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The risk of disease associated with these microorganisms after tick-bites remains, however, largely unclear. A prospective study was performed to investigate how many persons with tick-bites develop localized or systemic symptoms and whether these are associated with tick-borne microorganisms.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>In total, 297 <jats:italic>Ixodes ricinus<\/jats:italic> ticks were collected from 246 study participants who consulted a general practitioner on the island of Ameland for tick bites. Ticks were subjected to PCR to detect DNA of <jats:italic>Borrelia burgdorferi s.l.<\/jats:italic>, <jats:italic>Rickettsia<\/jats:italic> spp., <jats:italic>Babesia<\/jats:italic> spp. or <jats:italic>Ehrlichia\/Anaplasma<\/jats:italic> spp.. Sixteen percent of the collected ticks were positive for <jats:italic>Borrelia burgdorferi s.l<\/jats:italic>., 19% for <jats:italic>Rickettsia<\/jats:italic> spp., 12% for <jats:italic>Ehrlichia<\/jats:italic>\/<jats:italic>Anaplasma<\/jats:italic> spp. and 10% for <jats:italic>Babesia<\/jats:italic> spp.. At least six months after the tick bite, study participants were interviewed on symptoms by means of a standard questionnaire. 14 out of 193 participants (8.3%) reported reddening at the bite site and 6 participants (4.1%) reported systemic symptoms. No association between symptoms and tick-borne microorganisms was found. Attachment duration \u226524 h was positively associated with reddening at the bite site and systemic symptoms. Using logistic regression techniques, reddening was positively correlated with presence of <jats:italic>Borrelia afzelii<\/jats:italic>, and having 'any symptoms' was positively associated with attachment duration.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusion<\/jats:title>\n            <jats:p>The risk of contracting acute Lyme borreliosis, rickettsiosis, babesiosis or ehrlichiosis from a single tick bite was &lt;1% in this study population.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1756-3305-4-17","type":"journal-article","created":{"date-parts":[[2011,2,10]],"date-time":"2011-02-10T13:16:23Z","timestamp":1297343783000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":49,"title":["Small risk of developing symptomatic tick-borne diseases following a tick bite in the Netherlands"],"prefix":"10.1186","volume":"4","author":[{"given":"Ellen","family":"Tijsse-Klasen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jac J","family":"Jacobs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arno","family":"Swart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manoj","family":"Fonville","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Johan H","family":"Reimerink","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Afke H","family":"Brandenburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joke WB","family":"van der Giessen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Agnetha","family":"Hofhuis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hein","family":"Sprong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2011,2,10]]},"reference":[{"key":"265_CR1","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1186\/ar2853","volume":"11","author":"HJ Girschick","year":"2009","unstructured":"Girschick HJ, Morbach H, Tappe D: Treatment of Lyme borreliosis. 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