![]() As an alternative, the medical guidelines in the United States 2006 and the Netherlands since 2013 mention prophylactic antibiotic treatment of tick bites with a single 200-mg dose of doxycycline administered within 72 hours after tick removal. The recommended standard practice after tick removal is watchful waiting to monitor the skin for development of erythema migrans or other clinical symptoms indicative of Lyme borreliosis. And tick attachment durations shorter than 24 hours have been reported by patients with Lyme borreliosis in human observational studies in Europe. afzelii has been reported within the first 24 hours of Ixodes ricinus attachment in an animal experiment. In Europe, Lyme borreliosis is transmitted by Ixodes ricinus and caused mainly by other species of Borrelia such as B. As described for the North American vector Ixodes scapularis, detectable transmission of Borrelia burgdorferi sensu stricto requires attachment to the host for at least 24 hours in animal experiments. Another factor is the transmission of Borrelia from ticks to humans, which increases with the duration of the tick’s blood meal, and can be quantified as patient-estimated duration of the tick bite or as degree of engorgement of the tick. Among field collected host-seeking ticks, less than 1% of larvae are infected, about 10% to 30% of the nymph, and 15% to 40% of adults. The tick infection rate rises with its developmental stage. During a blood meal from an infected animal, ticks can become infected with Borrelia, and during the subsequent blood meals the bacteria can be transmitted to new hosts. ![]() After hatching from the eggs, ticks need a blood meal from a vertebrate before dropping off to moult to the next stage or to lay eggs in the case of an adult female. Ticks have four life stages: eggs, larva, nymph and adult. The risk of infection with Borrelia after a tick bite depends on several factors, one of these being the prevalence of Borrelia in ticks. To aid development of prevention strategies against Lyme borreliosis, understanding and quantification of the risk of developing Lyme borreliosis after a tick bite are required. The incidence of Lyme borreliosis has increased markedly in several regions of Europe. Late and more serious Lyme borreliosis can present with skin, neurological, musculoskeletal and cardiac manifestations. The most common clinical manifestation of Lyme borreliosis is erythema migrans, an expanding skin lesion indicating early localized infection at the site of the tick bite. Lyme borreliosis is a tick-borne disease caused by bacteria of the Borrelia burgdorferi sensu lato group (hereafter referred to as Borrelia). ![]() The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.Ĭompeting interests: On behalf of all authors, the corresponding author states that there are no conflicts of interest. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: S1 File contains the full dataset.įunding: This study was financed by, and conducted on behalf of, the Ministry of Health, Welfare and Sport of the Netherlands. Received: JanuAccepted: JPublished: July 24, 2017Ĭopyright: © 2017 Hofhuis et al. PLoS ONE 12(7):Įditor: Utpal Pal, University of Maryland, College Park, UNITED STATES (2017) Predicting the risk of Lyme borreliosis after a tick bite, using a structural equation model. Citation: Hofhuis A, van de Kassteele J, Sprong H, van den Wijngaard CC, Harms MG, Fonville M, et al. ![]()
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