Public Health Impact of Strain Specific Immunity to Borrelia Burgdorferi

Authors

Camilo E. Khatchikian, Evolution and Ecology of Disease Systems Laboratory, Department of Biology, University of Pennsylvania, Philadelphia, PA, USA. camilok@sas.upenn.edu.
Robert B. Nadelman, Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY, USA. robert_nadelman@nymc.edu.
John Nowakowski, Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY, USA. john_nowakowski@nymc.edu.
Ira Schwartz, Department of Microbiology and Immunology, New York Medical College, Valhalla, NY, USA. ira_schwartz@nymc.edu.
Michael Z. Levy, Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA. mzlevy@mail.med.upenn.edu.
Dustin Brisson, Evolution and Ecology of Disease Systems Laboratory, Department of Biology, University of Pennsylvania, Philadelphia, PA, USA. dbrisson@sas.upenn.edu.
Gary P. Wormser, Division of Infectious Diseases, Department of Medicine, New York Medical College, Valhalla, NY, USA. gwormser@nymc.edu.

Author Type(s)

Faculty

DOI

10.1186/s12879-015-1190-7

Journal Title

BMC Infectious Diseases

First Page

472

Document Type

Article

Publication Date

10-26-2015

Abstract

BACKGROUND: Lyme disease, caused by Borrelia burgdorferi, is the most common tick-borne infection in the United States. Although humans can be infected by at least 16 different strains of B. burgdorferi, the overwhelming majority of infections are due to only four strains. It was recently demonstrated that patients who are treated for early Lyme disease develop immunity to the specific strain of B. burgdorferi that caused their infection. The aim of this study is to estimate the reduction in cases of Lyme disease in the United States that may occur as a result of type specific immunity. METHODS: The analysis was performed based on three analytical models that assessed the effects of type specific immunity. Observational data on the frequency with which different B. burgdorferi strains cause human infection in culture-confirmed patients with an initial episode of erythema migrans diagnosed between 1991 and 2005 in the Northeastern United States were used in the analyses. RESULTS: Assuming a reinfection rate of 3 % and a total incidence of Lyme disease per year of 300,000, the estimated number of averted cases of Lyme disease per year ranges from 319 to 2378 depending on the duration of type specific immunity and the model used. CONCLUSION: Given the assumptions of the analyses, this analysis suggests that type specific immunity is likely to have public health significance in the United States.

Recommended Citation

Khatchikian, C. E., Nadelman, R. B., Nowakowski, J., Schwartz, I., Levy, M. Z., Brisson, D., & Wormser, G. P. (2015). Public Health Impact of Strain Specific Immunity to Borrelia Burgdorferi. BMC Infectious Diseases, 15, 472. https://doi.org/10.1186/s12879-015-1190-7