American Journal of Epidemiology Vol. 134, No. 1: 86-95
Copyright © 1991 by The Johns Hopkins University School of Hygiene and Public Health
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Anti-tick Saliva Antibody: A Biologic Marker of Tick Exposure That Is a Risk Factor for Lime Disease Seropositivity
1 Department of Environmental Health Sciences, Division of Occupational Health, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
2 Philadelphia Naval Hospital Philadelphia, PA
3 Department of Immunology and Infectious Diseases, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
4 Department of Epidemiology, The Johns Hopkins University School of Hygiene and Public Health Baltimore, MD
5 Occupational Medicine Department, Navy Environmental Health Center Norfolk, VA
Reprint requests to Dr. Brian S. Schwartz, Division of Occupational Health, The Johns Hopkins University School of Hygiene and Public Health, 615 North Wolfe Street, Room 7041, Baltimore, MD 21205.
Anti-tick saliva antibody (ATSA) has potential as a biologic marker of exposure to tick bites. In 1989, we conducted a cross-sectional study of 304 outdoor workers in Monmouth County, New Jersey, to evaluate associations between self-reported tick exposure, ATSA status, and Lyme disease antibody status. ATSA levels 1) were correlated with an index of tick exposure on the basis of three self-reported measures of tick exposure and outdoor hours worked per week (p = 0.01); 2) were consistently higher in pet owners compared with persons without pets (p = 0.03); and 3) when examined by duration since last tick bite, peaked at 3–5 weeks after tick bite and then declined (p = 0.06). ATSA levels dichotomized at the 75th percentile (approximately two standard deviations above the mean ATSA optical density of 25 subjects who denied recent tick exposure) were associated with self-reported tick exposure: adjusted odds ratios for high ATSA levels were 4.2 (95% confidence interval (Cl) 0.9–18.9) for moderate (versus none) tick exposure and 5.8 (95% Cl 1.2–27.2) for high (versus none) tick exposure. Finally, high ATSA levels were associated with Lyme disease seropositivity, with an adjusted odds ratio of 3.2 (95% Cl 1.3–7.6). The data suggest that ATSA is a biologic marker of tick exposure that is a risk factor for Lyme disease seropositivity. Am J Epidemiol 1991; 134: 86–95.
antibodies; biological markers; Borrelia; diagnostic tests; routine; Lyme disease; risk factors; ticks
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