LYME-DISEASE IN ITALY, 1983-1996

This paper is a brief review of the epidemiology of Lyme disease in It aly. The first case of the illness was identified by Crovato in Liguri a in 1983. In the following years, many other cases have been reported from all Italian regions with the exception of Valle d'Aosta, Basilic ata and Calabria. The exact number of cases in our country is not know n because Lyme disease was not a notifiable disease until 1990, but on the basis of literature data, at least 1324 cases have been observed in the fourteen-year period 1983-1996. Friuli-Venezia Giulia, Veneto a nd Trentino-Alto Adige are the main regions involved. Only few cases o f illness have been described in Mid and Southern Italy and in the Isl ands (6.0%). No reports exist on Lyme disease in animals. There is, ho wever, serological evidence of infection of domestic and wild animals. The causative agent, Borrelia burgdorferi sensu late, was first isola ted from Ixodes ricinus ticks by Cinco in Trieste in 1977. Since then many other strains, belonging to three different genomic species (B. b urgdorferi sensu stricto, B. garinii and B. afzelii), have been isolat ed from humans, reservoir hosts and ticks. Cases were reported for all age-groups, more frequently in females, following the typical seasona l course, with a marked seasonality from spring to autumn, when ticks are more active. Erythema chronicum migrans was the most frequent mani festation of LD. Several studies have been conducted on groups at risk (forest workers, gamekeepers, etc.). In contrast to the high prevalen ce of antibodies to B. burgdorferi sensu late in the groups at risk (u p to 27.2% for forest workers), the seroprevalence of the healthy popu lation is, in general, lower.