title: The incidence ofBorrelia burgdorferi, Anaplasma phagocytophilumandBabesia microticoinfections among foresters and farmers in eastern Poland.
abstract: OBJECTIVE
  Lyme borreliosis is the most common tick-borne disease in Europe and the USA. However, a great variety of pathogens are transmitted by ticks, which results in mixed infections, with Lyme borreliosis. The aim of the present study was to show the incidence of Borrelia burgdorferi, Anaplasma phagocytophilum, and Babesia microti coinfections among the population of foresters and farmers, as these people, due to their profession, are particularly exposed to tick contact.
  
  
  METHODS
  The study was carried out in eastern Poland (the northern part of the Lublin Province) in 2013. The study was performed in a group of 93 individuals occupationally exposed to tick bites (foresters and farmers), whose blood serum showed the presence of IgG anti-B. burgdorferi antibodies. Blood serum in this group were evaluated for IgG anti-A. phagocytophilum and IgG anti-B. microti antibodies by means of IFA IgG indirect immunofluorescence tests. Information related to age, sex, number of tick bite episodes, presence of various symptoms related to the tick bites, and antibiotic therapy applied as treatment for diagnosed Lyme borreliosis were obtained from the subjects through a structured questionnaire. The results were analyzed in Statistica v. 7.1 statistical analysis software.
  
  
  RESULTS
  The presence of IgG antibodies against the analyzed pathogens revealed B. burgdorferi and A. phagocytophilum coinfection in 26 (28%) of the examined subjects and B. burgdorferi and B. microti coinfection in one person (1.1%). No coinfection with all the three pathogens was observed in any individual. The co-occurrence of headache plus bone, joint and muscle pain was noted significantly more often among individuals diagnosed with B. burgdorferi and A. phagocytophilum coinfection.
  
  
  CONCLUSIONS
  Foresters and farmers are exposed to B. burgdorferi and A. phagocytophilum coinfection in the study area. Therefore, it is probable that these pathogens may severely interfere with the clinical course of Lyme borreliosis.
authors.affiliation: Institute of Health Sciences, Pope John Paul II State School of Higher Education in Biała Podlaska, Poland.
authors.forename: Anna
authors.initials: A
authors.lastname: Pañczuk
authors.affiliation: Institute of Health Sciences, Pope John Paul II State School of Higher Education in Biała Podlaska, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Tokarska-Rodak
authors.affiliation: Institute of Health Sciences, Pope John Paul II State School of Higher Education in Biała Podlaska, Poland.
authors.forename: Maria
authors.initials: M
authors.lastname: Kozioł-Montewka
authors.affiliation: Innovation Research Centre, Pope John Paul II State School of Higher Education in Biala Podlaska, Poland.
authors.forename: Dorota
authors.initials: D
authors.lastname: Plewik
mesh_terms: D000328:Adult; D041081:Anaplasma phagocytophilum / Q000276:immunology; D000907:Antibodies, Bacterial / Q000097:blood; D000913:Antibodies, Protozoan / Q000097:blood; D041001:Babesia microti / Q000276:immunology; D001404:Babesiosis / Q000453:epidemiology*; D025065:Borrelia burgdorferi / Q000276:immunology; D060085:Coinfection / Q000453:epidemiology; D016873:Ehrlichiosis / Q000453:epidemiology*; D000067565:Farmers; D005260:Female; D019084:Fluorescent Antibody Technique, Indirect; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood; D015994:Incidence; D008193:Lyme Disease / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure; D011044:Poland / Q000453:epidemiology; D055815:Young Adult
chemical_list: D000907:Antibodies, Bacterial; D000913:Antibodies, Protozoan; D007074:Immunoglobulin G