EPIDEMIOLOGICAL AND CLINICAL FEATURES OF LYME BORRELIOSIS AND ITS COMBINATION WITH EPSTEIN-BARR VIRUS INFECTION IN PATIENTS OF THE TERNOPIL REGION
DOI:
https://doi.org/10.11603/1811-2471.2023.v.i2.13905Keywords:
Lyme borreliosis, Epstein-Barr virus infection, epidemiology, clinic, diagnostics’ antibodies, ELISAAbstract
SUMMARY. The aim – to investigate the epidemiological features and clinical manifestations of Lyme borreliosis and its combination with Epstein-Barr virus infection in patients of the Ternopil region.
Material and methods. The study included 45 patients aged 23 to 74 years with Lyme borreliosis (LB) who were treated on an outpatient basis at the Ternopil Regional Clinical Skin and Venereological Dispensary during 2017–2022 including 23 (51.1 %) with Lyme borreliosis (group 1) and 22 (48.9 %) with Lyme borreliosis combined with Epstein-Barr virus (group 2). There were 7 men (15.6 %) and 38 women (84.4 %). Among the patients of both groups, urban residents prevailed over rural residents by number – 34 (75.6 %) vs. 11 (24.4 %) patients. Laboratory confirmation of LB was made by a serological diagnostic method (ELISA) by detecting specific IgM anti-B complex. burgdorferi s.l. complex antibodies in the patients’ blood sera (EUROIMMUN AG test systems, Germany): IgM antibodies were detected by the Anti-Borrelia burgdorferi ELISA (IgM) test system, IgG antibodies – by Anti-Borrelia plus VIsE ELISA (IgG). Serologic confirmation of Epstein-Barr virus infection was performed by detecting specific VCA IgG, VCA IgM and EVNA, which were determined by enzyme-linked immunosorbent assay (test systems from EUROIMMUN AG, Germany) in the blood serum of patients with LB. Anti-Epstein-Barr viral capsid antigen-IgM antibodies (VCA IgM) were detected by the test system Anti-EBV-CA ELISA (IgM), IgG antibodies to VCA IgG – by Anti-EBV-CA ELISA (IgG) and IgG antibodies to nuclear antigen 1 (EVNA) – by Anti-EBNA-1 ELISA (IgG). To study the epidemiological features of LB in patients of both groups a unified questionnaire that was developed by scientists of the Pope John Paul II State Higher School (Biala Podlaska, Poland) and adapted by the staff of the Department of Infectious Diseases with Epidemiology, Skin and Venereal Diseases for Ukrainian patients was used.
Results. It was found that patients in both groups were attacked by ticks from 5th to 10th months. More frequent bites of these arthropods were reported in patients with alone Lyme borreliosis in July, while patients with a combination of Lyme borreliosis and EBV infection were bitten a little bit later – in August. Patients of both groups most often reported tick attacks while staying in the villages, working in the summer cottage or in the garden – 20 (62.5 %) of 32 respondents, less often – in forests and woods – 9 (28.1 %) and even less often – in park areas – 3 (9.4 %) respondents.
Conclusions. Patients with LB alone more often reported more tick bites than patients with this disease combined with EBV infection – 30.4 vs. 13.6 %, respectively. At the same time, compared to patients with only LB, persons with the combined pathology of Lyme-borreliosis and EBV infection complained of eye damage and lymphadenopathy significantly more often – 22.7 vs. 8.7 % and 36.4 vs. 17.4 %, respectively, while among patients with only Lyme borreliosis had a higher proportion of those who were suffered by joint pain – 43.5 vs. 13.6 %, p<0.05.
References
Popovych, O.O. (2016). Laim-borelioz: suchasna problema infektolohii (klinichna lektsiia) [Lyme-borreliosis: a modern problem of infectology (clinical lecture)]. Aktualna infektolohiia – Actual Infectology, 3(12), 114-122 [in Ukrainian]. DOI: https://doi.org/10.22141/2312-413x.3.12.2016.81725
Stanek, G., Wormser, G.P., Gray, J., & Strle, F. (2012). Lyme borreliosis. Lancet (London, England), 379(9814), 461-473. DOI: 10.1016/S0140-6736(11)60103-7. DOI: https://doi.org/10.1016/S0140-6736(11)60103-7
Shkilna, M.I. (2016) Laim-borelioz u pratsivnykiv lisovykh hospodarstv Ternopilskoi oblasti [Lyme borreliosis in forestry workers of Ternopil region]. Infektsiini khvoroby – Infectious Diseases, 1(83), 36-40 [in Ukrainian].
Tokarska-Rodak, M., Shkilna, M., Plewik, D., Pańczuk, ., Korda, M., … Klishch, I. (2017). Serological research towards lyme borreliosis in hunters and forestry workers in selected areas of Poland and Ukraine. Health Problems of Civilization, 11(4), 287-292. DOI: 10.5114/hpc.2017.69024. DOI: https://doi.org/10.5114/hpc.2017.69024
Andreychyn, M., Pańczuk, A., Shkilna, M., Tokarska-Rodak, M., Korda, M., … Kozioł-Montewka, M. (2017). Epidemiological situation of Lyme borreliosis and diagnosis standards in Poland and Ukraine. Health Problems of Civilization, 11(3), 190-194. DOI: 10.5114/hpc.2017.69020. DOI: https://doi.org/10.5114/hpc.2017.69020
Pokrovska, T.V. (2014). Khronichna Epshteina –Barr virusna infektsiia – aktualni pytannia. [Chronic Epstein – Barr virus infection – current issues]. Infektsiini khvoroby – Infectious Diseases, 2, 70-74 [in Ukrainian].
Zavidniuk, N.H. (2015). Aktualni problemy diahnostyky Epshteina-Barr virusnoi infektsii. [Actual problems of diagnosis of Epstein-Barr virus infection]. Infektsiini khvoroby – Infectious Diseases, 4(82), 79-86 [in Ukrainian].
Duda, O.K., Kolesnyk, R.O., Okruzhnov, M.V., & Boiko, V.O. (2015). Klinichni formy khronichnoi Epshteina – Barr virusnoi infektsii: pytannia suchasnoi diahnostyky ta likuvannia [Clinical forms of chronic Epstein-Barr virus infection: issues of modern diagnosis and treatment]. Aktualna infektolohiia – Actual Infectology, 1(6), 15-20 [in Ukrainian].
Tumminello, R., Glaspey, L., Bhamidipati, A., Sheehan, P., & Patel, S. (2017). Early Disseminated Lyme Disease Masquerading as Mononucleosis: A Case Report. The Journal of Emergency Medicine, 53(6), e133-e135. DOI: 10.1016/j.jemermed.2017.09.005. DOI: https://doi.org/10.1016/j.jemermed.2017.09.005
