CLINICAL AND IMMUNOLOGICAL MANIFESTATIONS OF COMBINED BORELIOSIS IN FORESTRY WORKERS OF TERNOPIL REGION
Keywords:Lyme borreliosis, tick-bites relapsing fever, foresters, IgE, sorption capacity of erythrocytes
Introduction. The study of clinical and immunological manifestations of combined borreliosis remains an urgent problem of modern infectology.
The aim of the study – to a the clinical and immunological manifestations of combined borreliosis in forestry workers of Ternopil region.
Research Methods. A clinical and laboratory examination of 106 foresters was conducted; aged 20–65; men – 95.3 %, women – 4.7 %. The control group consisted of 25 blood donors, which by age and sex corresponded to the distribution of the examined persons,without ticks bites in anamnesis. The presence of specific IgM and IgG to Lyme borreliosis pathogens was determined in the blood sera of foresters using a two-stage diagnostic method (ELISA and immune blotting) using test systems by Euroimmun AG assay (Germany). The obtained results were interpreted according to the manufacturer's recommendations. Specific antibodies of IgM and IgG to B. miyamotoi (one of the causative agents of tick-borne relapsing fever) were determined in the laboratory IGeneX Inc. (Milpitas, CA, USA) by immune blotting. The concentration of immunoglobulins A, M, G and E were determined by ELISA using ELISA-Best kits. The level of endogenous intoxication was assessed by the sorption capacity of erythrocytes (SCE), which was determined by A. A. Togaybayev method (1981).
Results and Discussion. Among foresters of Ternopil region, according to two stage diagnostic methods (ELISA and immune blotting), a percentage of seropositive individuals for B. burgdorferi s. l. – 49.1 %, to B. burgdorferi s. l. and B. miyamotoi simultaneously – 25.5 %. Fever, headache, fatigue/general weakness, myalgias, lymphadenopathy, itchy skin, including far from the place of the tick bite significantly were more common in patients with combined borreliosis caused by B. burgdorferi s. l. and B. miyamotoi, unlike Lyme borreliosis caused only by B. burgdorferi s. l. (p<0.05). Foresters with combined borreliosis had significantly higher rates of IgE serum levels and sorption capacity of erythrocytes than persons with LB, caused only by B. burgdorferi s. l.
Conclusion. Patients with LB, who have a prolonged fever, severe itching of the skin far from places of tick bites, it is advisable to examine for the presence of possible infection of B. miyamotoi.
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