Lyme Borreliosis is a worldwide infectious disease causing a multisystem illness with considerable morbidity, particularly in North America and Europe. The causative agent is the spirochaete Borrelia burgdorferi, which is usually transmitted by the ixodid tick from animal reservoirs. This book is formed by contributions from the Second European Symposium on Lyme Borreliosis, held at St George's Hospital Medical School, London in 1993, which reviewed the current state of knowledge of the condition with regard to clinical manifestations, diagnosis, treatment, ecology, epidemiology, biology and immunopathogenesis. In this book, important data is reviewed concerning the clinical manifestations of Lyme Borreliosis. It seems that strain variation of the spirochaete is the main cause of regional differences seen in the clinical presentation of patients. One striking example of this, is the relatively high incidence of Lyme arthritis in the USA and apparent rarity of this manifestion in some areas of Europe. These important studies open the way for exciting new research that focuses on the immunological and molecular mechanisms that result in disease. A full insight into the ecology of Borrelia burgdorferi is essential to a balanced understanding of the disease and a number of excellent reviews on this subject are included. Significant advances with regard to the biology of Borrelia burgdorjeri and the immunopathogenic mechanisms that result in disease have been made, enabling the role of the Band T lymphocytes in disease to be established and the development of sophisticated phenotyping methods, improved diagnostic tests and effective vaccines.

The Henry Fuller Lecture Pathogenesis, Diagnosis and Treatment of Lyme Arthritis.- Clinical Manifestations and Treatment.- Clinical Manifestations of Lyme Borreliosis in an Italian Endemic Region.- Lyme Borreliosis in Children.- Lyme Carditis.- A Recombinant OspA and OspB Based Lyme Disease Vaccine.- Acrodermatitis Chronica Atrophicans and Lyme Arthritis: Study of Czech Lyme Borreliosis Patients Having both Syndromes.- Aspects of Lyme Carditis.- Borrelia Burgdorferi Shown by PCR from Skin Biopsy Specimen After a Fly Bite.- Lyme Arthritis: Experience from Somerset, England.- No Evidence to Implicate Borrelia Burgdorferi in the Pathogenesis of Dilated Cardiomyopathy in the UK.- Evidence for Lyme Disease in Urban Park Workers: A Potential New Health Hazard for City Inhabitants.- Management of a Deer Tick Bite.- Ecology & Epidemiology.- Lyme Borreliosis in Australia.- Geographic Diversity of Lyme Borreliosis.- Parallelism Between Lyme and Tick-Borne Encephalitis (TBE) Sero-Epidemiology Following Occupational Exposure in South Germany.- Investigation of Genetic Changes Associated with Attenuation of Borrelia Burgdorferi by In Vitro Cultivation.- Phytoecological Mapping of Ixodes Ricinus as an Approach to the Distribution of Lyme Borreliosis in France.- The Ecology of Lyme Borreliosis in Sweden.- Lyme Disease in Scotland - Results of a Serological Study in Sheep.- The Ecology of Lyme Borreliosis in the UK.- The relative Contributions of Transovarial and Transstadial Transmission to the Maintenance of Tick-Borne Diseases.- Epidemiology of Lyme Disease in Italy.- Role of Host Density in the Ecology of Lyme Disease.- Borrelia Burgdorferi Studies in Man and Ticks in Scotland.- Biology and Immunopathogenesis.- Expression of Public Idiotypes in Patients with Lyme Arthritis.-Cellular Immune Reactions to Borrelia Burgdorferi - The T-cell-Macrophage Axis.- OspB Sequence Variation to Borrelia Burgdorferi along the Coast of Maine.- Multiple Amino Acid Sequence Alignment of the Major Outer Surface Proteins OspA and OspB of Various Borrelia Burgdorferi Strains.- Lyme Disease in an Experimental Cat Model.- Borrelia Burgdorferi Infection in Mice: Aspects of Inflammation and Immune Responses.- Chemotaxonomy of Borrelia.- Phenotypic and Genotypic Analysis of Chinese Borrelia Burgdorferi from Various Sources.- Lyme Disease in an Experimental Mouse Model.- Sectional Uptake and Cytosolic Processing of Borrelia Burgdorferi by Human Phagocytes.- Physical and Genetic Maps of the Borrelia Burgdorferi Sensu Lato Chromosomes.- Repeated DNA Sequences on Circular and Linear Plasmids of Borrelia Burgdorferi Sensu Lato.- Biochemical and Immunological Analysis of a Polymorphie Low-Molecular-Weight Lipoprotein of Borrelia Burgdorferi.- Diagnosis.- Detection of Lyme Disease Spirochaete DNA in Clinical Samples.- Clinical and Serological Study of Lyme Borreliosis in a Population of Neurological Patients.- Pitfalls in the Laboratory Diagnosis of Lyme Borreliosis.- Serodiagnosis of Lyme Disease in the UK.- PCR-Based Detection of CSF Borrelia Burgdorferi as a Predictor of Treatment Response in CNS Lyme Borreliosis.- Diagnostic Detection of Borrelia Burgdorferi DNA by the Polymerase Chain Reaction (PCR).- Improved Detection of Immunoglobulin M in Sera of Erythema Migrans Patients by Western Blotting with a Local Borrelia Burgdorferi Skin Isolate.- Differentiation of Borrelia burgdorferi Isolates from Ticks and Humans by Different Monoclonal Antibodies in Immunofluorescence.- The use of PCR in the Direct Detection of Borrelia Burgdorferi from Ixodes Dammini.- BorreliaBurgdorferi Detected in the Blood, Synovium and Skin of Patients with Lyme Arthritis.