Role of birds in the biology of Lyme disease Borrelia

Sammanfattning: Lyme disease is a tick-transmitted illness caused by Borrelia burgdorferi sensu lato (s.l.), a group of spirochetes with at least three human pathogenic species, B. burgdorferi sensu stricto, B. afzelii and B. garinii. These spirochetes cycle between vertebrate reservoirs, mainly rodents, and ixodid ticks. Both terrestrial birds and seabirds can be infected with B. burgdorferi s.l. but the function of birds as reservoirs is largely unknown, even though they are potentially important epidemiologically due to their ability to carry ectoparasites and microorganisms over long distances. This thesis describes the role of birds in Lyme disease Borrelia biology in general and Borrelia ecology and epidemiology in particular.B. burgdorferi s.l. has previously been detected in the seabird tick Ixodes uriae and an enzootic Borrelia cycle distinct from terrestrial Borrelia cycles has been described. In this study B. garinii was isolated from the proposed seabird reservoirs and the tick I. uriae infesting them. The strains isolated did not show evident differences from human pathogenic B. garinii strains, indeed 7/8 strains had an ospC allele associated with Borrelia causing disseminated Lyme disease.Antibodies against B. burgdorferi s.l. were detected in people frequently bitten by I. uriae. Thus the marine enzootic Borrelia cycle may be a risk for humans, either by direct transfer of the spirochete from /. uriae or via introduction of Borrelia into a terrestrial enzootic Borrelia cycle.In order to investigate the role of passerine (Passeriformes) birds as amplification hosts in the terrestrial Borrelia cycle, experimental infections of canary finches (Serinus canaria) and redwing thrushes (Turdus iliacus) were carried out. The result showed that B. burgdorferi s.l. can persist for several months in passerine birds and the infection in redwing thrushes can be reactivated in response to migration. Thus, birds may be more infectious to ticks during their migration and therefore important long-range disseminators of B. burgdorferi s.l.Migration in birds is associated with elevated stress hormones that in turn can cause reactivation of latent infections. Lyme disease in humans could perhaps be activated when the immune response is modulated by stress. Herein I describe a patient with a stress activated latent Borrelia infection, which supports this hypothesis.The seabird tick I. uriae has a circumpolar distribution in both the northern and southern hemispheres and in this study identical B. garinii flagellin gene (flaB) sequences were detected in I. uriae from these hemispheres, indicating a transequatorial transport of B. garinii. Parsimony analysis of I. uriae ITS2 and 16S rDNA sequences suggested that northern and southern I. uriae might be reproductively separated. Therefore passive transport of infected ticks between the polar regions is unlikely and instead seabirds probably carry an active Borrelia infection during their migration.In conclusion, this work shows that migrating seabirds and passerine birds probably are important for the long-range dispersal of B. burgdorferi s.l., and that this mechanism of dispersal could be important for the distribution of human Lyme disease.