Investigation of lyme disease in patients with tick contact and identifying of ticks in bolu province

Introduction: Lyme disease is a multisystemic disease caused by the bacteria in Borrelia burgdorferi sensu lato complex, which is transmitted by ticks of the Ixodes genus. Although there are seroprevalence studies and case reports of lyme disease from various regions in Turkey, there is not a widespread epidemiological research. The aim of this study was to determine the incidence of lyme disease in the cases followed-up after tick contact and afterwards to examine the isolated ticks in order to reveal tick population in Bolu province. Material and method: In the study, cases who applied to the emergency department due to tick contact between April and September 2020 were evaluated in our infectious diseases and clinical microbiology outpatient clinic on the third day after tick contact. Patients included in the study were asked to reapply to our outpatient clinic at the 1st, 3rd, and 10th months. In the outpatient clinic follow-ups, the anamnesis of the cases was taken, clinical examination was made, routine blood tests were requested, antibodies were examined with the immunofluorescent antibody (IFA) method for lyme disease, and then an extra serum sample was taken to be studied with the enzyme-linked immunosorbent analysis (ELISA) method which was stored at -20°C until the study day. Results: Out of 123 patients included in this study, 72 patients could be followed-up for 10 months. One of these 72 patients (1.4%) was diagnosed with Lyme Borreliosis according to clinical and laboratory features. Erythema chronicum migrans did not occur in any of the cases. The serum samples of the cases were evaluated by IFA, asymptomatic infection was not detected in any of them. Afterwards the serum samples were evaluated by ELISA method. Asymptomatic infection was detected in 22 cases (30.5%). In addition, 47 ticks isolated from the cases in our study were examined and two genus were identified. 42 of them (89.3%) were Ixodes spp., and two of them (4.3%) were Hyalomma spp. Conclusion: In this study, which was carried out for the first time in the province of Bolu, it was concluded that the cases presenting with a history of tick contact were most frequently exposed to Ixodes spp ticks and the probability of developing Lyme Borreliosis was low (% 1,4) during the 10 month follow-up period . Further studies with larger number of cases and longer follow-up period are needed.