The overall aim of this dissertation is to determine to what extent endemic tick-borne pathogens other than Lyme spirochetes cause disease and/or aggravate Lyme borreliosis in humans. The disease incidence and disease burden of tick-borne diseases other than Lyme borreliosis is unknown, mostly because of poor medical awareness and absence of (good) supportive laboratory diagnostic tools. Raising awareness and improvement of the diagnosis for tick-borne diseases other than Lyme borreliosis is only warranted when there is more knowledge about the substantial risk of acquiring these diseases. To this end, we used a multidisciplinary approach to assess prevalence, enzootic cycles, epidemiology and human exposure, infection and disease of a range of pathogens transmitted by Ixodes ricinus ticks, as the dominant tick species present in the Netherlands.

Therefore, the objectives of the thesis are:
1. Identifying the enzootic cycles and main reservoir hosts for the various tick-borne pathogens in the Netherlands transmitted by Ixodes ricinus
2. Determining the human exposure, and possibly infection and disease of tick-borne pathogens other than Lyme spirochetes

Additional Metadata
Keywords Tick-borne diseases, public health, Lyme borreliosis, Anaplasma phagocytophilum, Candidatus Neoehrlichia mikurensis, spotted fever Rickettsia, Borrelia miyamotoi, Babesia species, tick-borne encephalitis virus, Ixodes ricinus
Promotor M.P.G. Koopmans D.V.M. (Marion) , J.W.R. Hovius (Joppe) , H. Sprong (Hein)
Publisher Erasmus University Rotterdam
ISBN 978-94-6295-728-2
Persistent URL
Jahfari, S. (2017, November 3). Tick-borne Diseases: Opening Pandora’s Box. Erasmus University Rotterdam. Retrieved from