Alabama Lyme disease abstracts

Authors: Wright JC. Chambers M. Mullen GR. Swango LJ. D'Andrea GH. Boyce AJ.
Institution: Department of Pathobiology, Auburn University, AL 36849, USA.
Title: Seroprevalence of Borrelia burgdorferi in dogs in Alabama, USA.
Source:Preventive Veterinary Medicine. 31(1-2):127-31, 1997 Jul.

Abstract: A random sample of private small-animal practices in Alabama submitted sera from dogs with known tick contact. A total of 579 samples from the three geographic regions of the state were collected (58% of the targeted sample size). Sera were screened for antibodies to Borrelia burgdorferi using an indirect fluorescent antibody (IFA) test which had a sensitivity and specificity of greater than 90%. Anti-B burgdorferi titers of > or = 1:64 were considered to be positive, based on results from B. burgdorferi-inoculated dogs. Ten of the 579 samples (1.7%) were positive, and titers ranged from 1:64 to 1:512. Seropositive dogs were found throughbout the state, and there was no significant difference in seroprevalence by region (Mantel-Haenszel chi 2, P = 0.85). These results indicate that the seroprevalence for canine Lyme disease in Alabama is low and that use of the canine Lyme disease vaccine is not justified.

Author: McFadden P.
Title: Lyme disease research [letter; comment].
Source: Science 270(5241):1419, 1995 Dec 1.
Comment on: Science 1995 Oct 13;270(5234):228-9,
Comment in: Science 1996 Mar 1;271(5253):1216-8.

Authors: Murray R. Morawetz R. Kepes J. el Gammal T. LeDoux M.
Institution: Department of Surgery, University of Alabama, School of Medicine, Birmingham.
Title: Lyme neuroborreliosis manifesting as an intracranial mass lesion.
Source: Neurosurgery. 30(5):769-73, 1992 May.

Abstract: Lyme neuroborreliosis is one of the chronic manifestations of Lyme disease and is caused by the neurotropic spirochete, Borrelia burgdorferi. Two of the three stages of Lyme disease potentially involve the central nervous system: a second stage that may manifest as meningitis, cranial neuritis, or radiculoneuritis; and a third stage, or chronic neuroborreliosis, with parenchymal involvement. The tertiary stage may mimic many conditions, including multiple sclerosis, polyneuropathy, viral encephalitis, brain tumor, vasculitis, encephalopathy, psychiatric illness, and myelopathy. We report a 10-year-old child with signs, symptoms, and radiological manifestations of intracranial mass lesions, without previously recognized manifestations of Lyme disease. This proved to be Lyme neuroborreliosis, documented by histological and serological examination, which responded well to antibiotic therapy. The need to establish a tissue diagnosis of intracranial mass lesions is emphasized, and the utility of a computed tomographic-guided stereotactic system for this purpose is discussed.

Authors: Luckhart S. Mullen GR. Durden LA. Wright JC.
Institution: Department of Entomology, Auburn University, Alabama 36949.
Title:Borrelia sp. in ticks recovered from white-tailed deer in Alabama.
Source:Journal of Wildlife Diseases. 28(3):449-52, 1992 Jul.

Abstract: Six hundred sixty-five hunter-killed white-tailed deer (Odocoileus virginianus) from 18 counties in Alabama (USA) were examined for ticks. Most of the collections were made at state-operated wildlife management areas. Four species of ticks (n = 4,527) were recovered: the lone star tick Amblyomma americanum (n = 482); the Gulf Coast tick A. maculatum (n = 11); the winter tick Dermacentor albipictus (n = 1,242); and the black-legged tick Ixodes scapularis (n = 2,792). Fifty-six percent of the ticks (n = 2,555) were examined for Borrelia sp. spirochetes using an immunofluorescent, polyclonal antibody assay. Spirochetes were detected in I. scapularis (five females, seven males) from Barbour, Butler, Coosa, and Lee counties and A. americanum (four males, four nymphs) from Hale, Lee, and Wilcox counties. Area-specific prevalences in ticks were as high as 3.3% for I. scapularis and 3.8% for A. americanum.

Authors: Magnarelli LA. Oliver JH Jr. Hutcheson HJ. Boone JL. Anderson JF.

