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Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area
- Cees C van den Wijngaard1 , Agnetha Hofhuis1 , Mariana Simões1 , Ente Rood2 , Wilfrid van Pelt1 , Herve Zeller3 , Wim Van Bortel4,5
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View Affiliations Hide AffiliationsAffiliations: 1 Epidemiology and Surveillance Unit, Centre for Infectious Disease Control, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands 2 Epidemiology Unit, KIT (Royal Tropical Institute) Health, Amsterdam, the Netherlands 3 Office of the Chief Scientist, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden 4 Surveillance and Response Support Unit, European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden (affiliation when the work was performed) 5 Institute of Tropical Medicine, Antwerp, Belgium (current affiliation)Wim Van Bortelwvanbortel itg.be
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Citation style for this article: van den Wijngaard Cees C, Hofhuis Agnetha, Simões Mariana, Rood Ente, van Pelt Wilfrid, Zeller Herve, Van Bortel Wim. Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area. Euro Surveill. 2017;22(27):pii=30569. https://doi.org/10.2807/1560-7917.ES.2017.22.27.30569 Received: 03 Jan 2017; Accepted: 05 May 2017
Abstract
Lyme borreliosis (LB) is the most prevalent tick-borne disease in Europe. Erythema migrans (EM), an early, localised skin rash, is its most common presentation. Dissemination of the bacteria can lead to more severe manifestations including skin, neurological, cardiac, musculoskeletal and ocular manifestations. Comparison of LB incidence rates in the European Union (EU)/European Economic Area (EEA) and Balkan countries are difficult in the absence of standardised surveillance and reporting procedures. We explored six surveillance scenarios for LB surveillance in the EU/EEA, based on the following key indicators: (i) erythema migrans, (ii) neuroborreliosis, (iii) all human LB manifestations, (iv) seroprevalence, (v) tick bites, and (vi) infected ticks and reservoir hosts. In our opinion, neuroborreliosis seems most feasible and useful as the standard key indicator, being one of the most frequent severe LB manifestations, with the possibility of a specific case definition. Additional surveillance with erythema migrans as key indicator would add value to the surveillance of neuroborreliosis and lead to a more complete picture of LB epidemiology in the EU/EEA. The other scenarios have less value as a basis for EU-level surveillance, but can be considered periodically and locally, as they could supply complementary insights.
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References
-
Stanek G, Wormser GP, Gray J, Strle F. Lyme borreliosis. Lancet. 2012;379(9814):461-73. https://doi.org/10.1016/S0140-6736(11)60103-7 PMID: 21903253
-
Stanek G, Fingerle V, Hunfeld KP, Jaulhac B, Kaiser R, Krause A, et al. Lyme borreliosis: clinical case definitions for diagnosis and management in Europe. Clin Microbiol Infect. 2011;17(1):69-79. https://doi.org/10.1111/j.1469-0691.2010.03175.x PMID: 20132258
-
van Dam AP, Kuiper H, Vos K, Widjojokusumo A, de Jongh BM, Spanjaard L, et al. Different genospecies of Borrelia burgdorferi are associated with distinct clinical manifestations of Lyme borreliosis. Clin Infect Dis. 1993;17(4):708-17. https://doi.org/10.1093/clinids/17.4.708 PMID: 7903558
