Search Results (422)

Borrelia burgdorferi sensu lato is a complex of spirochetes that includes the main pathogenic species B. burgdorferi sensu stricto, B. afzelii, and B. garinii, the causative agents of Lyme disease. Our aim was to determine the seroprevalence of anti-Borrelia IgG antibodies and assess associated risk factors among blood donors from Western Romania. We conducted a cross-sectional study of 1347 consecutive donors at the Regional Blood Transfusion Center in Timisoara, Western Romania, between November and December 2018. Participants completed an epidemiological questionnaire and serum samples were tested for IgG antibodies against B. burgdorferi sensu lato using the VIDAS^® Lyme IgG assay. The overall seroprevalence was 2.08% (28/1347). Individuals aged 46–55 years had the highest prevalence (3.79%) and a more than fivefold increased risk compared to those aged 18–25 years (aOR = 4.77; 95% CI: 1.24–18.27; p = 0.023). Soil exposure was also independently associated with higher seropositivity (aOR = 2.37; 95% CI: 1.10–5.09; p = 0.027). Other factors, including residence, gender, and pet ownership, showed no significant associations. Our findings provide new epidemiological data for Romania and emphasize the importance of environmental exposures in shaping Borrelia seroprevalence. Full article

Lyme neuroborreliosis (LNB) may mimic other neurological diseases, while neurological diseases may be misdiagnosed as LNB. The aims of the study were to contribute to the knowledge regarding the epidemiology and clinical manifestations of LNB, discuss differential diagnosis, and compare characteristics in patients with and without LNB. We present patients evaluated for suspected LNB by the multidisciplinary team of a “Lyme Borreliosis Centre” in a highly endemic area in Romania. A retrospective study was performed between January 2011 and October 2023 on patients referred for suspected LNB based on neurological manifestations and positive serology for Borrelia burgdorferi antibodies using two-tier testing. A lumbar puncture was performed for diagnosis, and the European LNB definition was used for classification. Of three hundred and three LNB suspected patients, five (1.65%) were classified as definite LNB, eighty-three (27.39%) as possible LNB, and in two hundred and fifteen patients (70.95%), LNB was excluded. Comparing the definite/possible to excluded LNB patients, there was no significant difference in neurological symptoms/manifestations. The patients presented fifty-one neurological, twelve rheumatological, and seven psychiatric diagnoses, with significantly more meningitis/encephalitis/myelitis diagnoses in the definite/possible LNB group, and more demyelinating disease and discopathy in the LNB-excluded group. Considering the complex differential diagnoses, access to laboratory diagnostics and multidisciplinary management should be available in centres that evaluate suspected LNB patients. Comparing results with data from the national surveillance system, we conclude that LNB is underdiagnosed/underreported in Romania. Full article

Background: Parasitic skin-related conditions represent a frequent and evolving challenge in human dermatology, as they often mimic other dermatoses, and are increasingly complicated by therapeutic resistance. With this study, we aimed to provide a practical, clinician-oriented overview of our experience, contextualising it within the current literature. Materials and Methods: We conducted a retrospective, single-centre observational study, reporting a case series of 88 patients diagnosed with parasitic or arthropod-related skin infestations at the San Raffaele Hospital Dermatology Unit (Milan) between 2019 and 2024, and integrated a concise narrative review of contemporary evidence on diagnosis, non-invasive imaging and management. For each case, we documented clinical presentation, dermoscopic or reflectance confocal microscopy (RCM) findings, and treatment response. Non-invasive tools (dermoscopy, videodermoscopy, RCM) were used when appropriate. Results: The spectrum of conditions included flea bites, bed bug bites, cutaneous larva migrans, subcutaneous dirofilariasis, Dermanyssus gallinae dermatitis, pediculosis, tick bites (including Lyme disease), myiasis, scabies, and cutaneous leishmaniasis. One case of eosinophilic dermatosis of haematologic malignancy was also considered due to its possible association with arthropod bites. Non-invasive imaging was critical in confirming suspected infestations, particularly in ambiguous cases or when invasive testing was not feasible. Several cases highlighted suspected therapeutic resistance: a paediatric pediculosis and three adult scabies cases required systemic therapy after standard regimens failed, raising concerns over putative resistance to permethrin and pyrethroids. In dirofilariasis, the persistence of filarial elements visualised by RCM justified the extension of antiparasitic therapy despite prior surgical removal. Conclusions: Our findings underline that accurate diagnosis, early intervention, and tailored treatment remain essential for the effective management of cutaneous infestations. The observed vast spectrum of isolated parasites reflects broader health and ecological dynamics, including zoonotic transmission, international mobility, and changing environmental conditions. At the same time, diagnostic delays, inappropriate treatments, and neglected parasitic diseases continue to pose significant risks. To address these challenges, clinicians should remain alert to atypical presentations, and consider a multidisciplinary approach including the consultation with parasitologists and veterinarians, as well as the incorporation of high-resolution imaging and alternative therapeutic strategies into their routine practice. Full article

