1
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Lyme neuroborreliosis in Japan: Borrelia burgdorferi sensu lato as a cause of meningitis of previously undetermined etiology in hospitalized patients outside of the island of Hokkaido, 2010–2021

      brief-report

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Background and Purpose

          Clinical manifestations of Lyme borreliosis (LB), caused by Borrelia burgdorferi sensu lato (Bbsl), include erythema migrans, Lyme neuroborreliosis (LNB), carditis, and arthritis. LB is a notifiable disease in Japan with <30 surveillance‐reported LB cases annually, predominately from Hokkaido Prefecture. However, LB, including LNB, may be under‐diagnosed in Japan since diagnostic tests are not readily available. We sought to determine if LNB could be a cause of previously undiagnosed encephalitis or meningitis in Japan.

          Methods

          Investigators at 15 hospitals in 10 prefectures throughout Japan retrieved serum and/or cerebrospinal fluid (CSF) samples collected in 2010–2021 from 517 patients hospitalized with encephalitis or meningitis which had an etiology that had not been determined. Samples were tested for Bbsl‐specific antibodies using ELISA and Western blot tests. In alignment with the European Union LNB case definition, a confirmed LNB case had CSF pleocytosis and intrathecal production of Bbsl‐specific antibodies and a probable LNB case had a CSF sample with pleocytosis and Bbsl‐specific antibodies.

          Results

          LNB was identified in three hospitalized patients with meningitis of previously undetermined etiology: a male resident of Aomori Prefecture was a confirmed LNB case, and two female residents of Oita Prefecture were probable LNB cases. None of the patients with confirmed or probable LNB had traveled in the month prior to symptom onset and none had samples previously tested for LB.

          Conclusion

          The identification of previously undiagnosed LNB cases indicates a need for enhanced disease awareness in Japan, particularly beyond Hokkaido Island, and more readily available LB diagnostic testing.

          Related collections

          Most cited references14

          • Record: found
          • Abstract: found
          • Article: not found

          Lyme borreliosis.

          Lyme borreliosis (Lyme disease) is caused by spirochaetes of the Borrelia burgdorferi sensu lato species complex, which are transmitted by ticks. The most common clinical manifestation is erythema migrans, which eventually resolves, even without antibiotic treatment. However, the infecting pathogen can spread to other tissues and organs, causing more severe manifestations that can involve a patient's skin, nervous system, joints, or heart. The incidence of this disease is increasing in many countries. Laboratory evidence of infection, mainly serology, is essential for diagnosis, except in the case of typical erythema migrans. Diagnosed cases are usually treated with antibiotics for 2-4 weeks and most patients make an uneventful recovery. No convincing evidence exists to support the use of antibiotics for longer than 4 weeks, or for the persistence of spirochaetes in adequately treated patients. Prevention is mainly accomplished by protecting against tick bites. There is no vaccine available for human beings. Copyright © 2012 Elsevier Ltd. All rights reserved.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease.

            (1995)
              Bookmark
              • Record: found
              • Abstract: found
              • Article: found
              Is Open Access

              Tick Surveillance for Relapsing Fever Spirochete Borrelia miyamotoi in Hokkaido, Japan

              During 2012–2013, a total of 4325 host-seeking adult ticks belonging to the genus Ixodes were collected from various localities of Hokkaido, the northernmost island of Japan. Tick lysates were subjected to real-time PCR assay to detect borrelial infection. The assay was designed for specific detection of the Relapsing fever spirochete Borrelia miyamotoi and for unspecific detection of Lyme disease-related spirochetes. Overall prevalence of B. miyamotoi was 2% (71/3532) in Ixodes persulcatus, 4.3% (5/117) in Ixodes pavlovskyi and 0.1% (1/676) in Ixodes ovatus. The prevalence in I. persulcatus and I. pavlovskyi ticks were significantly higher than in I. ovatus. Co-infections with Lyme disease-related spirochetes were found in all of the tick species. During this investigation, we obtained 6 isolates of B. miyamotoi from I. persulcatus and I. pavlovskyi by culture in BSK-M medium. Phylogenetic trees of B. miyamotoi inferred from each of 3 housekeeping genes (glpQ, 16S rDNA, and flaB) demonstrated that the Hokkaido isolates were clustered with Russian B. miyamotoi, but were distinguishable from North American and European B. miyamotoi. A multilocus sequence analysis using 8 genes (clpA, clpX, nifS, pepX, pyrG, recG, rplB, and uvrA) suggested that all Japanese B. miyamotoi isolates, including past isolates, were genetically clonal, although these were isolated from different tick and vertebrate sources. From these results, B. miyamotoi-infected ticks are widely distributed throughout Hokkaido. Female I. persulcatus are responsible for most human tick-bites, thereby I. persulcatus is likely the most important vector of indigenous relapsing fever from tick bites in Hokkaido.
                Bookmark