-
Lindgren E, Jaenson TGT. Lyme borreliosis in Europe: influences of climate and climate change, epidemiology, ecology and adaptation measures. Copenhagen: World Health Organization Europe; 2006. Available from: http://www.euro.who.int/__data/assets/pdf_file/0006/96819/E89522.pdf
-
Cimmino MA. Relative frequency of Lyme borreliosis and of its clinical manifestations in Europe. European Community Concerted Action on Risk Assessment in Lyme Borreliosis. Infection. 1998;26(5):298-300. https://doi.org/10.1007/BF02962251 PMID: 9795788
-
Hubálek Z. Epidemiology of lyme borreliosis. Curr Probl Dermatol. 2009;37:31-50. https://doi.org/10.1159/000213069 PMID: 19367096
-
Dobson AD, Taylor JL, Randolph SE. Tick (Ixodes ricinus) abundance and seasonality at recreational sites in the UK: hazards in relation to fine-scale habitat types revealed by complementary sampling methods. Ticks Tick Borne Dis. 2011;2(2):67-74. https://doi.org/10.1016/j.ttbdis.2011.03.002 PMID: 21771540
-
Medlock JM, Hansford KM, Bormane A, Derdakova M, Estrada-Peña A, George JC, et al. Driving forces for changes in geographical distribution of Ixodes ricinus ticks in Europe. Parasit Vectors. 2013;6(1):1. https://doi.org/10.1186/1756-3305-6-1 PMID: 23281838
-
Smith R, Takkinen J. Lyme borreliosis: Europe-wide coordinated surveillance and action needed? Euro Surveill. 2006;11(6):E060622.1. PMID: 16819127
-
European Centre for Disease Prevention and Control (ECDC). Meeting report. Second expert consultation on tick-borne diseases with emphasis on Lyme borreliosis and tick-borne encephalitis: Stockholm, Sweden, 22–23 November 2011. Stockholm: ECDC; 2012. Available from: http://www.ecdc.europa.eu/en/publications/Publications/Tick-borne-diseases-meeting-report.pdf
-
Hofhuis A, Harms M, Bennema S, van den Wijngaard CC, van Pelt W. Physician reported incidence of early and late Lyme borreliosis. Parasit Vectors. 2015;8(1):161. https://doi.org/10.1186/s13071-015-0777-6 PMID: 25889086
-
Hofhuis A, Harms M, van den Wijngaard C, Sprong H, van Pelt W. Continuing increase of tick bites and Lyme disease between 1994 and 2009. Ticks Tick Borne Dis. 2015;6(1):69-74. https://doi.org/10.1016/j.ttbdis.2014.09.006 PMID: 25448421
-
Hofhuis A, van der Giessen JW, Borgsteede FH, Wielinga PR, Notermans DW, van Pelt W. Lyme borreliosis in the Netherlands: strong increase in GP consultations and hospital admissions in past 10 years. Euro Surveill. 2006;11(6):E060622.2. PMID: 16819128
-
den Boon S, Schellekens JF, Schouls LM, Suijkerbuijk AW, Docters van Leeuwen B, van Pelt W. Verdubbeling van het aantal consulten voor tekenbeten en Lyme-borreliose in de huisartsenpraktijk in Nederland. [Doubling of the number of cases of tick bites and lyme borreliosis seen by general practitioners in the Netherlands]. Ned Tijdschr Geneeskd. 2004;148(14):665-70. Dutch. PMID: 15106318
-
de Mik EL, van Pelt W, Docters-van Leeuwen BD, van der Veen A, Schellekens JF, Borgdorff MW. The geographical distribution of tick bites and erythema migrans in general practice in The Netherlands. Int J Epidemiol. 1997;26(2):451-7. https://doi.org/10.1093/ije/26.2.451 PMID: 9169184
-
Vandenesch A, Turbelin C, Couturier E, Arena C, Jaulhac B, Ferquel E, et al. Incidence and hospitalisation rates of Lyme borreliosis, France, 2004 to 2012. Euro Surveill. 2014;19(34):20883. https://doi.org/10.2807/1560-7917.ES2014.19.34.20883 PMID: 25188613
