Małgorzata Tokarska-Rodak

Exposure to ticks and seroprevalence of Borrelia burgdorferi among a healthy young population living in the area of southern Podlasie, Poland

OBJECTIVES The objective of the study was assessment of risk of infection with Borrelia burgdorferi in the area of southern Podlasie in Poland, near the border with Belarus, by analysis of post-exposure procedure, and evaluation of asymptomatic infection in adolescents bitten by a tick, confirmed by serologic tests. MATERIAL AND METHODS The study was conducted among 128 healthy individuals aged 16-20 who declared being bitten by a tick. The level of IgM and IgG class antibodies was determined using the immunoenzymatic test (Borrelia 14 kD + OspC IgM ELISA and Borrelia IgG + VlsE ELISA, DRG Diagnostics). Positive and doubtful results were confirmed using the Western blot method (EUROLINE-WB, EUROIMMUN). RESULTS In the study group, the largest number of respondents (59.4%) declared tick bite in the region of the lower extremities, most often in the knee pit. Among the methods for removing the tick the largest number of respondents indicated removing it with the use of tweezers, with a simple, swift steady movement (29.7%), and pulling it out with the fingers (22.7%). In the ELISA test, a positive or doubtful result in at least one class was observed in 25.0% of respondents (n=32/128): in IgM class - 23.4% (n=30/128), and in IgG class - 4.7% (n=6/128). After verification with the Western blot test, infection was confirmed in 5.5% of respondents (n=7/128): in IgM class - 1.6% (n=2/128), in IgG class - 3.9% (n=5/128). In IgM class antibodies, the Western blot test confirmed positive or doubtful results of the ELISA test in 6.7%, while in IgG class antibodies in 83.3%. CONCLUSION Evaluation of the actual infection with Borrelia spp. using serologic tests is difficult due to a certain non-specificity of the ELISA test, especially in IgM class antibodies, and difficulties with performance of a wide scope of specific Western blot tests. The variety of methods of tick removal declared by adolescents suggests that a wider education of society concerning appropriate methods of removing the tick should become an especially important element of prophylactic actions in the area of borreliosis.

Preliminary study on the detection of hepatitis E virus (HEV) antibodies in pigs and wild boars in Poland

Abstract Introduction: Although HEV infection in pigs does not pose a major economic risk to pork production, the risk of zoonotic transmission to humans is an important aspect of public health. HEV genotype 3 infections were reported in developed countries in individuals who had consumed raw meat or meat products from deer, wild boars, or pigs. The aim of the study was the analysis of the occurrence of HEV-specific antibodies among wild boars and domestic pigs in Poland. Material and Methods: A total of 290 samples from wild boars and 143 samples from pigs were tested. The antibodies were tested by ELISA. Results: The presence of anti-HEV IgG was demonstrated in 44.1% of pigs and 31.0% of wild boars. Anti-HEV IgG antibodies were detected in 1.4% of samples from pigs and in 2.1% of samples from wild boars at borderline level. The statistical analysis shows significant differences in the positive results for anti-HEV IgG between the groups of pigs and wild boars (P = 0.0263). Conclusion: Regular surveillance of the occurrence of HEV in swine and wild boars should be performed in the future.

THE KNOWLEDGE ON LYME BORRELIOSIS AND OTHER TICK-BORNE DISEASES AMONG NURSING STUDENTS FROM POLAND AND SLOVAKIA

Tick-borne diseases are infectious diseases transmitted by the bites of infected ticks. The most common vector-borne disease in Europe is Lyme borreliosis (LB). The number of the reported cases of LB has been steadily increasing. For this reason, it is important to undertake educational activities in the field of tick-borne diseases. The aim of the study was to investigate the level and scope of knowledge on tick-borne diseases among nursing students from Poland and Slovakia. The study sample consisted of 428 nursing students (192 students of the State School of Higher Education in Biała Podlaska, Poland and 236 students of the University in Presov, Slovakia). The knowledge of the surveyed students on tick-borne diseases is limited. Polish students demonstrated greater knowledge about LB, while students from Slovakia showed greater awareness of the threat posed by tick-borne encephalitis. Particularly worrying is the lack of knowledge on proper way of removal of a tick attached to the skin. Students recognize the need to broaden their knowledge on tick-borne diseases, which should be taken into consideration in realized studies curricula.

