Seroprevalence of Borrelia burgdorferi infection among forestry workers and farmers in Duzce, north-western Turkey

Borrelia burgdorferi infection is the most frequent tick-transmitted disease worldwide. Our aim was to assess the seroprevalence of B. burgdorferi infection among forestry workers and farmers in Duzce, in the north-west region of Turkey. Blood samples from 349 forestry workers and farmers and 193 healthy blood donors were obtained to determine the presence of antibodies to B. burgdorferi. A two-step testing strategy was used; the sera were initially tested by ELISA and then by Western blot (WB) IgG. Demographic data regarding residence, age, gender, profession, tick bite history, contact with animals, and symptoms involving the skin, nervous system, and osteoarticular system were collected by questionnaire. All results were evaluated statistically using the chi2 test. The seroprevalence of B. burgdorferi was 10.9% (n=38) in forestry workers and farmers and 2.6% (n=5) in blood donors by ELISA, with a statistically significant difference (p<0.001). Seropositivity rates were related to age, gender, and common risk factors for the disease. IgG seropositivity was confirmed in four (1.1%) sera by WB. In this first seroepidemiological report from the northwest region of Turkey, tick bite exposure was found to be high, whereas B. burgdorferi infection was not common. Preventive measures against tick exposure and further studies to determine the distribution of Lyme disease in Turkey are proposed.