Current Status and Challenges Associated with Tick-Borne Pathogens and Diseases: Where Do We Stand?

Abstract

Lyme Borreliosis (LB), caused by Borrelia burgdorferi sensu lato (s.l.) and transmitted by specific Ixodes spp. ticks, is the most common vector-borne disease in the United States and the most common tick-borne disease in the northern hemisphere [1,2]. Despite accepted guidelines for diagnosing LB, with specific clinical case definitions, in the absence of relevant clinical information or when faced with an atypical presentation, clinicians tend to rely on serological tests when including LB in the differential diagnosis. Serological tests for LB, conducted in accordance with the European Concerted Action on LB guidelines as part of a two-stage diagnostic process, frequently pose challenges in interpretation, especially with nonspecific clinical presentations. This is primarily attributed to the significant occurrence of false-positive results, which can be influenced by cross-reactivity with acute viral infections [3]. In this Special Issue, Wojciechowska-Koszko et al. [4] confirm that serological tests used in the diagnosis of LB can generate false-positive results in patients with acute viral infections. More precisely, tests used for the first step of the two-stage approach, such as enzyme-linked immunosorbent (ELISA) or indirect immunofluorescence (IIFT), and the immunoblot (IB) method for the second step of the two-stage diagnostic approach all showed significant cross-reactivity and positive results in patients with Epstein–Barr virus (EBV), cytomegalovirus (CMV), and BK virus (BKV) infections without clinical manifestations related to LB.