Geographical Features and Seroprevalence of Borrelia burgdorferi in Erzincan, Turkey

  • Aytekin Cikman Department of Medical Microbiology, Erzincan University School of Medicine, Erzincan, Turkey
  • Merve Aydin Department of Medical Microbiology, Erzincan University School of Medicine, Erzincan, Turkey and Department of Medical Microbiology, KTO Karatay University School of Medicine, Konya, Turkey
  • Baris Gulhan Department of Medical Microbiology, Erzincan University School of Medicine, Erzincan, Turkey
  • Faruk Karakecili Department of Infectious Diseases, Erzincan University School of Medicine, Erzincan, Turkey
  • Levent Demirtas Department of Internal Medicine, Erzincan University School of Medicine, Erzincan, Turkey
  • Ozan Arif Kesik Department of Geography, Faculty of Arts and Sciences, Erzincan University, Erzincan, Turkey
Keywords: Borrelia burgdorferi, Seroprevalence, Geographical features, Altitude, Slope degree, Turkey


Background: We aimed to determine the geographical features and seroprevalence of Borrelia burgdorferi in Erzincan, Turkey, which has a high tick population due to its geographical position and climatic conditions. Methods: From January to December 2014, 368 people living in Erzincan, northeastern Turkey were enrolled. B. burgdorferi IgG antibodies were investigated in the collected serum samples using the ELISA method in 2015. Positive and borderline results were confirmed using the Western Blot (WB) method.  Results: Borrelia burgdorferi IgG positivity was found to be 4.1% by ELISA and 2.17% by WB. Of the seropositive people according to WB, 25% resided in areas within 2000m of rivers, 50% in areas with a slope of 0–5°, and 62.5% in areas with an altitude of lower than 1500 meters. Conclusion: The seroprevalence of Lyme borreliosis was high in Erzincan, particularly among people engaged in animal husbandry in rural areas. In addition, the seroprevalence of Borrelia varied according to geographical features, increasing in areas with a lower slope and altitude.


