{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T10:31:39Z","timestamp":1790159499254,"version":"4.1.0"},"reference-count":41,"publisher":"Elsevier BV","issue":"1","license":[{"start":{"date-parts":[[2020,1,1]],"date-time":"2020-01-01T00:00:00Z","timestamp":1577836800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2019,9,30]],"date-time":"2019-09-30T00:00:00Z","timestamp":1569801600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"EU\u2019s Interreg V Program","award":["20200422"],"award-info":[{"award-number":["20200422"]}]},{"name":"Swedish Research Council Branch of Medicine","award":["K2008-58X-14631-06-3"],"award-info":[{"award-number":["K2008-58X-14631-06-3"]}]},{"DOI":"10.13039\/100010805","name":"Medical Research Council of Southeast Sweden","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010805","id-type":"DOI","asserted-by":"publisher"}]},{"name":"ALF funds from the County Council of \u00d6sterg\u00f6tland","award":["LIO-56191"],"award-info":[{"award-number":["LIO-56191"]}]},{"DOI":"10.13039\/501100011958","name":"Independent Research Fund Denmark","doi-asserted-by":"publisher","award":["8020-00344B"],"award-info":[{"award-number":["8020-00344B"]}],"id":[{"id":"10.13039\/501100011958","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010113","name":"Wilhelm and Else Stockmann Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010113","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Foundation for \u00c5land Medical Research of the \u00c5land Culture Foundation"}],"content-domain":{"domain":["elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Ticks and Tick-borne Diseases"],"published-print":{"date-parts":[[2020,1]]},"DOI":"10.1016\/j.ttbdis.2019.101303","type":"journal-article","created":{"date-parts":[[2019,9,22]],"date-time":"2019-09-22T13:32:42Z","timestamp":1569159162000},"page":"101303","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":17,"title":["Emerging tick-borne pathogens in the Nordic countries: A clinical and laboratory follow-up study of high-risk tick-bitten individuals"],"prefix":"10.1016","volume":"11","author":[{"given":"Lukas Frans","family":"Ocias","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Wilhelmsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johanna","family":"Sj\u00f6wall","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna Jonsson","family":"Henningsson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marika","family":"Nordberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charlotte Sv\u00e6rke","family":"J\u00f8rgensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen Angeliki","family":"Krogfelt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pia","family":"Forsberg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Per-Eric","family":"Lindgren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"78","reference":[{"key":"10.1016\/j.ttbdis.2019.101303_bib0005","doi-asserted-by":"crossref","first-page":"438","DOI":"10.1089\/vbz.2012.1118","article-title":"Co-infection with \u201cCandidatus Neoehrlichia Mikurensis\u201d and Borrelia afzelii in Ixodes ricinus ticks in southern Sweden","volume":"13","author":"Andersson","year":"2013","journal-title":"Vector Borne Zoonotic Dis. Larchmt. N"},{"key":"10.1016\/j.ttbdis.2019.101303_bib0010","first-page":"65","article-title":"Presence of potentially pathogenic Babesia sp. for human in Ixodes ricinus in Switzerland","volume":"13","author":"Casati","year":"2006","journal-title":"Ann. Agric. Environ. Med. AAEM"},{"key":"10.1016\/j.ttbdis.2019.101303_bib0015","doi-asserted-by":"crossref","first-page":"1127","DOI":"10.3201\/eid1607.091907","article-title":"Septicemia caused by tick-borne bacterial pathogen Candidatus Neoehrlichia mikurensis","volume":"16","author":"Fehr","year":"2010","journal-title":"Emerg. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0020","doi-asserted-by":"crossref","first-page":"816","DOI":"10.1128\/JCM.42.2.816-818.2004","article-title":"Aneruptive fever associated with antibodies to Rickettsia helvetica in Europe and Thailand","volume":"42","author":"Fournier","year":"2004","journal-title":"J. Clin. Microbiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0025","doi-asserted-by":"crossref","first-page":"389","DOI":"10.3201\/eid0604.000412","article-title":"Evidence of Rickettsia helvetica infection in humans, eastern France","volume":"6","author":"Fournier","year":"2000","journal-title":"Emerg. