LYME-DISEASE IN AN ENDEMIC ZONE IN EUROPE - ANTIBODY PREVALENCE AND CLINICAL SPECTRUM

A representative sample of the population of two villages located in an area of North Baden where borreliosis is endemic was studied to ascertain the prevalence of antibodies against Borrelia burgdorferi and of clinical abnormalities. The aim of the study was to determine what clinical symptoms and signs were correlated with positive antibody status. Out of the 2928 inhabitants 1228 were investigated, and 207 of these (16.9%) were seropositive. Certain clinical abnormalities showed highly significant statistical correlations with positive antibody status. Arthritis (defined in terms of heat, redness and effusion) was noted in 34.3% of the seropositive patients, but in only 9.3% of seronegative patients (P < 0.0001). Complaints of arthralgia were noted in 23.4% of seropositive patients and 13.3% of seronegative patients (P < 0.001). Motor neuropathies showed similar correlation with seropositive status (12.0% vs 4.0%; P < 0.001), as did sensory neuropathies (25.4% vs 6.7%; P < 0.001). Differences were also noted in the prevalence of cardiac arrhythmias (ventricular extrasystoles, conduction abnormalities and intermittent tachyarrhythmias), which were found in 19.8% of the seropositive as against 3.0% of the seronegative subjects (P < 0.001). The findings are evidence of a causal link between the listed clinical abnormalities and the presence of antibodies against Borrelia burgdorferi.