Shared Odds of Borrelia and Rabies Virus Exposure in Serbia

Pavle Banović; Adrian Alberto Díaz-Sánchez; Dragana Mijatović; Dragana Vujin; Zsolt Horváth; Nenad Vranješ; Zorana Budakov-Obradović; Nevenka Bujandrić; Jasmina Grujić; Abdul Ghafar; Abdul Jabbar; Verica Simin; Dasiel Obregón; Alejandro Cabezas-Cruz

doi:10.3390/pathogens10040399

Shared Odds of Borrelia and Rabies Virus Exposure in Serbia

Pathogens. 2021 Mar 28;10(4):399. doi: 10.3390/pathogens10040399.

Authors

Pavle Banović^{1

2}, Adrian Alberto Díaz-Sánchez³, Dragana Mijatović¹, Dragana Vujin⁴, Zsolt Horváth⁵, Nenad Vranješ⁶, Zorana Budakov-Obradović^{7

8}, Nevenka Bujandrić^{7

8}, Jasmina Grujić^{7

8}, Abdul Ghafar⁹, Abdul Jabbar⁹, Verica Simin⁵, Dasiel Obregón^{10

11}, Alejandro Cabezas-Cruz¹²

Affiliations

¹ Ambulance for Lyme Borreliosis and Other Tick-Borne Diseases, Department of Prevention of Rabies and Other Infectious Diseases, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia.
² Department of Microbiology with Parasitology and Immunology, Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia.
³ Department of Biology, University of Saskatchewan, 112 Science Place, Saskatoon, SK S7N 5E2, Canada.
⁴ National Reference Laboratory for Rabies, Department of Microbiology, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia.
⁵ Agricultural School, Maršala Tita 167, 24300 Bačka Topola, Serbia.
⁶ Department for Research & Monitoring of Rabies & Other Zoonoses, Pasteur Institute Novi Sad, 21000 Novi Sad, Serbia.
⁷ Faculty of Medicine in Novi Sad, University of Novi Sad, 21000 Novi Sad, Serbia.
⁸ Blood Transfusion Institute Vojvodina, 21000 Novi Sad, Serbia.
⁹ Department of Veterinary Biosciences, Melbourne Veterinary School, Faculty of Veterinary and Agricultural Sciences, The University of Melbourne, Werribee, VIC 3030, Australia.
¹⁰ School of Environmental Sciences, University of Guelph, Guelph, ON N1G 2W1, Canada.
¹¹ Center for Nuclear Energy in Agriculture, University of São Paulo, Piracicaba, São Paulo 13400-970, Brazil.
¹² Anses, INRAE, Ecole Nationale Vétérinaire d'Alfort, UMR BIPAR, Laboratoire de Santé Animale, F-94700 Maisons-Alfort, France.

Abstract

Lyme borreliosis (LB) is the most common tick-borne disease in Serbia and other European countries. Rabies is a fatal zoonosis distributed worldwide and is caused by the rabies virus. Professionals at risk of rabies-including veterinarians, hunters, communal service workers, and forestry workers-overlap with some professions at a higher risk of exposure to tick bites and tick-borne pathogen infections. We hypothesized that individuals identified by the public health system as at risk of rabies virus infection, and consequently vaccinated against rabies virus, also share a higher likelihood of Borrelia exposure. To test our hypothesis, a case-control study was carried out during 2019 in Serbia to determine the seroprevalence of anti-Borrelia antibodies in two case groups (individuals at risk and vaccinated against rabies virus) and a control group (individuals without risk of rabies). Individuals vaccinated against rabies following either "pre-exposure protocol" (PrEP, n = 58) or "post-exposure protocol" (PEP, n = 42) were considered as rabies risk groups and healthy blood donors (n = 30) as the control group. The results showed higher Borrelia seroprevalence in PrEP (17.2%; 10/58) and PEP (19.0%; 8/42) groups compared with the control group (6.67%; 2/30). Furthermore, odds ratio (OR) analysis showed that risk of rabies (in either the PrEP (OR = 2.91) or PEP (OR = 3.29) groups) is associated with increased odds of being seropositive to Borrelia. However, the difference in Borrelia seroprevalence between groups was not statistically significant (Chi-square (χ²) test p > 0.05). The shared odds of LB and rabies exposure found in this study suggest that, in countries where both diseases occur, the common citizen can be at risk of both diseases when in a risky habitat. These findings are important to guide physicians in targeting high-risk groups, and diagnose LB, and to guide decision-makers in targeting control and prevention measures for both infections in risk areas.

Keywords: Borrelia; exposure; rabies; relative odds; seroprevalence.