Introduction
Lyme borreliosis is the most prevalent tick-borne infection in the North hemisphere. It is a chronic and multisystem infectious disease caused by several species of Borrelia burgdorferi sensu lato complex.
Three main species are known to cause the disease in Europe, namely Borrelia afzelii, Borrelia garinii, and Borrelia burgdorferi sensu stricto. The ability to cause persistent infection in humans and a wide variety of mammalian hosts is a common property of Lyme disease.Early manifestations of Lyme disease include typical skin lesion erythema migrans as a sign of early localized infection and/or unspecific flu-like symptoms, acute meningitis or meningopolyneuritis, and acute arthritis, which are signs of early disseminated infection. Late manifestations may appear as chronic neurological abnormalities, chronic arthritis, or acrodermatitis chronica atrophicans, marking late disseminated infection.
Bulgaria is endemic for Lyme borreliosis and a country with mandatory notification of the disease. The reported incidence of Lyme borreliosis in Bulgaria is about 6/100,000 of the population, but the true incidence is most probably much higher, because the disease often is self-limited and mild cases go unrecognized.
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