Borrelia burgdorferi in ticks and dogs in the province of Vojvodina, Serbia

Lyme disease is a tick borne zoonotic infection, caused by Borrelia burgdorferi s.l. bacteria. For the transmission of the disease, the presence of ticks is a prerequisite. Lyme borreliosis mostly occurs in people and dogs, but it may occur in other animals. Ticks which carry B. burgdorferi s.l. in Serbia are of the Ixodes ricinus specis. In Serbia, Lyme disease was detected for the first time in the late '80-es. In dogs, clinical symptoms may occur even months after a tick bite, and include weakness, lymphadenopathy, fever, lameness, arthritis, etc. In our survey, we have observed tick and dog populations in the province of Vojvodina (northern part of Serbia). I. ricinus ticks were collected and examined for the presence of B. burgdorferi s.l. in several chosen locations. In addition, blood samples were collected from house dogs and pets from the same locations, and analyzed for the presence of antibodies specific for B. burgdorferi s.l. The results showed a mean infection of ticks of 22.12%, and a mean seroprevalence of Lyme disease in dogs of 25.81%. We conclude that in Vojvodina there is an actual risk of Lyme borreliosis for other animals and humans, because of the persistence of B. burgdorferi s.l. in both tick and dog populations.

Semi-quantitative adsorption for detection of antibodies to Candida albicans germ tubes by indirect immunofluorescence test

Adsorption of antibodies against antigens expressed on the Candida albicans blastoconidia cell walls was standardized for the detection of antibodies to germ tubes by an indirect immunofluorescence test (IIFT). Sera from rabbits immunized with C. albicans bearing germ tubes, were diluted by two-fold serial dilutions to obtain specimens 1 : 640-1 : 20 positive by IIFT. Different volumes of specimens were adsorbed with different amounts of whole, heat-inactivated C. albicans blastoconidia. It was found that a 1 : 640 titre serum should be adsorbed at 30 microl by 50 mg cells, down to a 1 : 20 titre serum at 110 microl by 12.5 mg cells. Accurate detection of anti-germ tube antibodies by IIFT depends on the semi-quantitative relation between the positive titre of the specimen and the amount of blastoconidia used in adsorption.

[Tonsillo-pharyngeal form of tularemia]

Clinical, laboratory and serologic features of tonsillopharyngeal form of tularemia in 14 patients were analyzed in the study. The disease was ignored under the diagnosis of typical tonsillopharyngitis followed by cervical lymphadenopathy. Routine laboratory analyses results were non-specific and didn't reveal the disease etiology, while microagglutination test (MAT) of F. tularensis in the second week of disease was positive in 86% of patients. Skin tularin test was positive in all the tested patients during the first week of the disease. The best results in the treatment were achieved by administration of streptomycin and doxycycline. Well timed therapy prevented the lymph nodes colliquation, disease recurrence and infection generalization. The authors point out the significance of this clinical form of tularemia in the differential diagnosis of tonsillopharyngitis and cervical lymphodenopathy.

[Clinical characteristics of Lyme disease]

Clinical characteristics of Lyme disease were analysed in 22 patients. Erythema migrans was found in 20 (91%), arthralgia in 18 (81%), neuralgia in 8 (36%), encephalitis in 3 (13%), carditis in 2 (9%) and arthritis in 2 (9%) patients. The positive antibody titer was found in 14 (63%) patients. Favourable effects of antibiotic therapy was achieved in all patients. Erythema migrans has been manifested up to 12 days after tick sting and arthralgia, arthritis, neuralgia, hepatitis and chronic dermatitis within a year. Carditis and encephalitis have been developing from a month to ten years after tick sting. Lyme borreliosis is commonly manifested as a systemic disease. Together with the skin, most commonly have been involved ankle joints, heart and nervous system. The time from tick sting to the onset of first signs of the diseases varies by the involved organs.

[Ixodes ricinus proven as a vector of Lyme borreliosis in Yugoslavia]

263 fasting female Ixodes ricinus were examined for Borrelia burgorferi, the vector of Lyme borreliosis. Female ticks were collected by flagella in the biotopes (Belgrade and Osijek) in which ticks bite patients with Lyme borreliosis. Borrelia burgorferi was proved in 58 (22%) of 263 female ticks in the native preparations of the intestinal contents by darkfield microscopy. In macerates of two groups of 5 female ticks each, Borrelia burgorferi was isolated by cultivation in the modified Kelly nutrient media for borrelia. The supposition that Ixodes ricinus is the vector of Lyme borreliosis in Yugoslavia is confirmed.

[Reaction of the injured organism to infection]

Authors have examined degree of the immune response to experimentally inoculated agent in the early (6 hours) and late (7 days) phase of the organism response to thermal injury in BALB/c rats divided into two experimental groups and three control groups (only infected, only burnt and intact). Brucella abortus bovis of VA-19 species known as a good immune response stimulator in the host was i.p. inoculated in LD 50 (1 x 10(7) bact/ml). as the infective agent. Thermal injury-scalding was induced after the Art-hurson's method. Obtained results after observed brucella multiplication and spreading in blood, spleen, liver and lymph nodes as well as after determination of the phagocyte activation degree measured by the lumisol-dependent-chemiluminescence technique have pointed out that the general response to also confirm reliability of serologic diagnosis of toxoplasmosis by IgM antibody detecting in disease outbreaks. Acute acquired toxoplasmosis could not be reliably diagnosed on the basis of IgG-ELISA and IgG-IIF test findings. Enzyme immunoassays-ELISA are significantly more sensitive and more specific than IIF ones.

[Lyme disease in Yugoslavia]

Presented are results of the last five-year period study of the lyme disease in Yugoslavia. On the basis of published papers and professional communications over 2500 cases of lyme disease.were detected in our country within this period. Presented are common epidemiologic and clinical features of the disease and particularly cases diagnosed in Belgrade. Since 1987 a group of various specialists has been working on the research project in collaboration with many centres in the country. Indirect immunofluorescence test as the diagnostic laboratory technique has been introduced in the Military Medical Academy in Belgrade in 1987. First species of Borrelia burgdorferi from ticks Ixodes ricinus have been isolated and cultivated in May and June 1990. Current problems concerning research work, medical and epidemiological aspects of the lyme disease are presented.