-
Wilking H, Stark K. Trends in surveillance data of human Lyme borreliosis from six federal states in eastern Germany, 2009-2012. Ticks Tick Borne Dis. 2014;5(3):219-24. https://doi.org/10.1016/j.ttbdis.2013.10.010 PMID: 24656810
-
Vanthomme K, Bossuyt N, Boffin N, Van Casteren V. Incidence and management of presumption of Lyme borreliosis in Belgium: recent data from the sentinel network of general practitioners. Eur J Clin Microbiol Infect Dis. 2012;31(9):2385-90. https://doi.org/10.1007/s10096-012-1580-3 PMID: 22391757
-
Christova I, Komitova R. Clinical and epidemiological features of Lyme borreliosis in Bulgaria. Wien Klin Wochenschr. 2004;116(1-2):42-6. https://doi.org/10.1007/BF03040423 PMID: 15030123
-
Dessau RB, Espenhain L, Mølbak K, Krause TG, Voldstedlund M. Improving national surveillance of Lyme neuroborreliosis in Denmark through electronic reporting of specific antibody index testing from 2010 to 2012. Euro Surveill. 2015;20(28):21184. https://doi.org/10.2807/1560-7917.ES2015.20.28.21184 PMID: 26212143
-
Lopes de Carvalho I, Núncio MS. Laboratory diagnosis of Lyme borreliosis at the Portuguese National Institute of Health (1990-2004). Euro Surveill. 2006;11(10):257-60. PMID: 17130658
-
Mygland A, Ljøstad U, Fingerle V, Rupprecht T, Schmutzhard E, Steiner I. EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. Eur J Neurol. 2010;17(1):8-16, e1-4. https://doi.org/10.1111/j.1468-1331.2009.02862.x PMID: 19930447
-
Paradowska-Stankiewicz I, Chrześcijańska I. Lyme disease in Poland in 2012. Przegl Epidemiol. 2014;68(2):275-7, 375-7. PMID: 25135514
-
Dryden MS, Saeed K, Ogborn S, Swales P. Lyme borreliosis in southern United Kingdom and a case for a new syndrome, chronic arthropod-borne neuropathy. Epidemiol Infect. 2015;143(3):561-72. https://doi.org/10.1017/S0950268814001071 PMID: 24814098
-
Leeflang MM, Ang CW, Berkhout J, Bijlmer HA, Van Bortel W, Brandenburg AH, et al. The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: a systematic review and meta-analysis. BMC Infect Dis. 2016;16(1):140. https://doi.org/10.1186/s12879-016-1468-4 PMID: 27013465
-
Rizzoli A, Hauffe H, Carpi G, Vourc HG, Neteler M, Rosa R. Lyme borreliosis in Europe. Euro Surveill. 2011;16(27):19906. PMID: 21794218
-
Muller I, Freitag MH, Poggensee G, Scharnetzky E, Straube E, Schoerner C, et al. Evaluating frequency, diagnostic quality, and cost of Lyme borreliosis testing in Germany: a retrospective model analysis. Clin Dev Immunol. 2012;2012:595427. https://doi.org/10.1155/2012/595427
-
Dehnert M, Fingerle V, Klier C, Talaska T, Schlaud M, Krause G, et al. Seropositivity of Lyme borreliosis and associated risk factors: a population-based study in Children and Adolescents in Germany (KiGGS). PLoS One. 2012;7(8):e41321. https://doi.org/10.1371/journal.pone.0041321 PMID: 22905101
-
Kiewra D, Zaleśny G. Relationship between temporal abundance of ticks and incidence of Lyme borreliosis in Lower Silesia regions of Poland. J Vector Ecol. 2013;38(2):345-52. https://doi.org/10.1111/j.1948-7134.2013.12050.x PMID: 24581365
-
Schwarz A, Hönig V, Vavrušková Z, Grubhoffer L, Balczun C, Albring A, et al. Abundance of Ixodes ricinus and prevalence of Borrelia burgdorferi s.l. in the nature reserve Siebengebirge, Germany, in comparison to three former studies from 1978 onwards. Parasit Vectors. 2012;5(1):268. https://doi.org/10.1186/1756-3305-5-268 PMID: 23171708
-
