National Tick bites study

The last ten years we have observed an increase of hospitalisations for Lyme
disease and a threefold increase was seen of general practitioner consults for
tick bites and erythema migrans. Study results of ticks collected in the field
in 2001, 2002, 2003 and 2004 showed that ticks in the Netherlands were not only
contaminated with Borrelia, but also with other tick-borne micro-organisms such
as Ehrlichia, Rickettsia en Babesia. Like in other European countries, this
suggests an increasing risk of ticks being contaminated with these
micro-organisms. This poses an increasing but unknown threat for public health.

To gain insight in the risk of transmission of tick-borne micro-organisms
Borrelia, Ehrlichia, Rickettsia and Babesia to humans and to gain insight in
risk factors.

Patients will be invited to the study by their own general practitioner (GP)
when they consult their GP for a tick bite or erythema migrans.
If the tick was taken by the participant, it's sent to the RIVM for
determination of micro-organisms.
A first questionnaire gives insight into risk factors for tick bites and Lyme
disease.
7 ml blood for nul-serology (Borrelia), and 5 ml blood for PCR are collected
by means of a first venapuncture.

The participant returns to the GP in 10 to 12 weeks to receive a second study
kit.
A second questionnaire gives insight into the course of illness since the first
consult.
7 ml blood for serology (Borrelia) is collected by means of a first
venapuncture, to compare for seroconversion with the nul-serology.

The GP of a participant will only receive testresults in case of
seroconversion, on condition that the participant has provided permission. In
all other cases no test results will be communicated, unless the GP explicitly
asks for it.

The participant will be asked twice to fill in a questionnaire and to give
blood twice(a total of 2 tubes of 7 ml, and one tube of 5 ml)

Total time investment for the participant: 1 hour.