Background: We report an uncommon presentation of Lyme disease and highlight the importance of a detailed history in a patient with new-onset sixth nerve palsy. Methods: Case report and literature review. Results: A 46-year-old man receiving infliximab presented to the ophthalmology emergency department with horizontal binocular diplopia. History revealed a diffuse headache that had begun three weeks earlier. Ophthalmologic examination demonstrated a left sixth cranial nerve palsy. The workup showed positive Borrelia serum IgG, which was interpreted as a likely false-positive result given the limited specificity of serologic testing. At follow-up, the patient reported left-sided peripheral facial palsy, and worsening headache and diplopia. Further history revealed prior erythema migrans treated with doxycycline four months earlier. Considering these new findings, a lumbar puncture was performed and demonstrated intrathecal production of Borrelia antibodies. Neuroborreliosis, a neurologic involvement secondary to systemic infection by the spirochete Borrelia burgdorferi, was diagnosed. The patient was treated with oral doxycycline for 28 days with complete resolution of symptoms. Conclusions: Lyme disease may present with progressive neuro-ophthalmologic symptoms, underscoring the crucial role of ophthalmologists in its diagnosis. Moreover, immunosuppression may delay diagnosis and allow neurological progression, highlighting the need for careful history taking and close follow-up. Full article

Hard ticks are important vectors for several human and zoonotic pathogens, transmitting diseases such as Crimean–Congo hemorrhagic fever, Lyme disease, Kyasanur forest disease, Powassan virus disease, Tick-borne encephalitis, Rickettsiosis, and Anaplasmosis. Morphological identification of ticks relies on taxonomic keys but is often challenging due to damaged, engorged, or immature specimens and requires expertise. Molecular taxonomy can be a supplement to species identification and usually requires nucleotide sequencing of the genetic markers. PCR-RFLP is an important tool for tick identification and can be supplemented to the classical taxonomy. The current study focused on the morphological identification of important hard tick vectors from India, their phylogenetic positioning, and developing a PCR-RFLP based diagnostic tool for easy identification of hard tick vectors. The primer sets were designed to amplify the ITS-2 region from important tick vectors causing human and zoonotic diseases in India. These ticks were morphologically identified with taxonomical keys, and the extracted genomic DNA were used for ITS-2 based PCR amplification. The nucleotide sequences from each vector were used for their phylogenetic positioning. We obtained variable sizes of ITS-2 amplicons from each species and utilized the sequence for RFLP assays design. We have successfully shown PCR-RFLP based assays with two different restriction enzymes (Hae III & Rsa I) with specific restriction sites on the amplified regions. The PCR-RFLP tool showed different DNA fragment patterns on the agarose gel, specific for each hard tick vector. This study presents the phylogenetic positioning of Indian tick vectors and demonstrates the development and applicability of a molecular tool for their identification. Full article

Vector-borne infections are a growing public health concern in Romania, influenced by ecological diversity, climate change, and socioeconomic factors. West Nile virus, tick-borne encephalitis, and Lyme borreliosis represent the most significant threats, with additional risks posed by emerging pathogens, such as leishmaniasis, and the potential reintroduction of malaria. While surveillance systems exist for human cases and, to a lesser extent, vectors, these remain fragmented, underfunded, and limited in their integration across human, veterinary, and environmental health domains. By highlighting both gaps and opportunities, this review provides a forward-looking perspective on strengthening Romania’s capacity to anticipate and manage vector-borne disease threats. Transitioning from reactive surveillance to proactive, prediction-driven strategies will be critical to safeguarding public health in the context of accelerating environmental change. Full article

