TY - JOUR
T1 - Clinical and laboratory evidence of Lyme disease in North India, 2016–2019
AU - Vinayaraj, E. V.
AU - Gupta, Nitin
AU - Sreenath, K.
AU - Thakur, Chandan Kumar
AU - Gulati, Sheffali
AU - Anand, Vaishakh
AU - Tripathi, Manjari
AU - Bhatia, Rohit
AU - Vibha, Deepti
AU - Dash, Deepa
AU - Soneja, Manish
AU - Kumar, Uma
AU - Padma, M. V.
AU - Chaudhry, Rama
N1 - Publisher Copyright:
© 2021 Elsevier Ltd
PY - 2021/9/1
Y1 - 2021/9/1
N2 - Background: Lyme disease is endemic to parts of the Americas, Europe and Asia. However, only a handful of sporadic cases have been reported from India. In this study, we systematically evaluated the clinical and epidemiological features of Lyme disease in North India. Method: All samples were tested by using the standard two-tiered testing algorithm (STTA). Paired serum and cerebrospinal fluid (CSF) were used for demonstrating Borrelia burgdorferi specific intrathecal IgG antibody synthesis (AI). In addition, a commercial tick-borne bacterial flow chip (TBFC) system and a real-time PCR were also used to detect Borrelia species and Anaplasma phagocytophilum in patients who were positive by STTA. Results: The diagnosis of Lyme disease was confirmed in 18 (7.14%) of the 252 clinically suspected cases by STTA. Neurological involvement was reported in 14 (77.78%) patients, whereas joint and heart involvement was reported in five (27.78%) and three (16.67%) patients, respectively. Lymphocytic pleocytosis (median 37.5 cells/mm3; range 12–175 cells/mm3) in the CSF was seen in 11 of 14 Lyme neuroborreliosis (LNB) patients. Intrathecal production of Borrelia specific IgG antibodies was demonstrated in 9 (64.28%, n = 14) patients, a highly specific finding for neuroborreliosis. Two patients (11.11%) were also found to be co-infected with human granulocytic anaplasmosis. Conclusions: The results of this study show clinical and laboratory evidence of endemic Lyme disease in North India and thus, highlight the importance for travel medicine practitioners and physicians to evaluate for Lyme disease in patients with compatible symptoms and a history of travel to tick risk areas.
AB - Background: Lyme disease is endemic to parts of the Americas, Europe and Asia. However, only a handful of sporadic cases have been reported from India. In this study, we systematically evaluated the clinical and epidemiological features of Lyme disease in North India. Method: All samples were tested by using the standard two-tiered testing algorithm (STTA). Paired serum and cerebrospinal fluid (CSF) were used for demonstrating Borrelia burgdorferi specific intrathecal IgG antibody synthesis (AI). In addition, a commercial tick-borne bacterial flow chip (TBFC) system and a real-time PCR were also used to detect Borrelia species and Anaplasma phagocytophilum in patients who were positive by STTA. Results: The diagnosis of Lyme disease was confirmed in 18 (7.14%) of the 252 clinically suspected cases by STTA. Neurological involvement was reported in 14 (77.78%) patients, whereas joint and heart involvement was reported in five (27.78%) and three (16.67%) patients, respectively. Lymphocytic pleocytosis (median 37.5 cells/mm3; range 12–175 cells/mm3) in the CSF was seen in 11 of 14 Lyme neuroborreliosis (LNB) patients. Intrathecal production of Borrelia specific IgG antibodies was demonstrated in 9 (64.28%, n = 14) patients, a highly specific finding for neuroborreliosis. Two patients (11.11%) were also found to be co-infected with human granulocytic anaplasmosis. Conclusions: The results of this study show clinical and laboratory evidence of endemic Lyme disease in North India and thus, highlight the importance for travel medicine practitioners and physicians to evaluate for Lyme disease in patients with compatible symptoms and a history of travel to tick risk areas.
UR - https://www.scopus.com/pages/publications/85109160435
UR - https://www.scopus.com/inward/citedby.url?scp=85109160435&partnerID=8YFLogxK
U2 - 10.1016/j.tmaid.2021.102134
DO - 10.1016/j.tmaid.2021.102134
M3 - Article
C2 - 34216802
AN - SCOPUS:85109160435
SN - 1477-8939
VL - 43
JO - Travel Medicine and Infectious Disease
JF - Travel Medicine and Infectious Disease
M1 - 102134
ER -
