Geographical and Chronological Analysis of Lyme Borreliosis in Stara Zagora Region

Objectives: Until recently, Lyme Borreliosis (LB) was not commonly seen in Bulgaria. Now, this infectious disease, which is spread in the form of natural foci, is seen in Bulgaria as well as in North America, Europe and Asia. The objective of the present study is to analyze the dynamics and characteristics of the LB epidemic process for Stara Zagora region over two periods, due to the incompleteness of the data available to Regional Health Inspectorate of Stara Zagora (1993-1997 and 2008-2012). Methods: Complex epidemiological methods, including the epidemiological analysis method, were applied in the data interpretation. Routine methods have been previously applied in studying serological samples from patients diagnosed with LB, including indirect IFA (until 1997) and ELISA (until 2012). Results: During the first period of our study (1993-1997), the distribution of LB patients by years was irregular, with the highest number of patients in 1993 (32) and 1995(39). During the second period (2008-2012), the highest number of LB patients was recorded in 2008 (93). During both the first and second study periods, we found that LB disease in Stara Zagora Region decreased. However, on a national and world scale, LB disease is increasing, most likely due to the methods of diagnostics, climate change and increased migration. Conclusions: Because the incidence of LB is increasing worldwide, we believe that the laboratory and clinical diagnostics of LB should be more precise. J Microbiol Infect Dis 2018; 8(1):13-17

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  • 1. Dimitrova T. [Epidemiology and ecology of natural focal diseases in the Republic of Bulgaria (1970-2008)], [habilitation paper for acquiring the title professor in epidemiology]. Medical University- Sofia, 2009; 457. (Bulgarian) 2. [Lyme incidence rate for the period 1995-2012], annual book, Regional Health Inspectorate – Stara Zagora, 2013. (Bulgarian) 3. Marinov М. Epidemiological studies of Lyme Borreliosis cases in Stara Zagora Region. Infectology 1994; ХХХІ, 4:16-17. (Bulgarian) 4. Marinov M. Retrospective studies on the presence of Lyme disease in Stara Zagora region. Official bulletin of the National Centre of Infectious and Parasitic Diseases 1992; 6:13-17. (Bulgarian) 5. [Ordinance No.21/2005 on the rules for recording, announcing and reporting infectious diseases and its amendment and supplement in effect as of 2011]. Ministry of Health 2011. (Bulgarian) 6.Savova Y, Angelov L, Vaptsarov I. Erythema migrans and Lyme disease. Dermatology and Venerology 1988; 2: 62-65. 7.Tomov A, Tsvetkova E, KryakovY,, Ivanova K. For the first time in Bulgaria the bacterium Borrelia burgdorferi causing the Lyme disease was isolated. Infectology 1994; ХХХІ, 2: 29-31. 8. Hristova I, Nikolova M, Manev H. IgM and IgG immune response in the onset of Lyme borreliosis. Infectology 1995; 1:22-23. (Bulgarian) 9. Hristova I. Abstract of dissertation paper for awarding the scientific rank„ Doctor of Medical Sciences”. 2012; 103. (Bulgarian) 10. Hristova I. Problems of microbiological diagnostics of Lyme disease. Infectology 1992; 4:3-8. 11.CDC. Reported cases of Lyme disease by year, United States, 2002-2011.Atlanta 2012; 1. 12.Chandra A, Latov N, Wormser G, Marques A, Alaedini A. Epitope mapping of antibodies to VlsE protein of Borrelia burgdorferi in Post-Lyme disease syndrome. Clin Immunol 2011; 141(1), 103-110. 13.Eicken C, Sharma V, Klabunde T, et al. Crystal structure of Lyme disease variable surface antigen VlsE of Borrelia burgdorferi. Journal of biological chemistry 2002; 277: 21691-21696. 14.Pfister H, Wilske B, Weber Kl. Lyme borreliosis: basic science and clinical aspects. THE LANCET 1994; vol.343: 1013-1016. 15.Stafford K, Cartter M, Magnarelli L, Ertel St, Mshar P. Temporal correlations between tick abundance and prevalence of tiks infected with Borrelia burgdorferi and increasing incidence of Lyme disease. J Clin Microbiol 1998; 36 (5):1240-1244. 16.Stiernstedt G, Dattwyler R, Duray P, et al. Diagnostic tests in Lyme borreliosis. Scand J Infect Dis 1991 (Suppl) 77:136-142.