Lyme Borreliosis, Po River Valley, Italy

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Volume 16, Number 8–August 2010
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Lyme Borreliosis, Po River Valley, Italy
Dario Pistone,1 Massimo Pajoro,1 Massimo Fabbi, Nadia Vicari, Piero Marone, Claudio Genchi, Stefano Novati, Davide Sassera, Sara Epis, and Claudio Bandi
Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico San Matteo, Pavia, Italy (D. Pistone, P. Marone, S. Novati); Istituto Zooprofilattico Sperimentale della Lombardia e dell'Emilia Romagna, Pavia (M. Pajoro, M. Fabbi, N. Vicari); and Università degli Studi di Milano, Milano, Italy (C. Genchi, D. Sassera, S. Epis, C. Bandi)

Suggested citation for this article

Abstract
We aimed to determine the presence of Ixodes ricinusticks in heavily populated areas of the Po River Valley after report of a Lyme disease case. Eighteen percent of ticks examined from 3 locations were positive for Lyme disease borreliae. Lyme disease was diagnosed for 3 workers at risk for tick bite.

Lyme disease, caused by Borrelia burgdorferisensu lato (1), is endemic to various areas of Italy (2). The main vector of Lyme disease in Italy is the hard tick (Ixodes ricinus), a species widespread in mountain regions populated by wild ungulates (2). Residents of these areas and forestry workers are at risk for Lyme disease (3). Heavily populated flat regions are not considered as risk areas. For example, I. ricinusticks have never been reported in the flat areas of the Po River Valley in the Lombardy region, one of the most important industrial districts in Europe and an area of intensive agriculture and livestock breeding. Human population density is high; >6 million persons reside in Milano and surrounding counties. In areas of Italy to which I. ricinusticks are known to be endemic, physicians have appropriate awareness of the risks from tick bite and Lyme disease; outside these areas, awareness probably is not adequate.

In late spring 2008, a forestry worker at a natural park west of Milano in the Po River Valley was treated for cutaneous mycosis on the basis of an erythematous rash on an arm. In August 2008, this patient described this skin alteration to one of us (C.B.). Subsequent clinical examination and serologic analyses led to diagnosis of Lyme disease. Because of this case, we investigated different areas of the park for ticks; collected ticks were screened by PCR for Lyme borreliae. We conducted a retrospective analysis of forestry workers in the area; 2 workers reporting the appearance of erythematous rash in the previous months underwent serologic analyses.

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Suggested Citation for this Article
Pistone D, Pajoro M, Fabbi M, Vicari N, Marone P, Genchi C, et al. Lyme borreliosis, Po River Valley, Italy. Emerg Infect Dis [serial on the Internet]. 2010 Aug [date cited]. http://www.cdc.gov/EID/content/16/8/1289.htm

DOI: 10.3201/eid1608.100152

1These authors contributed equally to this article.