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Tickborne Borrelia Infections, An Issue of Clinics in Laboratory Medicine, E-Book

Tickborne Borrelia Infections, An Issue of Clinics in Laboratory Medicine, E-Book

Elitza S. Theel

(2016)

Abstract

Topics in this publication on tickborne borrelia infections include: Lyme disease epidemiology and transmission; Clinical manifestation and treatment of Lyme disease; Neuroborreliosis; Prevention of Lyme disease; Lyme disease diagnosis - serology; Lyme disease diagnosis - alternatives to serology; Lyme disease co-infections; Relapsing fever borrelia (global review); Emerging tickborne borrelia - B. miyamotoi; Lyme Disease and the immune response. Led by Elli Theel Director of the Infectious Diseases Serology Laboratory of Mayo Clinic, this issue includes authors from the United States, United Kingdom, and Canada to present their expertise on tickborne disease for the clinical pathologist, the infectious disease specialist, and other clinicians who work with patients with these diseases.

Table of Contents

Section Title Page Action Price
Front Cover Cover
Tickborne Borrelia Infections\r i
Copyright\r ii
Contributors iii
EDITOR iii
AUTHORS iii
Contents v
Preface: Tickborne Borrelia Infections: Beyond Just Lyme Disease\r v
Ecology and Epidemiology of Lyme Borreliosis\r v
Borrelia burgdorferi Pathogenesis and the Immune Response\r v
Clinical Manifestations and Treatment of Lyme Disease\r v
Nervous System Lyme Disease\r v
Lyme Disease Diagnosis: Serology\r vi
Alternatives to Serologic Testing for Diagnosis of Lyme Disease\r vi
Lyme Disease Coinfections in the United States\r vi
Relapsing Fever Borreliae: A Global Review\r vii
Borrelia miyamotoi Disease: Neither Lyme Disease Nor Relapsing Fever\r vii
Methods to Prevent Tick Bites and Lyme Disease\r vii
CLINICS IN LABORATORY MEDICINE\r viii
FORTHCOMING ISSUES viii
March 2016 viii
June 2016 viii
RECENT ISSUES viii
September 2015 viii
June 2015 viii
March 2015 viii
Preface: Tickborne Borrelia Infections: Beyond Just Lyme Disease \r ix
Ecology and Epidemiology of Lyme Borreliosis 723
Key points 723
INTRODUCTION 723
GEOGRAPHIC DISTRIBUTION OF THE DISEASE 724
THE ETIOLOGIC AGENT 724
THE VECTOR 727
RESERVOIR HOSTS AND THE AMPLIFICATION OF BORRELIA BURGDORFERI S.L. IN NATURE 729
SEASONALITY OF TICK ACTIVITY AND HUMAN INFECTIONS 731
GENETIC FACTORS 733
LYME DISEASE IN THE SOUTHERN UNITED STATES 734
RISK FACTORS FOR LYME DISEASE 735
SELF-ASSESSMENT 736
REFERENCES 736
Borrelia burgdorferi Pathogenesis and the Immune Response 745
Key points 745
INTRODUCTION 745
BORRELIA BURGDORFERI GENOMIC VARIATION 746
BORRELIA BURGDORFERI PATHOGENIC MECHANISMS 747
BORRELIA BURGDORFERI ADHESINS 747
Decorin Binding 747
Fibronectin Binding 747
Integrin Binding 748
IMMUNE EVASION 749
Antigenic Variation 749
Complement Resistance 750
BORRELIA BURGDORFERI VIRULENCE FACTORS 750
THE INNATE IMMUNE RESPONSE TO BORRELIA BURGDORFERI 751
THE INITIAL HOST-PATHOGEN INTERFACE: THE ERYTHEMA MIGRANS LESION 752
EFFECT OF VECTOR-ENCODED FACTORS ON INNATE IMMUNITY 753
CONCLUDING REMARKS 754
SELF-ASSESSMENT 754
REFERENCES 755
Clinical Manifestations and Treatment of Lyme Disease 765
Key points 765
INTRODUCTION 765
NATURAL COURSE OF UNTREATED DISEASE 766
EARLY, LOCALIZED LYME DISEASE 766
EARLY DISSEMINATED LYME DISEASE 766
LATE LYME DISEASE 769
POST-LYME DISEASE SYMPTOMS 770
POST-LYME DISEASE SYNDROME 770
CONGENITAL INFECTION 770
RELAPSE VERSUS REINFECTION 771
DIFFERENTIAL DIAGNOSIS 771
THERAPY 771
EARLY INFECTION 772
LATE INFECTION 773
TREATMENT OF CHILDREN AND DURING PREGNANCY 773
POST-LYME DISEASE SYMPTOMS/SYNDROME 773
SELF-ASSESSMENT 774
REFERENCES 776
Nervous System Lyme Disease 779
Key points 779
BACKGROUND 779
NEUROLOGY 101 780
LYME DISEASE AFFECTING THE NERVOUS SYSTEM OR NEUROBORRELIOSIS 781
HISTORIC BEGINNINGS 781
The First Described Case of Neuroborreliosis 781
Lyme Pathophysiology 782
LABORATORY DIAGNOSIS OF NEUROBORRELIOSIS 783
CLINICAL MANIFESTATIONS 786
Peripheral Nervous System Involvement 786
Radiculitis 786
Cranial neuritis 787
Mononeuropathy 787
Confluent mononeuropathy multiplex 787