Title: Antibodies to Borrelia burgdorferi in rodents in the eastern and southern United States.

Source: Journal of Clinical Microbiology. 30(6):1449-52, 1992 Jun.

Abstract: Serologic studies were conducted to determine whether white-footed mice (Peromyscus leucopus) and cotton mice (Peromyscus gossypinus) contained serum antibodies to Borrelia burgdorferi, the causative agent of Lyme borreliosis. Enzyme-linked immunosorbent assays detected antibodies to this spirochete in 35.7 and 27.3% of 56 P. leucopus and 535 P. gossypinus serum samples, respectively, collected in Connecticut, North Carolina, South Carolina, Georgia, Florida, Alabama, and Mississippi. Antibody titers ranged from 1:160 to greater than or equal to 1:40,960. On the basis of adsorption tests, the antibodies detected appeared to be specific to Borrelia spirochetes. Seropositive rodents in the eastern and southern United States, areas where human cases of Lyme borreliosis have been reported, indicate a widespread geographic distribution of B. burgdorferi or a closely related spirochete.

Authors: Luckhart S. Mullen GR. Wright JC.
Institution: Department of Entomology, Auburn University, Alabama 36849-5413.
Title: Etiologic agent of Lyme disease, Borrelia burgdorferi, detected in ticks (Acari: Ixodidae) collected at a focus in Alabama.
Source: Journal of Medical Entomology. 28(5):652-7, 1991 Sep.

Abstract: The study was conducted at sites of known transmission of Borrelia burgdorferi in east central Alabama. The objectives were to determine species of ticks present at these sites, their host associations, and species of ticks and small mammals naturally infected with B. burgdorferi. A total of 451 hosts were examined for ticks, including cotton mice, Peromyscus gossypinus (Le Conte); cotton rats, Sigmodon hispidus Say & Ord; southern short-tailed shrews, Blarina carolinensis (Bachman); house mice, Mus musculus L.; golden mice, Ochrotomys nuttalli (Harlan); and white-tailed deer, Odocoileus virginianus (Zimmermann). Ticks were examined for B. burgdorferi using indirect and direct fluorescent antibody assays. Ear biopsy samples from rodents were cultured in modified Kelly's medium in attempts to isolate B. burgdorferi. A total of 859 Amblyomma americanum L., Dermacentor albipictus (Packard), D. variabilis (Say), Ixodes scapularis Say, and Rhipicephalus sanguineus (Latreille) were recovered from hosts and by dragging. A. americanum and I. scapularis accounted for 53.4% of all ticks collected. Nearly half of all ticks collected were examined for the agent. Spirochetes were detected in four nymphal and two adult A. americanum recovered from white-tailed deer and three larval I. scapularis recovered from cotton mice. No spirochetes were cultured from field-caught rodents.

Authors: Durden LA. Luckhart S. Mullen GR. Smith S.
Institution: Department of Entomology, Auburn University, Alabama 36849.
Title: Tick infestations of white-tailed deer in Alabama.
Source: Journal of Wildlife Diseases. 27(4):606-14, 1991 Oct.

Abstract: Four species of ticks were collected from 537 white-tailed deer (Odocoileus virginianus), examined during the hunting seasons (November to January) of 1988-89 and 1989-90 at selected locations in Alabama (USA). Ixodes scapularis was the most common tick recovered (2,060 specimens) and infested 54% of the deer. Dermacentor albipictus was the second most frequent tick (1,253 specimens) and infested 15% of the deer. Amblyomma americanum was the third most frequent tick (315 specimens) and infested 24% of the deer; this was the only species of tick collected from deer at all sampling locations. Amblyomma maculatum was an infrequent parasite (five specimens) and infested only 1% of the deer; this tick species was only recorded during the 1989-90 season. Year-to-year and geographical differences in tick infestation parameters were noted. The data are compared with those reported for previous surveys of ticks infesting white-tailed deer in Alabama and adjacent states.

Authors: McBryde RR.
Title: Lyme disease in Alabama.
Source: Alabama Medicine. 59(11):24-7, 1990 May.

Authors: Kelley MD.
Institution: University of Alabama School of Medicine, Tuscaloosa Program, AL.
Title: Possible Lyme meningitis.
Source: Alabama Medicine. 59(7):19-20, 1990 Jan.