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0030","doi-asserted-by":"crossref","first-page":"643","DOI":"10.1016\/j.annepidem.2007.03.013","article-title":"Participation rates in epidemiologic studies","volume":"17","author":"Galea","year":"2007","journal-title":"Ann. Epidemiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0035","doi-asserted-by":"crossref","first-page":"1462","DOI":"10.3201\/eid2108.150060","article-title":"Infections with CandidatusNeoehrlichia mikurensis and Cytokine Responses in 2 Persons Bitten by Ticks, Sweden","volume":"21","author":"Grankvist","year":"2015","journal-title":"Emerg. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0040","doi-asserted-by":"crossref","first-page":"1519","DOI":"10.1128\/jcm.32.6.1519-1525.1994","article-title":"Serological follow-up after treatment of patients with erythema migrans and neuroborreliosis","volume":"32","author":"Hammers-Berggren","year":"1994","journal-title":"J. Clin. Microbiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0045","doi-asserted-by":"crossref","first-page":"545","DOI":"10.1128\/jcm.27.3.545-551.1989","article-title":"Serodiagnosis of erythema migrans and acrodermatitis chronica atrophicans by the Borrelia burgdorferi flagellum enzyme-linked immunosorbent assay","volume":"27","author":"Hansen","year":"1989","journal-title":"J. Clin. Microbiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0050","doi-asserted-by":"crossref","first-page":"996","DOI":"10.3201\/eid2505.171751","article-title":"Value of PCR, serology, and blood smears for human granulocytic anaplasmosis diagnosis, France","volume":"25","author":"Hansmann","year":"2019","journal-title":"Emerg. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0055","doi-asserted-by":"crossref","first-page":"153","DOI":"10.1186\/s12866-015-0486-5","article-title":"Detection of Anaplasma phagocytophilum in Ixodes ricinus ticks from Norway using a realtime PCR assay targeting the Anaplasma citrate synthase gene gltA","volume":"15","author":"Henningsson","year":"2015","journal-title":"BMC Microbiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0060","doi-asserted-by":"crossref","first-page":"1485","DOI":"10.3201\/eid2208.151962","article-title":"Human tick-borne encephalitis and characterization of virus from biting tick","volume":"22","author":"Henningsson","year":"2016","journal-title":"Emerg. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0065","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pntd.0005042","article-title":"Molecular detection of tick-borne pathogens in humans with tick bites and erythema migrans, in the Netherlands","volume":"10","author":"Jahfari","year":"2016","journal-title":"PLoS Negl. Trop. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0070","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.mimet.2008.12.012","article-title":"Evaluation of serological tests for the diagnosis of rickettsiosis in Denmark","volume":"76","author":"Kants\u00f8","year":"2009","journal-title":"J. Microbiol. Methods"},{"key":"10.1016\/j.ttbdis.2019.101303_bib0075","doi-asserted-by":"crossref","first-page":"10","DOI":"10.1016\/j.ttbdis.2015.07.016","article-title":"Babesia species in questing Ixodes ricinus, Sweden","volume":"7","author":"Karlsson","year":"2016","journal-title":"Ticks Tick-Borne Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0080","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1016\/j.ttbdis.2015.12.010","article-title":"Serological and molecular evidence for spotted fever group Rickettsia and Borrelia burgdorferi sensu lato co-infections in The Netherlands","volume":"7","author":"Koetsveld","year":"2016","journal-title":"Ticks Tick-Borne Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0085","doi-asserted-by":"crossref","first-page":"923","DOI":"10.1093\/infdis\/169.4.923","article-title":"Diagnosis of babesiosis: evaluation of a serologic test for the detection of Babesia microti antibody","volume":"169","author":"Krause","year":"1994","journal-title":"J. