ArticlePloS one2013
A prospective study among patients presenting at the general practitioner with a tick bite or erythema migrans in The Netherlands.
Article in PloS one, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 citations in OpenAlex.
- Seroprevalence of Lyme Borreliosis in Europe: Results from a Systematic Literature Review (2005-2020).Vector borne and zoonotic diseases (Larchmont, N.Y.) · 2023Pooled it
- Symptom load and general function among patients with erythema migrans: a prospective study with a 1-year follow-up after antibiotic treatment in Norwegian general practice.Scandinavian journal of primary health care · 2017Trial
- Dynamics of Borrelial Antibodies in European Lyme Borreliosis Patients with Erythema Migrans.Medical sciences (Basel, Switzerland) · 2026Article
- Consultations in general practice related to a tick bite episode in mainland France in 2023-2024.BMC public health · 2026Article
- Incidence of Lyme borreliosis following Ixodes ricinus tick bites in Poland: a citizen science approach.Parasites & vectors · 2025Article
- The prevalence of pathogens in ticks collected from humans in Belgium, 2021, versus 2017.Parasites & vectors · 2024Article
- Article
- Genome-wide analyses in Lyme borreliosis: identification of a genetic variant associated with disease susceptibility and its immunological implications.BMC infectious diseases · 2024Article
- Estimated Incidence of Symptomatic Lyme Borreliosis Cases in Lublin, Poland in 2021.Microorganisms · 2023Article
- Lyme Borreliosis Serology: A Prospective Cohort Study of Forestry Service Workers in the Netherlands over 8 Years (2008 to 2016) of Follow-Up.Life (Basel, Switzerland) · 2023Article
- Estimated Number of Symptomatic Lyme Borreliosis Cases in Adults in Finland in 2021 Using Seroprevalence Data to Adjust the Number of Surveillance-Reported Cases: A General Framework for Accounting for Underascertainment by Public Health Surveillance.Vector borne and zoonotic diseases (Larchmont, N.Y.) · 2023Article
- Incidence of Lyme Borreliosis in the Dutch General Practice Population: A Large-Scale Population-Based Cohort Study Across the Netherlands Between 2015 and 2019.Vector borne and zoonotic diseases (Larchmont, N.Y.) · 2023Article
- Retrospective Study of Tick Bites Associated with Neurological Disease in a Level Three University Hospital in Switzerland.Infectious disease reports · 2023Article
- Self-reported symptoms and health complaints associated with exposure to Ixodes ricinus-borne pathogens.Parasites & vectors · 2022Article
- Low Risk Perception about Ticks and Tick-Borne Diseases in an Area Recently Invaded by Ticks in Northwestern Italy.Veterinary sciences · 2021Article
- Case report: first symptomatic Candidatus Neoehrlichia mikurensis infection in Slovenia.BMC infectious diseases · 2021Article
- Ticking on Pandora's box: a prospective case-control study into 'other' tick-borne diseases.BMC infectious diseases · 2021Article
- Infections with Tickborne Pathogens after Tick Bite, Austria, 2015-2018.Emerging infectious diseases · 2021Article
- Comparative Cost and Effectiveness of a New Algorithm for Early Lyme Disease Diagnosis: Evaluation in US, Germany, and Italy.ClinicoEconomics and outcomes research : CEOR · 2021Article
- The Unexpected Holiday Souvenir: The Public Health Risk to UK Travellers from Ticks Acquired Overseas.International journal of environmental research and public health · 2020Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundWe performed a nationwide prospective study on the transmission risk for Borrelia to humans, investigating symptoms and serology at enrolment and three months after tick bites, and after standard treatment for erythema migrans (EM). Aiming to quantify the infection risk at point of care by physicians, we explored risk factors such as tick testing for Borrelia and assessment of the duration of the tick's blood meal. METHODS AND
findingsQuestionnaires, blood samples and ticks from patients who consulted one of 307 general practitioners for tick bites (n = 327) or EM (n = 283) in 2007 and 2008, were collected at enrolment and three months later at follow-up. Borrelia burgdorferi sensu lato DNA was detected in 29.3% of 314 ticks, using PCR/reverse line blot and real-time PCR on the OspA gene. Seroconversion in C6 ELISA, IgM or IgG immunoblots for Borrelia-specific antibodies was observed in 3.2% of tick bite cases. Fourteen tick bite cases had evidence of early Borrelia infection, of which EM developed among seven cases. The risk of developing EM after tick bites was 2.6% (95%CI: 1.1%-5.0%), and the risk of either EM or seroconversion was 5.1% (95%CI: 2.9%-8.2%). Participants with Borrelia-positive ticks had a significantly higher risk of either EM or seroconversion (odds ratio 4.8, 95%CI: 1.1-20.4), and of seroconversion alone (odds ratio 11.1, 95%CI: 1.1-108.9). A third (34%) of the cases enrolled with EM did not recall preceding tick bites. Three EM cases (1%) reported persisting symptoms, three months after standard antibiotic treatment for EM.
conclusionsOne out of forty participants developed EM within three months after tick bites. The infection risk can be assessed by tick testing for Borrelia at point of care by physicians. However, further refining is needed considering sensitivity and specificity of tick tests, accuracy of tick attachment time and engorgement.
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