Background: COVID-19 has taken millions of lives and continues to affect people worldwide. Post-Acute Sequelae of SARS-CoV-2 Infection (also known as Post-Acute Sequelae of COVID-19 (PASC) or more commonly, Long COVID) occurs in the aftermath of COVID-19 and is poorly understood despite its widespread effects. Methods: We created a machine-learning model that distinguishes PASC from PASC-similar diseases. The model was trained to recognize PASC-dysregulated metabolites (p ≤ 0.05) using molecular descriptors. Results: Our multi-layer perceptron model accurately recognizes PASC-dysregulated metabolites in the independent testing set, with an AUC-ROC of 0.8991, and differentiates PASC from myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), Lyme disease, postural orthostatic tachycardia syndrome (POTS), and irritable bowel syndrome (IBS). However, it was unable to differentiate fibromyalgia (FM) from PASC. Conclusions: By creating and testing models pairwise on each of these diseases, we elucidated the unique strength of the similarity between FM and PASC relative to other PASC-similar diseases. Our approach is unique to PASC diagnosis, and our use of molecular descriptors enables our model to work with any metabolite where molecular descriptors can be identified, as these descriptors can be generated and compared for any metabolite. Our study presents a novel approach to PASC diagnosis that partially circumvents the lengthy process of exclusion, potentially facilitating faster interventions and improved patient outcomes. Full article

Tick bites acquired in the northern or southern hemisphere can transmit microbes that may cause illness. The most prevalent infection is Lyme borreliosis (LB), with all proven cases to date having been acquired in the northern hemisphere. The existence of endemic LB in Australia has not been proven explicitly, and there is uncertainty concerning the cause of “Lyme-like” disease (LLD) in Australia. As many tick-borne diseases (TBDs) are diagnosed by serology, validated assays for use in both the northern and southern hemispheres are required. Using a multiplex enzyme-linked immunosorbent assay (TICKPLEX^®), two independent laboratories tested a total of 53 well-characterized reference sera that consisted of 33 samples from northern hemisphere patients with confirmed tick-borne disease (TBD) and 20 randomly selected sera from Australian patients with suspected TBDs, presenting with or without LLD. Antibody responses to multiple microbial antigens from causative agents of TBDs were found. High concordance between laboratories was demonstrated on this small set of samples. The results obtained provide the basis for further evaluation of TICKPLEX^® on a larger number of samples from Australian patients with suspected TBDs. These findings should be considered preliminary, providing proof-of-concept evidence that warrants validation in larger, clinically diverse cohorts. Full article

The tick species Ixodes ricinus is the most widely distributed throughout Europe and serves as the primary vector for the spirochete Borrelia burgdorferi sensu lato (s.l.), which is responsible for Lyme borreliosis. The present study evaluated the prevalence of B. burgdorferi (s.l.) in I. ricinus ticks using nPCR amplification. Ticks were collected from three geographical regions in Bulgaria: the Black Sea Coast in the east, the Pleven region in the north, and the Stara Zagora region in the central south. This study focused on urban and peri-urban areas, including heavily traveled trails in parks. The results indicated statistically significant differences in infection rates, with the highest percentage of infected ticks found in Pleven (52.34%), followed by Stara Zagora (35.46%) and the lowest on the Black Sea Coast (23.08%). Furthermore, we conducted genospecies molecular identification of B. afzelii and B. garinii by PCR amplification of genospecies-specific nucleotide sequences in the 16S rRNA gene. The lowest prevalence of B. afzelii was recorded in Stara Zagora at 10.64%, followed by the Black Sea region at 12.5%, while the statistically highest frequency was observed in Pleven at 21.03%. The prevalence of B. garinii among the total number of I. ricinus ticks was greatest in Pleven at 15.89%, followed by the Black Sea region at 8.65%, and the lowest in the Stara Zagora region at 4.96%. Statistically significant differences were found only between Pleven and Stara Zagora (p = 0.002), but no significant differences in infection rates were observed between adults and nymphs in the regions examined. Overall, the prevalence of B. afzelii in each region exceeds that of B. garinii, and when considered collectively for Bulgaria, the frequency of B. afzelii (15.9%) is higher than that of B. garinii (10.89%) in infected ticks. In a controlled epidemiological context, managing the population of I. ricinus infected with B. burgdorferi s.l. can mitigate the health burden of Lyme disease, although this preventive strategy may not guarantee complete protection. Full article