van den Wijngaard CC, Hofhuis A, Harms MG, Haagsma JA, Wong A, de Wit GA, et al. The burden of Lyme borreliosis expressed in disability-adjusted life years. Eur J Public Health. 2015;25(6):1071-8. https://doi.org/10.1093/eurpub/ckv091 PMID: 26082446
-
van den Wijngaard CC, Hofhuis A, Wong A, Harms MG, de Wit GA, Lugnér AK, et al. The cost of Lyme borreliosis. Eur J Public Health. 2017;27(3):538-47. https://doi.org/10.1093/eurpub/ckw269 PMID: 28444236
-
European Centre for Disease Prevention and Control (ECDC), European Food Safety Authority (EFSA). VectorNet: A European network for sharing data on the geographic distribution of arthropod vectors, transmitting human and animal disease agents. Stockholm: ECDC. [Accessed 27 Dec 2016]. Available from: http://ecdc.europa.eu/en/healthtopics/vectors/VectorNet/Pages/VectorNet.aspx
-
Wormser GP, Dattwyler RJ, Shapiro ED, Halperin JJ, Steere AC, Klempner MS, et al. The clinical assessment, treatment, and prevention of lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases Society of America. Clin Infect Dis. 2006;43(9):1089-134. https://doi.org/10.1086/508667 PMID: 17029130
-
Kullberg BJ, Berende A, van der Meer JW. The challenge of Lyme disease: tired of the Lyme wars. Neth J Med. 2011;69(3):98-100. PMID: 21444933
-
Berende A, ter Hofstede HJ, Donders AR, van Middendorp H, Kessels RP, Adang EM, et al. Persistent Lyme Empiric Antibiotic Study Europe (PLEASE)--design of a randomized controlled trial of prolonged antibiotic treatment in patients with persistent symptoms attributed to Lyme borreliosis. BMC Infect Dis. 2014;14(1):543. https://doi.org/10.1186/s12879-014-0543-y PMID: 25318999
-
Berende A, ter Hofstede HJ, Vos FJ, van Middendorp H, Vogelaar ML, Tromp M, et al. Randomized Trial of Longer-Term Therapy for Symptoms Attributed to Lyme Disease. N Engl J Med. 2016;374(13):1209-20. https://doi.org/10.1056/NEJMoa1505425 PMID: 27028911
-
World Health Organization (WHO). Immunization, Vaccines and Biologicals. Sentinel Surveillance Geneva: WHO. [Accessed 27 Dec 2016]. Available from: http://www.who.int/immunization/monitoring_surveillance/burden/vpd/surveillance_type/sentinel/en/
-
Krause G, Ropers G, Stark K. Notifiable disease surveillance and practicing physicians. Emerg Infect Dis. 2005;11(3):442-5. https://doi.org/10.3201/eid1103.040361 PMID: 15757561
-
Jelastopulu E, Merekoulias G, Alexopoulos EC. Underreporting of communicable diseases in the prefecture of Achaia, western Greece, 1999-2004 - missed opportunities for early intervention. Euro Surveill. 2010;15(21):19579. PMID: 20519103
-
Richard JL, Vidondo B, Mäusezahl M. A 5-year comparison of performance of sentinel and mandatory notification surveillance systems for measles in Switzerland. Eur J Epidemiol. 2008;23(1):55-65. https://doi.org/10.1007/s10654-007-9187-1 PMID: 17899399
-
Gibbons CL, Mangen MJ, Plass D, Havelaar AH, Brooke RJ, Kramarz P, et al. Measuring underreporting and under-ascertainment in infectious disease datasets: a comparison of methods. BMC Public Health. 2014;14(1):147. https://doi.org/10.1186/1471-2458-14-147 PMID: 24517715
-
Braks M, Medlock JM, Hubalek Z, Hjertqvist M, Perrin Y, Lancelot R, et al. Vector-borne disease intelligence: strategies to deal with disease burden and threats. Front Public Health. 2014;2:280. https://doi.org/10.3389/fpubh.2014.00280 PMID: 25566522
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