Abstract: Lyme disease was first recognized in 1975 because of a cluster of patients with arthritis in the vicinity of Lyme, Connecticut. Subsequently the arthritis was linked with erythema chronicum migrans (88%), cardiac (8%), and nervous system diseases (11%). By 1983, the etiology of the disease had been confirmed as an infection caused by a spirochete, Borrelia burgdorferi, transmitted to man by the bite of a tick, Ixodes dammini. Then it became apparent that this was the same disease reported as far back as the 1920's, known in Europe as tick-borne meningeal polyneuritis, lymphocytic meningoradiculitis, or Bannwarth's syndrome. The usual presentation includes exposure to ticks or tick-infested areas of the Northeast, the characteristic rash, and then the neurological abnormalities, then the arthritis. This case is presented to illustrate the possible presence of the disease with no history of tick exposure, no travel to areas usually considered endemic and no characteristic rash.

Authors: Woernle CH.
Title: Surveillance for Lyme disease in Alabama.
Source: Alabama Medicine. 58(10):19-20, 1989 Apr.

Abstract: To estimate the frequency of occurrence of Lyme disease in Alabama, in September 1988 the Department of Public Health requested physicians and laboratories to begin voluntary reporting of cases of Lyme disease. Thirteen cases, 5 confirmed, 1 probable, 4 presumptive and 3 possible, were reported for the years 1986-1988. Counties in which tick exposure likely occurred included Calhoun, Cleburne, Mobile, Monroe, Shelby, Talladega and Tallapoosa. Lyme disease occurs in Alabama but appears to be uncommon.

Authors: Mullen GR. Piesman J.
Title: Serologically substantiated case of Lyme disease and potential tick vectors in Alabama.
Source: Alabama Journal of Medical Sciences. 24(3):306-7, 1987 Jul.

Authors: Felz MW, Chandler FW Jr, Oliver JH Jr, Rahn DW, Schriefer ME.
Title: Solitary erythema migrans in Georgia and South Carolina.
Source: Archives of Dermatology. 135(11):1317-26, 1999 Nov.

Abstract: OBJECTIVE: To evaluate the incidence of Borrelia burgdorferi infection in humans with erythema migrans (EM) in 2 southeastern states. DESIGN: Prospective case series. SETTING: Family medicine practice at academic center. PATIENTS: Twenty-three patients with solitary EM lesions meeting Centers for Disease Control and Prevention (CDC) criteria for Lyme disease. INTERVENTIONS: Patients underwent clinical and serologic evaluation for evidence of B burgdorferi infection. All lesions underwent photography, biopsy, culture and histopathologic and polymerase chain reaction analysis for B burgdorferi infection. Patients were treated with doxycycline hyclate and followed up clinically and serologically. MAIN OUTCOME MEASURES: Disappearance of EM lesions and associated clinical symptoms in response to antibiotic therapy; short-term and follow-up serologic assays for diagnostic antibody; growth of spirochetes from tissue biopsy specimens in Barbour-Stoenner-Kelly II media; special histopathologic stains of tissue for spirochetes; and polymerase chain reaction assays of tissue biopsy specimens for established DNA sequences of B burgdorferi. RESULTS: The EM lesions ranged from 5 to 20 cm (average, 9.6 cm). Five patients (22%) had mild systemic symptoms. All lesions and associated symptoms resolved with antibiotic therapy. Overall, 7 patients (30%) had some evidence of B burgdorferi infection. Cultures from 1 patient (4%) yielded spirochetes, characterized as Borrelia garinii, a European strain not known to occur in the United States; 3 patients (13%) demonstrated spirochetallike forms on special histologic stains; 5 patients (22%) had positive polymerase chain reaction findings with primers for flagellin DNA sequences; and 2 patients (9%) were seropositive for B burgdorferi infection using recommended 2-step CDC methods. No late clinical sequelae were observed after treatment. CONCLUSIONS: The EM lesions we observed are consistent with early Lyme disease occurring elsewhere, but laboratory confirmation of B burgdorferi infection is lacking in at least 16 cases (70%) analyzed using available methods. Genetically variable strains of B burgdorferi, alternative Borrelia species, or novel, uncharacterized infectious agents may account for most of the observed EM lesions.