Abstract:
Introduction. Tick-borne infections (TBIs) are increasingly recognized as a public health concern in North America and
Europe, with Lyme disease being the most notable. The Centers for Disease Control and Prevention (CDC) acknowledges
that official statistics likely underestimate the true incidence of TBIs due to diagnostic challenges and underreporting.
Co-infections, where multiple pathogens are transmitted through a single tick bite or multiple bites, complicate diagnosis
and treatment, leading to more severe symptoms and longer illness durations. Studies indicate a significant percentage of
Lyme disease patients also have co-infections, with babesiosis being a common co-infection.
Materials and methods. A comprehensive narrative literature review was conducted using PubMed and Scopus, resulting
in 52 manuscripts. Additional reports from the CDC and European Centre for Disease Prevention and Control (ECDC), as
well as relevant academic books, were included to meet the study’s objectives. The Elicit platform was utilized to enhance
reference identification and information synthesis.
Results. The paper provides an overview of tick-borne co-infections, emphasizing the diagnostic challenges posed by overlapping and nonspecific symptoms. It discusses various diseases, including Lyme disease, babesiosis, anaplasmosis, ehrlichiosis, Rocky Mountain spotted fever, and tick-borne encephalitis, detailing their causative organisms, vectors, clinical
features, and common co-infections. The review critically examines diagnostic methods such as serological tests, molecular
tests, and blood smears, highlighting issues like the „window period” false negatives/positives, and differentiating active
from past infections. It also explores emerging technologies and biomarkers, including multiplex assays and next-generation sequencing, which enhance detection capabilities but face challenges in data analysis and standardization.
Conclusions. Accurate diagnosis is crucial to manage these infections effectively, particularly in vulnerable populations.
The rise in co-infections and inadequate testing presents a significant public health challenge, necessitating improved surveillance and diagnostic approaches.
