Abstract
BackgroundLyme borreliosis is the most common vector-borne disease in Europe and North America. The objective of this study is to estimate the incidence of tick bites and Lyme borreliosis, representative of our entire country, including erythema migrans, disseminated Lyme borreliosis and persisting symptoms attributed to Lyme borreliosis.MethodsA questionnaire on clinical diagnoses of Lyme borreliosis was sent to all GPs, company physicians, and medical specialists. To adjust for possible misclassification and telescoping bias, we sent additional questionnaires to categorize reported cases according to likelihood of the diagnosis and to exclude cases diagnosed outside the target period.ResultsAdjusted annual incidence rate for disseminated Lyme borreliosis was 7.7 GP reports per 100,000 inhabitants, and for persisting symptoms attributed to Lyme borreliosis was 5.5 GP reports per 100,000 inhabitants, i.e. approximately 1,300 and 900 cases respectively. GP consultations for tick bites and erythema migrans diagnoses were 495 and 132 per 100,000 inhabitants, respectively, i.e. 82,000 and 22,000 cases in 2010.ConclusionsThis is the first reported nationwide physician survey on the incidence of tick bites and the whole range of manifestations of Lyme borreliosis, including persisting symptoms attributed to Lyme borreliosis. This is crucial for complete assessment of the public health impact of Lyme borreliosis.Electronic supplementary materialThe online version of this article (doi:10.1186/s13071-015-0777-6) contains supplementary material, which is available to authorized users.
Highlights
Lyme borreliosis is the most common vector-borne disease in Europe and North America
The incidence for persisting symptoms attributed to Lyme borreliosis was adjusted according to the proportion of likely diagnosis, and to the proportion of general practitioners (GPs) reports within the targeted period of diagnosis 2008 to 2010. ****Target period adjustment scenario: The incidence for disseminated Lyme borreliosis was adjusted according to the proportion of very likely, likely, and possible diagnosis, and to the proportion of GP reports within the targeted period of diagnosis 2009 and 2010
The incidence for persisting symptoms attributed to Lyme borreliosis was adjusted according to the proportion of likely diagnosis and possible diagnosis, and to the proportion of GP reports within the targeted period of diagnosis 2008 to 2010
Summary
Lyme borreliosis is the most common vector-borne disease in Europe and North America. The objective of this study is to estimate the incidence of tick bites and Lyme borreliosis, representative of our entire country, including erythema migrans, disseminated Lyme borreliosis and persisting symptoms attributed to Lyme borreliosis. The disease most commonly manifests as erythema migrans, a slowly expanding skin lesion indicating early localized infection. Marked increases in the incidence of Lyme borreliosis have been reported over the past decades in several European countries [2,3,4] and in North America [5,6]. Assessment of the disease burden of Lyme borreliosis requires incidence estimates of all disease outcomes of Lyme borreliosis, ranging from the most common relatively mild early manifestation erythema migrans to the more severe disseminated Lyme borreliosis manifestations, and even
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