In this article, mathematical modeling and stability analysis of Lyme disease and its transmission dynamics using Caputo fractional-order derivatives is presented. The compartmental model has been formulated to analyze the spread of Borrelia burgdorferi virus through tick vectors and mammalian hosts. The feasible region is established, and the boundedness of the model is verified. Analytically, the disease-free equilibrium and the basic reproduction number $\left({\Re }_0\right)$ has been determined to assess outbreak potential. By virtue of the fixed-point theory, the existence and uniqueness of solutions has been established. The numerical simulations are obtained via the Runge–Kutta 4 method, demonstrating the model’s ability to capture realistic disease progression. Finally, sensitivity analysis and control strategies (tick population reduction, host vaccination, public awareness, and early treatment) are evaluated, revealing that integrated control measures significantly reduce infection rates and enhance recovery. Full article

Background and Objectives: MGN-3/Biobran (BRM4, Lentin Plus or Ribraxx) is a natural, rice bran-derived arabinoxylan immunoceutical that modulates the adaptive immune response to viral infections. In response to bacterial infections, basophils act as “first responders” and are also associated with modulation of the adaptive immune response. The maturation of pluripotent CD34⁺ stem cells into basophils is supported by the cytokine interleukin-3 (IL-3). The aim was to test the hypothesis that modulation of the adaptive immune response in bacterial infection by MGN-3/Biobran entails a basophilic response. The tick-related disorder Lyme borreliosis was chosen as the disease model; tick bites are associated with cutaneous IL-3-mediated basophil recruitment. Materials and Methods: A three-month randomised double-blind placebo-controlled trial was conducted in patients with a history of borreliosis who were suffering from symptoms attributable to this disorder. The immunoceutical group received oral Biobran; the dosage for both groups was 1 g thrice daily. Both groups were matched for age, sex, and ethnicity. Results: A higher percentage of basophil count occurred in the immunoceutical group (p = 0.038). The final general linear model included the group (immunoceutical/placebo) and change in fatigue assessed by the 11-item Chalder Fatigue Questionnaire (CFQ) (r² = 0.63; p = 0.0066). The change in basophil count was positively correlated with CFQ change (r_s = 0.633; p = 0.020); only the immunoceutical group showed a positive correlation. Conclusions: These results support the hypothesis being tested. Basophils may modulate the adaptive immune response by acting as immunoregulatory cells. They can regulate the functioning of type 2 T-helper lymphocytes, enhance immunological memory, and present antigens to CD8 T lymphocytes. Further studies are needed to clarify potential mechanistic factors and the timing of this basophilic response. Full article

Monitoring the occurrence of Borreliaceae spirochetes in ticks may provide an indication of the risks of acquiring Lyme borreliosis (LB) and Borrelia miyamotoi disease (BMD). All ticks obtained in our study from humans in the years 2018–2022 (n = 1232) were identified morphologically for species, sex and developmental stage. The detection of Borreliaceae spirochetes and species identification were performed by nested PCR based on the flaB gene fragment and the region between the mag and trnI genes. Two species of ticks were identified: Ixodes ricinus (96.9%) and Dermacentor reticulatus (3.1%). The infection of I. ricinus ticks with Borreliaceae spirochetes was found to reach 18.3%, including B. miyamotoi (2.5%). Among Borreliella species, Bl. afzelii was the most frequent, followed by Bl. burgdorferi, Bl. spielmanii, Bl. valaisiana, Bl. garinii, Bl. bissettiae, Bl. californiensis and Bl. carolinensis. Borreliaceae spirochetes were also found in D. reticulatus ticks, of which Bl. afzelii and B. miyamotoi were the most common. In conclusion, ticks affecting humans in Poland represent a real risk of infection with Borreliaceae spirochetes, and knowledge of the prevalence and distribution of these bacteria is an important tool in assessing the risks of LB and BMD. Full article