Seroprevalence of Rubella and Cytomegalia in Young Women from Biała Podlaska District

The aim of this study was to analyze the seroprevalence of rubella and cytomegalia among young women. The study included 175 healthy women from the Biała Podlaska District, aged 16 to 35 years. Anti-rubella and anti-CMV IgG were determined by ELISA. 172 (98.3%) study subjects tested positive for rubella antibodies, 1 (0.6%) was seroindeterminate and 2 (1.1%) were seronegative. CMV antibodies were detected in 119 (68.0%) participants; the series included also 1 (0.6%) seroindeterminate and 55 (31.4%) seronegative women. The levels of rubella and CMV antibodies were not significantly affected by age, place of residence and educational level of the study subjects.

The Serological Surveillance of Hepatitis E virus among Hunters and Foresters in Eastern Poland

The aim of the study was the analysis of the occurrence of specific antibodies against HEV among hunters and foresters who are at risk to be exposed. The study group consisted of 210 hunters (23-80 years old) and 60 foresters (22-64 years old). Anti-HEV IgG were present in 3.81% of the samples of the hunters and in 5% of the samples of the foresters. The statistical analysis shows no significant differences in the results anti-HEV IgG between the groups of hunters and foresters (p = 0.5278). Significantly higher anti-HEV IgG titers were found in the older age group (> 55 years old).

KNOWLEDGE IN THE PREVENTION OF LYME BORRELIOSIS AND EXPOSURE TO TICKS IN WOMEN AND MEN STUDYING NON-MEDICAL COURSES IN LATVIA

Authors’ contribution Wkład autorów: A. Study design/planning zaplanowanie badań B. Data collection/entry zebranie danych C. Data analysis/statistics dane – analiza i statystyki D. Data interpretation interpretacja danych E. Preparation of manuscript przygotowanie artykułu F. Literature analysis/search wyszukiwanie i analiza literatury G. Funds collection zebranie funduszy Summary Background. The aim of the following study was to assess the level of knowledge in the prevention of Lyme borreliosis and exposure to ticks in non-medical students, broken down by gender. Material and methods. The study group comprised 274 students from Latvia, including 229 women and 45 men aged 18-35. As for the research tool, the authors’ own questionnaire survey was used. Results. Latvian male students are more likely to use repellents and more often examine their bodies on return from green areas (86.6% and 97.8% respectively) than women (66.3% and 93.9%, respectively). The biggest group of the respondents (35.6% of the men and 41.1% of the women) considered that twisting the tick out with tweezers was the correct method of removing ticks. Slightly fewer respondents, i.e. 26.6% of the men and 36.2% of the women, opted for tweezing it out with a swift steady movement. In practice, most people do not do this on their own − 28.9% of the men turn to a doctor / nurse for help and 32.3% of the women to some other person. Students critically assess their knowledge regarding Lyme borreliosis: 60% of the men evaluate it as minimal and 53.1% of the women as average. More than 86% of the men and 73.4% of the women in the study group reported being bitten by a tick. Conclusions: The results of the study reflect the attitudes of Latvian academic youth towards Lyme borreliosis as well as knowledge about the disease and its prevention, which allows for assessing the need for intensifying public education in the subject.

AWARENESS OF TICK-BORNE BACTERIAL INFECTION IN THE STUDENTS OF NON-MEDICAL UNIVERSITIES IN TERNOPIL REGION (WESTERN UKRAINE)

1I. Horbachevsky Ternopil State Medical University, Ukraine 2Institute of Physical Education and Physiotherapy, Pope John Paul II State School of Higher Education in Biala Podlaska, Poland 3Institute of Health Sciences, Pope John Paul II State School of Higher Education in Biala Podlaska, Poland 4Innovation Research Centre, Pope John Paul II State School of Higher Education in Biala Podlaska, Poland

[Monoinfections caused by Borrelia burgdorferi and Borrelia burgdorferi / Anaplasma phagocytophilum co-infections in forestry workers and farmers].

