Occurrence of Lyme disease infection in a non endemic area in Northern Italy

BACKGROUND: In Italy, the incidence of human tick borne disease has increased over the last decades. Since 2015 a multidisciplinary group has been established in Sacco Hospital for the management of the patients affected by Lyme Disease (LD). A retrospective evaluation (2015-2017) was performed for LD in non-endemic areas. METHODS: Retrospective analysis of all 1000 samples for 800 patients screened for LD antibodies at the Sacco Hospital in 3 years (2015-2017). Revision of clinical et epidemiological patients data available and correlation with the serological results. RESULTS: Among the 800 patients screened only 134 of them were diagnosed with borreliosis: 37 cases during 2015, 31 during 2016 and 66 during 2017. Localized Lyme disease was diagnosed of 134 cases (69%): in most of them (N=63) erythema migrans (EM) has been documented; in 37 out of 100 it was not possible to detect it. In only three cases, patients complained of different clinicalì symptoms such as headache, arm and facial pain respectively. 23 out of 144 cases (16%) showed a persistence of serological positivity and symptoms with osteomuscular involvement and fatigue, despite the therapy (Late Lyme disease). In that same study 11 out of 144 patients (7%) received a diagnosis of neuroborreliosis. CONCLUSIONS: Our data reported an high percentage of Lyme Disease infection (19%) in non endemic area. The definition of a multidisciplinary working group and a clinical care pathway allowed a better clinical management of Lyme disease cases treated in Sacco Hospital, Milan.