Lyme disease, caused by the Borrelia burgdorferi bacterium and transmitted through black-legged (deer) tick bites, is becoming increasingly prevalent globally. According to data from the Lyme Disease Association, the number of cases has surged by more than 357% over the past 15 years. According to the Infectious Disease Society of America, traditional diagnostic methods are often slow, potentially allowing bacterial proliferation and complicating early management. This study proposes a novel hybrid deep learning framework to classify Lyme disease rashes, addressing the global prevalence of the disease caused by the Borrelia burgdorferi bacterium, which is transmitted through black-legged (deer) tick bites. This study presents a novel hybrid deep learning framework for classifying Lyme disease rashes, utilizing pre-trained models (ResNet50 V2, VGG19, DenseNet201) for initial classification. By combining VGG19 and DenseNet201 architectures, we developed a hybrid model, SkinVisualNet, which achieved an impressive accuracy of 98.83%, precision of 98.45%, recall of 99.09%, and an F1 score of 98.76%. To ensure the robustness and generalizability of the model, 5-fold cross-validation (CV) was performed, generating an average validation accuracy between 98.20% and 98.92%. Incorporating image preprocessing techniques such as gamma correction, contrast stretching and data augmentation led to a 10–13% improvement in model accuracy, significantly enhancing its ability to generalize across various conditions and improving overall performance. To improve model interpretability, we applied Explainable AI methods like LIME, Grad-CAM, CAM++, Score CAM and Smooth Grad to visualize the rash image regions most influential in classification. These techniques enhance both diagnostic transparency and model reliability, helping clinicians better understand the diagnostic decisions. The proposed framework demonstrates a significant advancement in automated Lyme disease detection, providing a robust and explainable AI-based diagnostic tool that can aid clinicians in improving patient outcomes. Full article

The high incidence of tick-borne diseases (particularly Lyme disease) and the challenges associated with their serious health consequences motivated us to undertake research aimed at developing robust protection against ticks. There is still no effective method for preventing or treating Lyme disease, and humans who spend time outdoors—whether for occupational or recreational purposes—remain unprotected. This paper presents an innovative design of anti-tick textile bands intended for standalone use or integration into protective trousers. The bands are designed to receive repellent-sprayed inserts and provide a barrier layer separating the chemical from the user. In the research, the protective performance of the bands was evaluated using a novel test stand specially constructed for tick repellency testing. Experiments involving live ticks demonstrated the highest effectiveness for bands incorporating an insert impregnated with 20% DEET. Two limitations were noted: peak protection was achieved approx. 15 min after DEET application, and repellent reapplication was required after three hours to maintain protection. These findings are directly relevant to protective equipment design, offering a practical solution for high-risk groups such as forestry workers. By providing an experimentally validated strategy for tick bite prevention, this work addresses an urgent need in occupational and public health. Full article

The spirochete Borrelia is responsible for Lyme disease, a multisystemic infection and growing public health concern. This study aimed to evaluate host response dynamics to Borrelia bavariensis by analyzing hematological parameters as potential immuno-inflammatory markers in a murine model. Forty C3He/HeNCrl mice were inoculated intradermally with B. bavariensis (5 × 10⁵ spirochetes/100 µL/mouse) and monitored for 90 days. Samples were collected at defined intervals for microbiological examination, hematology, and qPCR. Microbiological and qPCR testing revealed infection between days 7–21; results were negative on days 28–42. At later stages (days 60 and 90), Borrelia was only detectable by qPCR, highlighting differences in diagnostic sensitivity. Hematological analysis showed that the neutrophil-to-lymphocyte ratio (NLR) and systemic immuno-inflammatory index (SII) peaked on day 7 (p < 0.0001), followed by gradual normalization until day 35. These markers reflected the intensity of the inflammatory response and defined three distinct phases of host reaction. Overall, results demonstrate the complexity of immune responses in B. bavariensis infection and underscore the value of monitoring hematological indices for understanding host–pathogen interactions. This approach supports the potential use of simple blood markers in diagnostic strategies with translational relevance for clinical practice. Full article