LATE LYME BORRELIOSIS - EPIDEMIOLOGY, DIAGNOSIS AND CLINICAL-FEATURES

Lyme borreliosis is endemic in the Aland Islands. Exposure of the inha bitants to bites of the tick Ixodes ricinus is heavy. The purpose of t his study was to describe symptoms and signs of patients with late Lym e borreliosis in this area, and to correlate the findings with the epi demiological setting. The first 100 consecutive patients with late Lym e borrellosis found in the region since 1984 are included in this stud y. Neurological, articular and muscular symptoms and signs dominate. G eneral screening for Lyme disease is not recommended in the area due t o uncertainty about how to deal with seropositive healthy persons in t his heavily exposed population. The recognition and prompt treatment o f erythema migrans and other manifestations of primary Lyme borrellosi s is important in order to avoid the late stages of the disease. Treat ment of all those suffering tick-bites with an antibiotic would be an option in view of the incidence of infected ticks, but cannot be consi dered because tick-bites are extremely common among the inhabitants. T he region would be suitable for general immunization against Borrelia burgdorferi if the means for doing this becomes available in the futur e.