BACKGROUND The presence of co-infections induced by tick-borne pathogens in humans is an important epidemiological phenomenon. This issue has attracted growing attention of doctors and people working under conditions of an increased risk of being exposed to tick bites. MATERIAL AND METHODS The research group consisted of 93 individuals with current anti-immunoglobulin M/G (IgM/ IgG) Borrelia burgdorferi or IgG anti-Anaplasma phagocytophilum. The respondents were identified during the screening survey in a group of farmers and foresters occupationally exposed to tick bites. The aim of the work was to analyse the frequency of antibodies to specific antigens of B. burgdorferi and the levels of cytokines in forestry workers and farmers with B. burgdorferi monoinfections and B. burgdorferi / A. phagocytophilum co-infections. Statistical analysis was performed using the Chi2, Mann-Whitney U and Kruskal-Wallis tests. RESULTS There is a stronger generation of IgG antibodies to B. burgdorferi antigens in patients with B. burgdorferi / A. phagocytophilum co-infections, such as variable major protein-like sequence expressed (VlsE) (p < 0.05), p19 (p < 0.02), p17 (p < 0.05) and complement regulator-acquiring surface protein 3 (CRASP3) (p < 0.02) compared to persons with B. burgdorferi monoinfections. The discrepancies in the synthesis of cytokines interleukin 6 (IL-6), IL-10, and tumor necrosis factor α (TNF-α) have not been found in persons with B. burgdorferi monoinfections and B. burgdorferi / A. phagocytophilum co-infection. CONCLUSIONS The immune response directed against B. burgdorferi is stronger in patients co-infected with B. burgdorferi and A. phagocytophilum than in those with monoinfection.

The Serology Diagnostic Schemes in Borrelia burgdorferi Sensu Lato Infections – Significance in Clinical Practice

Lyme borreliosis is a world-wide multi-organic disease caused by spirochete Borrelia burgdorferi sensu lato. Numerous gene-species Borrelia are identified with a various frequency in Europe, Asia and America (Ruderko, et al., 2009; Siegel, et al., 2008; Stanek G, 2011; Wilske, et al., 2007 Wodecka, 2006a). Within the last few years, as well as in Europe as in North America, there were prepared strategies, directives and guidelines for diagnostics and treatment of Lyme disease, including the frequency of occurrence of specific genespecies and a specification of clinical symptoms (Center for Disease Control and Prevention [CDC], 2011; European Concerted Action on Lyme Borreliosis [EUCALB], 2008). Lyme disease seems to be easy to diagnose and treat due to the pathogenic factor known for a long-time and elaborated diagnostic and therapeutic schemas. In serological diagnostics an impediment constitutes a wide range of genospecies B. burgdorferi, changes of expression of particular genes occurring in various stages of an infection, and cross reactions which occur in the presence of other pathogenic microorganisms and disease entities connected with an immune response disorders. It is connected with the necessary use of appropriately configured diagnostic tests and recombinant proteins common for particular genospecies and related to the immunological response at different stages of the infection (EUCALB, 2008; Zajkowska, et al., 2006a,2006b). As well as a diagnostician as a doctor has to consider not only the results of the serological tests but also numerous, coexisting, frequently unspecified factors in order to make an accurate diagnose confirming or excluding B. burgdorferi infection. In many cases, even early and accurate diagnosis and antibiotic therapy appropriately applied does not guarantee the effective eradication of a pathogen, and what is important for a patient a complete elimination of symptoms of the disease. Posttreatment Lyme disease Syndrome (PTLDS) has been confirmed in some patients – it is a complex of lingering, unspecified clinical symptoms which impede a complete physical and mental recovery in patients after being treated from Lyme disease. This is a crucial problem as well as in health as in social life which is frequently ignored. The symptoms concerning Lyme arthritis and neuroborreliosis are frequently the cause of an immense disability in patients in numerous life activities and it is required to undertake a rehabilitation program (Tokarska-Rodak et al., 2007).