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Borreliosis: Lyme or Ljubljana

The first cases of Lyme disease (LD) were recognized in Lyme, Connecticut in 1975. Although many assume that the condition is largely limited to the United States, LD has been reported in 63 countries as of 2010, with cases in Latin America, Asia, Europe and North Africa. Surprisingly, the world’s highest LD rates are reported in Slovenia, followed by the Baltic countries and Czech Republic (see graph). [1,2]

Borrelia burgdorferi was first isolated from patients in Slovenia in 1988, and from ticks in 1993.

Prevalence surveys:
7.7% to 46% of febrile illness following tick bite
45.5% of ticks in the Italy/Slovenia transborder territory (2008 publication)

Seroprevalence surveys:
15.4% of children and young adults in Slovenia (2000 publication)
23.8% of forestry workers (ELISA, 2002)

Infecting species:
– Borrelia burgdorferi, B. afzelii and B. garinii are encountered.
– B. afzelii accounts for the majority of isolates; however, B. garinii predominates among strains cultured from cerebrospinal fluid.
– B. bissettii has been isolated from humans with Lyme disease in Slovenia.
– Borrelia spielmanii (Borrelia A14S) has been implicated in cases of erythema chronicum migrans in Slovenia.

References:
1. Berger SA. Infectious Diseases of Slovenia, 2010, 373 pp. Gideon e-book series. https://www.gideononline.com/ebooks/country/infectious-diseases-of-slovenia/
2. Berger SA. Lyme disease: Global Status, 2010, 66 pp. Gideon e-book series. https://www.gideononline.com/ebooks/disease/lyme-disease-global-status/

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