authors.affiliation: e Bavarian Health and Food Safety Authority , Oberschleißheim , Germany.
authors.forename: Fabian
authors.initials: F
authors.lastname: Meyer
authors.affiliation: e Bavarian Health and Food Safety Authority , Oberschleißheim , Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Sebah
authors.affiliation: a Department of Infectious Diseases , Iuliu Haţieganu University of Medicine and Pharmacy , Cluj-Napoca , Romania.
authors.forename: Dumitru
authors.initials: D
authors.lastname: Cârstina
authors.affiliation: c Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine , University of Agricultural Sciences and Veterinary Medicine , Cluj-Napoca , Romania.
authors.forename: Andrei D
authors.initials: AD
authors.lastname: Mihalca
authors.affiliation: c Department of Parasitology and Parasitic Diseases, Faculty of Veterinary Medicine , University of Agricultural Sciences and Veterinary Medicine , Cluj-Napoca , Romania.
authors.forename: Călin M
authors.initials: CM
authors.lastname: Gherman
authors.affiliation: d National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority , Oberschleißheim , Germany.
authors.forename: Cecilia
authors.initials: C
authors.lastname: Hizo-Teufel
authors.affiliation: e Bavarian Health and Food Safety Authority , Oberschleißheim , Germany.
authors.forename: Ingrid
authors.initials: I
authors.lastname: Huber
authors.affiliation: d National Reference Centre for Borrelia, Bavarian Health and Food Safety Authority , Oberschleißheim , Germany.
authors.forename: Volker
authors.initials: V
authors.lastname: Fingerle
authors.affiliation: a Department of Infectious Diseases , Iuliu Haţieganu University of Medicine and Pharmacy , Cluj-Napoca , Romania.|b Clinical Hospital of Infectious Diseases , Cluj-Napoca , Romania.
authors.forename: Mihaela
authors.initials: M
authors.lastname: Lupșe
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000907:Antibodies, Bacterial / Q000097:blood*; D015748:Borrelia burgdorferi Group / Q000276:immunology / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006761:Hospitals; D006801:Humans; D007299:Insect Bites and Stings / Q000150:complications*; D018884:Ixodes / Q000382:microbiology*; D008193:Lyme Disease / Q000453:epidemiology* / Q000276:immunology; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012383:Romania; D011795:Surveys and Questionnaires; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial
keywords: Borrelia burgdorferi sensu lato; Ixodes ricinus; Lyme borreliosis; Romania