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0090","doi-asserted-by":"crossref","first-page":"317","DOI":"10.1007\/s10096-012-1742-3","article-title":"Seroreactivity for spotted fever rickettsiae and co-infections with other tick-borne agents among habitants in central and southern Sweden","volume":"32","author":"Lindblom","year":"2013","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis. Off. Publ. Eur. Soc. Clin. Microbiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0095","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1111\/j.1468-1331.2009.02862.x","article-title":"EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis","volume":"17","author":"Mygland","year":"2010","journal-title":"Eur. J. Neurol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0100","doi-asserted-by":"crossref","first-page":"79","DOI":"10.1016\/j.jinf.2008.06.005","article-title":"Septicaemia with Rickettsia helvetica in a patient with acute febrile illness, rash and myasthenia","volume":"58","author":"Nilsson","year":"2009","journal-title":"J. Infect."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0105","doi-asserted-by":"crossref","first-page":"490","DOI":"10.3201\/eid1603.090184","article-title":"Rickettsia helvetica in patient with meningitis, Sweden, 2006","volume":"16","author":"Nilsson","year":"2010","journal-title":"Emerg. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0110","doi-asserted-by":"crossref","first-page":"1169","DOI":"10.1016\/S0140-6736(99)04093-3","article-title":"Association of Rickettsia helvetica with chronic perimyocarditis in sudden cardiac death","volume":"354","author":"Nilsson","year":"1999","journal-title":"Lancet Lond. Engl."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0115","article-title":"Coinfection with Rickettsia helvetica and herpes simplex virus 2 in a young woman with meningoencephalitis","volume":"2011","author":"Nilsson","year":"2011","journal-title":"Case Rep. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0120","doi-asserted-by":"crossref","first-page":"3057","DOI":"10.1128\/JCM.00457-15","article-title":"Coinfection with \u201cRickettsia sibirica subsp. mongolitimonae\u201d and Rickettsia conorii in a human patient: a challenge for molecular diagnosis tools","volume":"53","author":"Nogueras","year":"2015","journal-title":"J. Clin. Microbiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0125","doi-asserted-by":"crossref","first-page":"433","DOI":"10.1097\/QCO.0000000000000298","article-title":"State of the art of diagnosis of rickettsial diseases: the use of blood specimens for diagnosis of scrub typhus, spotted fever group rickettsiosis, and murine typhus","volume":"29","author":"Paris","year":"2016","journal-title":"Curr. Opin. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0130","doi-asserted-by":"crossref","first-page":"256","DOI":"10.3201\/eid1202.050900","article-title":"Rickettsial infections and fever, Vientiane, Laos","volume":"12","author":"Phongmany","year":"2006","journal-title":"Emerg. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0135","doi-asserted-by":"crossref","first-page":"715","DOI":"10.1016\/j.ttbdis.2017.05.004","article-title":"Candidatus Neoehrlichia mikurensis and Borrelia burgdorferi sensu lato detected in the blood of Norwegian patients with erythema migrans","volume":"8","author":"Quarsten","year":"2017","journal-title":"Ticks Tick-Borne Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0140","first-page":"69","article-title":"Lyme borreliosis: clinical case definitions for diagnosis and management in Europe","volume":"17","author":"Stanek","year":"2011","journal-title":"Clin. Microbiol. Infect. Off. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0145","doi-asserted-by":"crossref","first-page":"1083","DOI":"10.4269\/ajtmh.2005.73.1083","article-title":"A highly sensitive and specific real-time PCR assay for the detection of spotted fever and typhus group rickettsiae","volume":"73","author":"Stenos","year":"2005","journal-title":"Am. J. Trop. Med. Hyg."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0150","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1016\/j.ttbdis.2018.10.007","article-title":"High seroprevalence of Babesia antibodies among Borrelia burgdorferi-infected humans in Sweden","volume":"10","author":"Svensson","year":"2019","journal-title":"Ticks Tick-Borne Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0155","doi-asserted-by":"crossref","first-page":"708","DOI":"10.1128\/CMR.00011-06","article-title":"Coinfections acquired from Ixodes ticks","volume":"19","author":"Swanson","year":"2006","journal-title":"Clin. Microbiol. Rev."