                Author and article information

                Contributors
                frederick.angulo@pfizer.com
                Journal
                Eur J Neurol
                Eur J Neurol
                10.1111/(ISSN)1468-1331
                ENE
                European Journal of Neurology
                John Wiley and Sons Inc. (Hoboken )
                1351-5101
                1468-1331
                14 January 2025
                January 2025
                : 32
                : 1 ( doiID: 10.1111/ene.v32.1 )
                : e70005
                Affiliations
                [ 1 ] Department of Clinical Laboratory and Internal Medicine National Center of Neurology and Psychiatry Tokyo Japan
                [ 2 ] Department of Veterinary Medicine, Joint Faculty of Veterinary Medicine Yamaguchi University Yamaguchi Japan
                [ 3 ] National Research Center for the Control and Prevention of Infectious Diseases Nagasaki University Nagasaki Japan
                [ 4 ] Department of Neurology Aomori Prefectural Central Hospital Aomori Japan
                [ 5 ] Department of Neurology Oita Prefectural Hospital Oita Japan
                [ 6 ] Department of Neurology National Hospital Organization, Shinshu Ueda General Hospital Nagano Japan
                [ 7 ] Department of Neurology University of Fukui Hospital Fukui Japan
                [ 8 ] Department of Neurology Hokkaido University Hospital Hokkaido Japan
                [ 9 ] Department of Neurology Southern Tohoku General Hospital Fukushima Japan
                [ 10 ] Division of Neurology Jichi Medical University Tochigi Japan
                [ 11 ] Department of Neurology National Hospital Organization Beppu Medical Center Oita Japan
                [ 12 ] Department of Neurology Nihon University Itabashi Hospital Tokyo Japan
                [ 13 ] Department of Neurology Kurashiki Central Hospital Okayama Japan
                [ 14 ] Department of Neurology Tenri Hospital Nara Japan
                [ 15 ] Department of Neurology Nara Medical University Hospital Nara Japan
                [ 16 ] Department of Neurology National Hospital Organization Asahikawa Medical Center Hokkaido Japan
                [ 17 ] Department of Neurology Okayama University Hospital Okayama Japan
                [ 18 ] Vaccines and Antivirals Medical Affairs, Pfizer Vaccines Collegeville Pennsylvania USA
                [ 19 ] Vaccines Medical Affairs Pfizer Japan Inc Tokyo Japan
                [ 20 ] Vaccines and Antivirals Medical Affairs, Pfizer Vaccines Vienna Austria
                [ 21 ] Vaccines and Antivirals Medical Affairs, Pfizer Vaccines Cambridge Massachusetts USA
                [ 22 ] Vaccines and Antivirals Medical Affairs, Pfizer Vaccines Paris France
                [ 23 ] Department of Neurology National Center of Neurology and Psychiatry Tokyo Japan
                Author notes
                [*] [* ] Correspondence

                Frederick J. Angulo, Vaccines and Antivirals Medical Affairs, Pfizer Vaccines, 500 Arcola Road, Collegeville, PA 19426, USA.

                Email: frederick.angulo@ 123456pfizer.com

                Author information
                https://orcid.org/0000-0002-5919-3738
                https://orcid.org/0000-0002-2154-9196
                https://orcid.org/0000-0002-3120-7704
                Article
                ENE70005 EJoN-24-1780.R2
                10.1111/ene.70005
                11729742
                39807698
                cd4fb309-c766-4bd6-984e-97a224434187
                © 2024 The Author(s). European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 28 August 2024
                : 06 December 2024
                Page count
                Figures: 0, Tables: 2, Pages: 6, Words: 3600
                Funding
                Funded by: Pfizer , doi 10.13039/100004319;
                Categories
                Short Communication
                Short Communication
                Custom metadata
                2.0
                January 2025
                Converter:WILEY_ML3GV2_TO_JATSPMC version:6.5.2 mode:remove_FC converted:14.01.2025

                Neurology
                epidemiology,disease burden,lyme neuroborreliosis,meningitis,tick‐borne disease
                Neurology
                epidemiology, disease burden, lyme neuroborreliosis, meningitis, tick‐borne disease

                Comments

                Comment on this article