Central Nervous System Involvement 787
Lyme Encephalopathy 788
Posttreatment Lyme Disease Syndrome and Chronic Lyme Disease 789
TREATMENT OF LYME NEUROBORRELIOSIS 790
SUMMARY 790
SELF-ASSESSMENT 790
REFERENCES 791
Lyme Disease Diagnosis 797
Key points 797
INTRODUCTION 797
INFECTION AND IMMUNE RESPONSE 798
SEROLOGY BEFORE 1995 799
STANDARDIZED 2-TIER TESTING 802
STANDARDIZED 2-TIER TESTING PERFORMANCE, 1995 TO PRESENT 802
PITFALLS IN STANDARDIZED 2-TIER TESTING 804
Testing Too Soon After Early Infection 804
Single-Tier Testing 804
Immunoglobulin M Western Immunoblotting Regardless of Duration of Illness 804
Overinterpretation of Less Than Positive Standardized 2-tier Testing Results 805
POSTTREATMENT TESTING 805
DEVELOPMENTS SINCE 1995 AND STANDARDIZED 2-TIER TESTING 805
Two-tier Enzyme Immunoassays 806
Centers for Disease Control and Prevention Lyme Serum Repository 807
Predictive Value of Serology Results 807
TESTING FOR INFECTIONS ACQUIRED OUTSIDE NORTH AMERICA 810
SUMMARY 810
SELF-ASSESSMENT 810
ACKNOWLEDGMENTS 812
REFERENCES 812
Alternatives to Serologic Testing for Diagnosis of Lyme Disease 815
Key points 815
CULTURE 816
ANTIGEN DETECTION 817
ASSAYS TO DETECT CELL-MEDIATED IMMUNITY 817
NUCLEIC ACID AMPLIFICATION TESTS 818
Erythema Migrans 819
Disseminated Infection 819
Acute Versus Chronic Infection 820
SUMMARY 820
SELF-ASSESSMENT 821
REFERENCES 822
Lyme Disease Coinfections in the United States 827
Key points 827
INTRODUCTION 827
Anaplasma phagocytophilum (Anaplasmosis) 828
Introduction 828
Epidemiology 828
Clinical presentation 829
Laboratory diagnosis 829
Treatment and prognosis 833
Coinfection with Lyme disease 833
Vectors and reservoir hosts 833
Humans 833
Babesia Species (Babesiosis) 833
Introduction 833
Epidemiology 834
Clinical presentation 834
Laboratory diagnosis 835
Treatment and prognosis 835
Coinfection with Lyme disease 836
Vectors and reservoir hosts 836
Humans 836
Deer Tick (Powassan) Virus 836
Introduction 836
Epidemiology 836
Clinical presentation 836
Laboratory diagnosis 837
Treatment and prognosis 837
Coinfection with Lyme disease 837
Vectors and reservoir hosts 837
Humans 837
Borrelia miyamotoi (Relapsing Fever Borreliosis) 837
Introduction 837
Epidemiology 838
Clinical presentation 838
Laboratory diagnosis 838
Treatment and prognosis 838
Coinfection with Lyme disease 838
Vectors and reservoir hosts 838
Humans 838
Ehrlichia muris–like Agent (Ehrlichiosis) 838
Introduction 838
Epidemiology 839
Clinical presentation 839
Laboratory diagnosis 839
Treatment and prognosis 839
Coinfection with Lyme disease 839
Vectors and reservoir hosts 839
Humans 840
SUMMARY 840
SELF-ASSESSMENT 840
REFERENCES 841
Relapsing Fever Borreliae 847
Key points 847
HISTORICAL BACKGROUND 847
CLASSIFICATION 848
MICROBIOLOGY 848
ECOLOGY AND TRANSMISSION 851
EPIDEMIOLOGY 853
PATHOGENESIS 854
CLINICAL FEATURES 855
TREATMENT AND PROGNOSIS 856
DIAGNOSTIC METHODS 857
Microscopy 857
Animal Inoculation 857
Cultivation 858
Serologic Detection 858
Molecular Detection 858
Proteomics 858
CONTROL AND INTERVENTION 859
CONCLUDING REMARKS 859
SELF-ASSESSMENT 860
REFERENCES 860
Borrelia miyamotoi Disease 867
Key points 867
INTRODUCTION 868
EPIDEMIOLOGY 870
TRANSMISSION 871
CLINICAL PRESENTATION 872
Case 1. Uncomplicated Borrelia miyamotoi Disease 873
Case 2. Human Anaplasmosis or Borrelia miyamotoi Disease? 873
Case 3. Recurrent Fever Presentation 874
DIAGNOSIS 875
TREATMENT 878
SELF-ASSESSMENT 878
REFERENCES 880
Methods to Prevent Tick Bites and Lyme Disease 883
Key points 883
INTRODUCTION 883
Avoiding Risk Areas 884
Preventing Bites and Pathogen Transmission 885
Use of topical repellents 886
Wear appropriate clothing 886
Clothing treatments 886
Tick checks 887
Effectiveness of personal protection 887
Reducing Environmental Risk 888
Use of pesticides to control ticks 888
Management of tick hosts including reservoirs 888
Vegetation or landscape management 889
Biological control 889
Effectiveness of tick control 890
Human vaccines against Lyme disease 890
Prophylactic Treatment for Those Bitten by Ticks 890
Recommendations 892
SELF-ASSESSMENT 892
ACKNOWLEDGMENTS 893
REFERENCES 893