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0160","doi-asserted-by":"crossref","first-page":"206","DOI":"10.11150\/kansenshogakuzasshi1970.81.206","article-title":"Pediatric pneumonia, pleural effusion, and pericarditis following cat scratch disease and serological cross-reactions among Bartonella henselae and Rickettsia japonica determined by indirect fluorescence antibodies","volume":"81","author":"Takeda","year":"2007","journal-title":"Kansenshogaku Zasshi"},{"key":"10.1016\/j.ttbdis.2019.101303_bib0165","doi-asserted-by":"crossref","first-page":"379","DOI":"10.3201\/eid1603.090443","article-title":"Bartonella spp. transmission by ticks not established","volume":"16","author":"Telford","year":"2010","journal-title":"Emerg. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0170","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1186\/1756-3305-6-347","article-title":"Co-infection of Borrelia burgdorferi sensu lato and Rickettsia species in ticks and in an erythema migrans patient","volume":"6","author":"Tijsse-Klasen","year":"2013","journal-title":"Parasit. Vectors"},{"key":"10.1016\/j.ttbdis.2019.101303_bib0175","doi-asserted-by":"crossref","first-page":"541","DOI":"10.3109\/00365549209052642","article-title":"First documented case of human babesiosis in Sweden","volume":"24","author":"Uhnoo","year":"1992","journal-title":"Scand. J. Infect. Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0180","doi-asserted-by":"crossref","first-page":"2630","DOI":"10.1128\/JCM.00588-10","article-title":"Detection of \u201cCandidatus Neoehrlichia mikurensis\u201d in two patients with severe febrile illnesses: evidence for a European sequence variant","volume":"48","author":"von Loewenich","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0185","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1016\/j.ttbdis.2011.11.003","article-title":"Prevalence of Rickettsia spp., Anaplasma phagocytophilum, and Coxiella burnetii in adult Ixodes ricinus ticks from 29 study areas in central and southern Sweden","volume":"3","author":"Wallm\u00e9nius","year":"2012","journal-title":"Ticks Tick-Borne Dis."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0190","doi-asserted-by":"crossref","first-page":"3072","DOI":"10.1128\/JCM.00741-14","article-title":"Asymptomatic \u201cCandidatus Neoehrlichia mikurensis\u201d infections in immunocompetent humans","volume":"52","author":"Welc-Fal\u0119ciak","year":"2014","journal-title":"J. Clin. Microbiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0195","doi-asserted-by":"crossref","first-page":"4169","DOI":"10.1128\/JCM.01061-10","article-title":"Prevalence and diversity of Borrelia species in ticks that have bitten humans in Sweden","volume":"48","author":"Wilhelmsson","year":"2010","journal-title":"J. Clin. Microbiol."},{"key":"10.1016\/j.ttbdis.2019.101303_bib0200","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0081433","article-title":"Prevalence, diversity, and load of Borrelia species in ticks that have fed on humans in regions of Sweden and \u00c5land Islands, Finland with different Lyme borreliosis incidences","volume":"8","author":"Wilhelmsson","year":"2013","journal-title":"PLoS One"},{"key":"10.1016\/j.ttbdis.2019.101303_bib0205","doi-asserted-by":"crossref","first-page":"8","DOI":"10.1056\/NEJM199307013290102","article-title":"Cat scratch disease in Connecticut. Epidemiology, risk factors, and evaluation of a new diagnostic test","volume":"329","author":"Zangwill","year":"1993","journal-title":"N. Engl. J. Med."}],"container-title":["Ticks and Tick-borne Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877959X1930278X?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1877959X1930278X?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2022,7,17]],"date-time":"2022-07-17T20:19:35Z","timestamp":1658089175000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1877959X1930278X"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1]]},"references-count":41,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,1]]}},"alternative-id":["S1877959X1930278X"],"URL":"https:\/\/doi.org\/10.1016\/j.ttbdis.2019.101303","relation":{},"ISSN":["1877-959X"],"issn-type":[{"value":"1877-959X","type":"print"}],"subject":[],"published":{"date-parts":[[2020,1]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"Emerging tick-borne pathogens in the Nordic countries: A clinical and laboratory follow-up study of high-risk tick-bitten individuals","name":"articletitle","label":"Article Title"},{"value":"Ticks and Tick-borne Diseases","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.ttbdis.2019.101303","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2019 The Authors. Published by Elsevier GmbH.","name":"copyright","label":"Copyright"}],"article-number":"101303"}}