TY - JOUR
T1 - Ticking on Pandora’s box: a prospective case-control study into ‘other’ tick-borne diseases
AU - Hoornstra, D.
AU - Harms, M. G.
AU - Gauw, S. A.
AU - Wagemakers, A.
AU - Azagi, T.
AU - Kremer, K.
AU - Sprong, H.
AU - van den Wijngaard, C. C.
AU - Hovius, J. W.
N1 - Funding Information: The authors acknowledge the following colleagues for their valuable assistance in setting up and performing this study: G.A. (Anneke) Oei, BASc; J.I. (Jasmin) Ers?z, BASc; Nienke Verhaar, BASc; Jeanine Ursinus, MD; M.E. (Ewoud) Baarsma, MD; Amber Vrijlandt, MD; Joris Koetsveld, MD-PhD; J.J.A. (Jos) Trentelman, MASc; Abhijeet Nayak, PhD; A.P. (Alje) van Dam, MD-PhD; C.W. (Wim) Ang, MD-PhD (all Amsterdam UMC); Arieke Docters-van Leeuwen, BASc; Manoj Fonville, BASc; Ankje de Vries, BASc; Lola Tulen, BASc; (all RIVM). Protocol version 1: 02-01-2018 Protocol version 2: 06-02-2018 Protocol version 3: 13-02-2018 Recruitment started: 16-04-2018 Funding Information: This study is funded by the Netherlands Organization for Health Research and Development (ZonMw, project number 52200–30-07), which has a peer-reviewed the grant application. It was additionally made possible by a small donation through the AMC Foundation (amcfoundation.nl). JWH and HS are supported by the NorthTick, European Union, European Regional Development Fund, in the North Sea Region Programme. None of the funding organizations had or will have any role in the design or the data analysis and interpretation of the study. Publisher Copyright: © 2021, The Author(s).
PY - 2021/12/1
Y1 - 2021/12/1
N2 - Background: Tick-borne pathogens other than Borrelia burgdorferi sensu lato – the causative agent of Lyme borreliosis – are common in Ixodes ricinus ticks. How often these pathogens cause human disease is unknown. In addition, diagnostic tools to identify such diseases are lacking or reserved to research laboratories. To elucidate their prevalence and disease burden, the study ‘Ticking on Pandora’s Box’ has been initiated, a collaborative effort between Amsterdam University Medical Center and the National Institute for Public Health and the Environment. Methods: The study investigates how often the tick-borne pathogens Anaplasma phagocytophilum, Babesia species, Borrelia miyamotoi, Neoehrlichia mikurensis, spotted fever group Rickettsia species and/or tick-borne encephalitis virus cause an acute febrile illness after tick-bite. We aim to determine the impact and severity of these tick-borne diseases in the Netherlands by measuring their prevalence and describing their clinical picture and course of disease. The study is designed as a prospective case-control study. We aim to include 150 cases – individuals clinically suspected of a tick-borne disease – and 3 matched healthy control groups of 200 persons each. The controls consist respectively of a group of individuals with either a tick-bite without complaints, the general population and of healthy blood donors. During a one-year follow-up we will acquire blood, urine and skin biopsy samples and ticks at baseline, 4 and 12 weeks. Additionally, participants answer modified versions of validated questionnaires to assess self-reported symptoms, among which the SF-36, on a 3 monthly basis. Discussion: This article describes the background and design of the study protocol of ‘Ticking on Pandora’s Box’. With our study we hope to provide insight into the prevalence, clinical presentation and disease burden of the tick-borne diseases anaplasmosis, babesiosis, B. miyamotoi disease, neoehrlichiosis, rickettsiosis and tick-borne encephalitis and to assist in test development as well as provide recommendations for national guidelines. Trial registration: NL9258 (retrospectively registered at Netherlands Trial Register, trialregister.nl in in February 2021).
AB - Background: Tick-borne pathogens other than Borrelia burgdorferi sensu lato – the causative agent of Lyme borreliosis – are common in Ixodes ricinus ticks. How often these pathogens cause human disease is unknown. In addition, diagnostic tools to identify such diseases are lacking or reserved to research laboratories. To elucidate their prevalence and disease burden, the study ‘Ticking on Pandora’s Box’ has been initiated, a collaborative effort between Amsterdam University Medical Center and the National Institute for Public Health and the Environment. Methods: The study investigates how often the tick-borne pathogens Anaplasma phagocytophilum, Babesia species, Borrelia miyamotoi, Neoehrlichia mikurensis, spotted fever group Rickettsia species and/or tick-borne encephalitis virus cause an acute febrile illness after tick-bite. We aim to determine the impact and severity of these tick-borne diseases in the Netherlands by measuring their prevalence and describing their clinical picture and course of disease. The study is designed as a prospective case-control study. We aim to include 150 cases – individuals clinically suspected of a tick-borne disease – and 3 matched healthy control groups of 200 persons each. The controls consist respectively of a group of individuals with either a tick-bite without complaints, the general population and of healthy blood donors. During a one-year follow-up we will acquire blood, urine and skin biopsy samples and ticks at baseline, 4 and 12 weeks. Additionally, participants answer modified versions of validated questionnaires to assess self-reported symptoms, among which the SF-36, on a 3 monthly basis. Discussion: This article describes the background and design of the study protocol of ‘Ticking on Pandora’s Box’. With our study we hope to provide insight into the prevalence, clinical presentation and disease burden of the tick-borne diseases anaplasmosis, babesiosis, B. miyamotoi disease, neoehrlichiosis, rickettsiosis and tick-borne encephalitis and to assist in test development as well as provide recommendations for national guidelines. Trial registration: NL9258 (retrospectively registered at Netherlands Trial Register, trialregister.nl in in February 2021).
KW - Fever after tick-bite
KW - Hard tick-borne fever
KW - Ixodes ricinus ticks
KW - Prospective case-control study
KW - Study protocol
KW - Tick-borne diseases
KW - Tick-borne pathogens
UR - http://www.scopus.com/inward/record.url?scp=85107250321&partnerID=8YFLogxK
U2 - https://doi.org/10.1186/s12879-021-06190-9
DO - https://doi.org/10.1186/s12879-021-06190-9
M3 - Article
C2 - 34051756
SN - 1471-2334
VL - 21
JO - BMC Infectious Diseases
JF - BMC Infectious Diseases
IS - 1
M1 - 501
ER -