Lyme borreliosis in Europe

A Rizzoli,R Rosà,G Carpi,G I Vourc’H,M Neteler,H C Hauffe

doi:10.2807/ese.16.27.19906-en

A Rizzoli, R Rosà + Show 4 more

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https://doi.org/10.2807/ese.16.27.19906-en

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Journal: Eurosurveillance	Publication Date: Jul 7, 2011
Citations: 365	License type: CC BY 4.0

Affiliation: Fondazione Edmund Mach, Zero to Three

Abstract

Despite improvements in prevention, diagnosis and treatment, Lyme borreliosis (LB) is still the most common arthropod-borne disease in temperate regions of the northern hemisphere, with risk of infection associated with occupation (e.g. forestry work) and certain outdoor recreational activities (e.g. mushroom collecting). In Europe, LB is caused by infection with one or more pathogenic European genospecies of the spirochaete Borrelia burgdorferi sensu lato, mainly transmitted by the tick Ixodes ricinus. Recent surveys show that the overall prevalence of LB may be stabilising, but its geographical distribution is increasing. In addition, much remains to be discovered about the factors affecting genospecific prevalence, transmission and virulence, although avoidance of tick bite still appears to be the most efficient preventive measure. Uniform, European-wide surveillance programmes (particularly on a local scale) and standardisation of diagnostic tests and treatments are still urgently needed, especially in the light of climate change scenarios and land-use and socio-economic changes. Improved epidemiological knowledge will also aid development of more accurate risk prediction models for LB. Studies on the effects of biodiversity loss and ecosystem changes on LB emergence may identify new paradigms for the prevention and control of LB and other tick-borne diseases.

Highlights

Lyme disease is a multisystemic inflammatory disorder caused by an immune response to the pathogenic genomic species of Borrelia burgdorferi sensu lato, which are transmitted by the hard ticks of the Ixodes ricinus species complex [1,2]
In Europe, the annual number Lyme borreliosis (LB) cases is increasing in some areas, and tick vectors are expanding their range, to higher altitudes and latitudes, suggesting that LB will remain an important health concern in the coming decades, especially in light of economic, land use and climate change predictions
The effect of the resulting biodiversity loss and ecosystem changes on LB emergence should be an important focus of investigation, especially to identify new paradigms for the prevention and control of LB and other tick-borne diseases

Summary

Introduction

Lyme disease (or Lyme borreliosis, LB) is a multisystemic inflammatory disorder caused by an immune response to the pathogenic genomic species of Borrelia burgdorferi sensu lato (sl), which are transmitted by the hard ticks of the Ixodes ricinus species complex [1,2]. Despite substantial efforts to improve surveillance and control of LB in recent decades, it is still the most prevalent arthropod-borne disease in the temperate regions of the northern hemisphere [1], with approximately 65,500 patients annually in Europe (including notified cases and qualified estimates per country from 1987 to 2006, the years covered vary) [3]. LB is likely to become an increasingly relevant health risk in the near future due to complex interactions between diverse environmental and socio-economic factors, which will affect various aspects of disease ecology and epidemiology, as outlined below

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