Tick-borne Diseases: Opening Pandora’s Box

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