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Observational Study
. 2025 Oct 24;18(1):428.
doi: 10.1186/s13071-025-07078-2.

Tick-borne lymphadenopathy in northeastern France: a human and vector clinical-epidemiological study

Jeanne Kotzyba  1 , Elisabeth Baux  2 , Yves Hansmann  3 , Pierre Boyer  4 , Benoît Jaulhac  4 , Martin Martinot  5 , Benoît Martha  6 , Charlotte Kaeuffer  7 , Thomas Bonijoly  8 , Firouzé Bani-Sadr  9 , Antoine Legoff  10 , Florence Hoefler  11 , Mathieu Blot  12 , Loïc Bourdellon  13 , Laurence Zilliox  4 , Nathalie Boulanger  4 , Benjamin Lefevre  14
Affiliations
Observational Study

Tick-borne lymphadenopathy in northeastern France: a human and vector clinical-epidemiological study

Jeanne Kotzyba et al. Parasit Vectors. .

Abstract

Background: Tick-borne lymphadenopathy (TIBOLA) is a tick-borne disease transmitted by Dermacentor ticks and is usually caused by Rickettsia. In 2021, clinicians in northeastern France reported an increase in TIBOLA cases.

Methods: This entomo-clinical, multicenter, retrospective, and observational study aimed to describe the evolution of the number of TIBOLA cases between 2016 and 2021 in northeastern France as well as the evolution of the Dermacentor tick population.

Results: A total of 35 cases of TIBOLA were identified, 16 of which occurred in 2021, with clear predominance in April and May. A longitudinal study performed in the Alsace region (endemic for ticks and tick-borne diseases) revealed a peak in tick activity in 2021. A trend toward an increase in TIBOLA cases in 2021 in the northeastern region of France was observed, as was an increase in the Dermacentor tick population in some biotopes.

Conclusions: TIBOLA appears to be an emerging disease that should be monitored, as should the Dermacentor population.

Trial registration: ClinicalTrials.gov NCT05458245.

Keywords: Dermacentor; DEBONEL; Inoculation eschar; Rickettsiosis; SENLAT; TIBOLA; Tick-borne disease.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: This study complies with the principles outlined in the Declaration of Helsinki and its later amendments. This study was approved by the Nancy Hospital Ethics Committee (22 April 2022; decision no. 348). Patients received complete information about the study (ClinicalTrials.gov ID NCT05458245). In accordance with French law, patient consent was not needed. Nevertheless, patients could decline to participate. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests.

Figures

Figure 1
Figure 1
Flow chart of patients retrospectively identified as TIBOLA in northeastern France between 2016 and 2021
Figure 2
Figure 2
Evolution of the number of TIBOLA cases between 2016 and 2021 in northeastern France
Figure 3
Figure 3
Spatial distribution of the locations in which patients affected by TIBOLA were bitten (or if unavailable, their place of residence)
Figure 4
Figure 4
Monthly distribution of TIBOLA cases diagnosed between 2016 and 2021 in northeastern France
Figure 5
Figure 5
Longitudinal study of the cumulative Dermacentor density at four sites in the Alsace region from 2014 to 2023
None
See this image and copyright information in PMC

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