1. Melaun C, Zotzmann S, Santaella VG, Werblow A, Zumkowski-Xylander H, Kraiczy P, Klimpel S (2016) Occurence of Borrelia burgdorferi s.l. in different genera of mosquitoes (Culicidae) in Central Europe. Ticks Tick Borne Dis. 7(2): 256–263.
2. Potkonjak A, Kleinerman G, Gutiérrez R, Savić S, Vračar V, Nachum-Biala Y, Jurišić A, Rojas A, Petrović A, Ivanović I, Harrus S, Baneth G (2016) Occurence of Borrelia burgdorferi Sensu Lato in Ixodes ricinus ticks with first identification of Borrelia miyamotoi in Vojvodina, Ser-bia. Vector Borne Zoonotic Dis. 16(10): 631–635.
3. Millins C, Gilbert L, Johnson P, James M, Kilbride E, Birtles R, Biek R (2016) Heterogeneity in the abundance and dis-tribution of Ixodes ricinus and Borrelia burgdorferi (sensu lato) in Scotland: implications for risk prediction. Parasit Vectors. 9: 595.
4. Wójcik-Fatla A, Zając V, Sawczyn A, Sroka J, Cisak E, Dutkiewicz J (2016) Infections and mixed infections with the selected species of Borrelia burgdorferi sensu lato complex in Ixodes ricinus ticks collec-ted in eastern Poland: a significant in-crease in the course of 5 years. Exp Appl Acarol. 68(2): 197–212.
5. Araya-Anchetta A, Busch JD, Scoles GA, Wagner DM (2015) Thirty years of tick population genetics: a comprehensive review. Infect Genet Evol. 29: 164–179.
6. Jovanovic D, Atanasievska S, Protic-Djokic V, Rakic U, Lukac-Radoncic E, Ristano-vic E (2015) Seroprevalence of Borrelia burgdorferi in occupationally exposed persons in the Belgrade area, Serbia. Braz J Microbiol. 46(3): 807–814.
7. Heymann WR, Ellis DL (2012) Borrelia burgdorferi infections in the United States. J Clin Aesthet Dermatol. 5(8): 18–28.
8. Vourc'h G, Abrial D, Bord S, Jacquot M, Masséglia S, Poux V, Pisanu B, Bailly X, Chapuis JL (2016) Mapping human risk of infection with Borrelia burgdorferi sensu lato, the agent of Lyme borreliosis, in a periurban forest in France. Ticks Tick Borne Dis. 7(5): 644–652.
9. Rizzoli A, Hauffe H, Carpi G, Vourc'h G, Neteler M, Rosa R (2011) Lyme borre-liosis in Europe. Euro Surveill. 16(27): 19906.
10. De Keukeleire M, Robert A, Kabamba B, Dion E, Luyasu V, Vanwambeke SO (2016) Individual and environmental factors associated with the seroprevalence of Borrelia burgdorferi in Belgian far-mers and veterinarians. Infect Ecol Epi-
demiol. 6: 32793.
11. Bhate C, Schwartz RA (2011) Lyme dis-ease: Part I. Advances and perspectives. J Am Acad Dermatol. 64(4): 619–636.
12. Sanchez JL (2015) Clinical manifestations and treatment of Lyme disease. Clin Lab Med. 35(4): 765–778.
13. Nazari M, Najafi A (2016) Epidemiological study of endemic relapsing fever in Ha-madan Province, west of Iran. J Arth-ropod Borne Dis. 10(4): 586–594.
14. Akın Belli A, Derviş E, Özbaş Gök S, Midilli K, Gargılı A (2015) Evaluation of 10 cases of Lyme disease presentng with erythema migrans in Istanbul, Tur-key. Mikrobiyol Bul. 49(4): 525–531.
15. Wright WF, Riedel DJ, Talwani R, Gilliam BL (2012) Diagnosis and management of Lyme disease. Am Fam Physician. 85(11): 1086–1093.
16. Wilking H, Fingerle V, Klier C, Thamm M, Stark K (2015) Antibodies against Borrelia burgdorferi sensu lato among adults, Germany, 2008–2011. Emerg In-fect Dis. 21(1): 107–110.
17. Leeflang MM, Ang CW, Berkhout J, Bijl-mer HA, Van Bortel W, Brandenburg AH, Van Burgel ND, Van Dam AP, Dessau RB, Fingerle V, Hovius JW, Jaulhac B, Meijer B, Van Pelt W, Schellekens JF, Spijker R, Stelma FF, Stanek G16, Verduyn-Lunel F, Zeller H, Sprong H (2016) The diagnostic ac-curacy of serological tests for Lyme borreliosis in Europe: a systematic re-view and meta-analysis. BMC Infect Dis. 16: 140.
18. Schotthoefer AM, Frost HM (2015) Ecology and epidemiology of Lyme Borreliosis. Clin Lab Med. 35(4): 723–743.
19. Pritt BS, Mead PS, Johnson DK, Neitzel DF, Respicio-Kingry LB, Davis JP, Schiffman E, Sloan LM, Schriefer ME, Replogle AJ, Paskewitz SM, Ray JA, Bjork J, Steward CR, Deedon A, Lee X, Kingry LC, Miller TK, Feist MA, Theel ES, Patel R, Irish CL, Petersen JM (2016) Identification of a novel patho-genic Borrelia species causing Lyme borreliosis with unusually high spiro-chaetaemia: a descriptive study. Lancet Infect Dis. 16(5): 556–564.
20. Parlak M, Bayram Y, Çıkman A, Ceylan N, Berktaş M (2015) Seropositivity of Borrelia burgdorferi in risky groups in Van region, Turkey. Mikrobiyol Bul. 49(3): 439–445.
21. Güner ES, Hashimoto N, Takada N, Kaneda K, Imai Y, Masuzawa T (2003) First iso-lation and characterization of Borrelia burgdorferi sensu lato strains from Ixo-des ricinus ticks in Turkey. J Med Mic-robiol. 52(9): 807–813.
23. Mead PS (2015) Epidemiology of Lyme disease. Infect Dis Clin North Am. 29 (2): 187–210.
24. van den Wijnngaard CC, Hofhuis A, Harms MG, Haagsma JA, Wong A, de With GA, Havelaar AH, Lugnér AK, Suijkerbuijk AW, van Pelt W (2015) The burden of Lyme borreliosis expressed in disability-adjusted life years. Eur J Public Health. 25(6): 1071–1078.
25. Biesiada G, Czepiel J, Leśniak MR, Gar-licki A, Mach T (2012) Lyme disease: review. Arch Med Sci. 8(6): 978–982.
26. Calderaro A, Montecchini S, Gorrini C, Piccolo G, Chezzi C, Dettori G (2011) Presence of anti-Borrelia burgdorferi antibodies and Borrelia burgdorferi sensu lato DNA in samples of subjects in an area of the Northern Italy in the period 2002–2008. Diagn Microbiol Infect Dis. 70(4): 455–460.
27. Stanek G, Reiter M (2011) The expanding Lyme Borrelia complex-clinical signi-ficance of genomic species? Clin Mic-robiol Infect. 17(4): 487–493.
28. Schulte-Spechtel U, Lehnert G, Liegl G, Fingerle V, Heimerl C, Johnson BJ, Wilske B (2003) Significant im-provement of the recombinant Borrelia-specific immunoglobulin G immunoblot test by addition of VısE and a DbpA homologue derived from Borrelia garinii for diagnosis of early neuroboreliosis. J Clin Microbiol. 41(3): 1299–1303.
29. Branda JA, Strle F, Strle K, Sikand N, Ferraro MJ, Steere AC (2013) Perfor-mance of United States serologic assays in the diagnosis of Lyme borreliosis acquired in Europe. Clin Infect Dis. 57(3): 333–340.
30. Aslan Başbulut E, Gözalan A, Sönmez C, Cöplü N, Körhasan B, Esen B, Akın L, Ertek M (2012) Seroprevalence of Borrelia burgdorferi and tick-borne en-cephalitis virus in a rural area of Sam-sun, Turkey. Mikrobiyol Bul. 46(2): 247–256.
31. Lewandowska A, Kruba Z, Filip R (2013) Epidemiology of Lyme disease among workers of forest inspectorates in Po-land. Ann Agric Environ Med. 20(2): 329–331.
32. Kmieciak W, Ciszewski M, Szewczyk EM (2016) Tick-borne diseases in Po-land: Prevalence and difficulties in diag-nostics. Med Pr. 67(1): 73–87.
33. Margos G, Piesman J, Lane RS, Ogden NH, Sing A, Straubinger RK, Fingerle V (2014) Borrelia kurtenbachii sp. nov., a widely distributed member of the Borrelia burgdorferi sensu lato species complex in North America. Int J Syst Evol Microbiol. 64(1): 128–130.
34. Vestrheim DF, White RA, Aaberge IS, Aase A (2016) Geographical differences in seroprevalence of Borrelia burgdorferi antibodies in Norway, 2011–2013. Ticks Tick Borne Dis. 7(5): 698–702.
How to Cite
Cikman A, Aydin M, Gulhan B, Karakecili F, Demirtas L, Kesik OA. Geographical Features and Seroprevalence of Borrelia burgdorferi in Erzincan, Turkey. J Arthropod Borne Dis. 12(4):378-386.
Original Article