Epidemiology of Lyme borreliosis through two surveillance systems: the national Sentinelles GP network and the national hospital discharge database, France, 2005 to 2016

Septfons, Alexandra; Goronflot, Thomas; Jaulhac, B.; Roussel, Victoire; Martino, S. De; Guerreiro, Serge; Launay, Titouan; Fournier, L.; Valk, Henriette de; Figoni, Julie; Blanchon, Thierry; Couturier, Élisabeth

doi:10.2807/1560-7917.es.2019.24.11.1800134

Cited by 36 publications

(37 citation statements)

References 30 publications

(41 reference statements)

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“…Each SGP participating in continuous surveillance activities uses an online system (https://www.sentiweb.fr) to report new LB cases to the Réseau Sentinelles. Case information was collected by the SGP during the medical consultation using a standardized questionnaire [7,19,20]. A case was diagnosed by the presence of erythema migrans alone (no size limit) or late manifestations associated with LB confirmed by laboratory [7].…”

Section: Data Collation and Managementmentioning

confidence: 99%

“…Based on the collected LB data, the estimated LB incidence remained stable during 2009-2015, but has increased from 2016 (from 46 (95% CI [34; 58]) in 2009 to 84 (95% CI [70; 98]) per 100,000 inhabitants in 2016) [7]. A spatial heterogeneity of LB incidence between regions (the largest French administrative district, level 1) and years has been reported [7,19,20]. However, very few published studies formally explored the spatial and temporal patterns of LB reports in Europe [21] or in France.…”

Section: Introductionmentioning

confidence: 99%

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Exploratory Space–Time Analyses of Reported Lyme Borreliosis Cases in France, 2016–2019

Bonnet

Figoni

et al. 2021

Pathogens

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In recent decades, the incidence of Lyme borreliosis (LB) in Europe seems to have increased, underpinning a growing public health concern. LB surveillance systems across the continent are heterogeneous, and the spatial and temporal patterns of LB reports have been little documented. In this study, we explored the spatio-temporal patterns of LB cases reported in France from 2016 to 2019, to describe high-risk clusters and generate hypotheses on their occurrence. The space–time K-function and the Kulldorf’s scan statistic were implemented separately for each year to evaluate space–time interaction between reported cases and searching clusters. The results show that the main spatial clusters, of radius size up to 97 km, were reported in central and northeastern France each year. In 2017–2019, spatial clusters were also identified in more southern areas (near the Alps and the Mediterranean coast). Spatio-temporal clustering occurred between May and August, over one-month to three-month windows in 2016–2017 and in 2018–2019. A strong spatio-temporal interaction was identified in 2018 within 16 km and seven days, suggesting a potential local and intense pathogen transmission process. Ongoing improved surveillance and accounting for animal hosts, vectors, meteorological factors and human behaviors are keys to further elucidate LB spatio-temporal patterns.

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Section: Data Collation and Managementmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Exploratory Space–Time Analyses of Reported Lyme Borreliosis Cases in France, 2016–2019

Bonnet

Figoni

et al. 2021

Pathogens

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“…The Alsace region of France is an area with a high density of I. ricinus [13][14][15]. Since B. miyamotoi was found in I. ricinus ticks in France and surrounding countries [16][17][18], we aimed to study the prevalence of B. miyamotoi in patients suspected of post-tick bite febrile illness in northeastern France using direct and indirect diagnostic tools, as well as by measuring B. miyamotoi infection rates in I. ricinus ticks collected in the same region.…”

Section: Introductionmentioning

confidence: 99%

Assessment of Borrelia miyamotoi in febrile patients and ticks in Alsace, an endemic area for Lyme borreliosis in France

et al. 2020

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Background: Borrelia miyamotoi is a relapsing fever Borrelia species transmitted by ticks of the Ixodes ricinus complex. Human disease caused by B. miyamotoi was first described in Russia and later in the USA and Japan. Additionally, five cases of meningoencephalitis in immunocompromised patients and one case in an apparently immunocompetent patient were described. Methods: We investigated the presence of B. miyamotoi in I. ricinus nymphs and in patients suspected of human granulocytic anaplasmosis, in Alsace (France), an endemic area for I. ricinus ticks and Lyme borreliosis, using direct (PCR) and indirect diagnosis (glycerophosphoryldiester-phosphodiesterase (GlpQ) serology). Results: Borrelia miyamotoi was found in 2.2% of 4354 ticks collected between 2013 and 2016. None of the 575 blood samples, collected from the patients suspected of HGA, was found positive for B. miyamotoi by PCR. Acute and late sera from 138 of these 575 patients were available. These paired sera were tested for IgM and IgG antibodies against the B. miyamotoi GlpQ antigen. A total of 14 out of 138 patients had at least one positive parameter (i.e. anti-GlpQ IgG and/or IgM). One patient seroconverted for IgG, and three had isolated IgM in the acute serum. These three patients were treated with doxycycline which could have prevented seroconversion. After reviewing clinical data and other biological tests performed, co-exposure among different microorganisms vectored by ticks or serological cross-reactivity could not be ruled out in these different cases. One patient had persistent IgG, which strongly suggests previous exposure to B. miyamotoi. Conclusions: Humans can be exposed to B. miyamotoi through tick bites in Alsace. We present serological data for possible B. miyamotoi exposure or infection of patients with fever after tick bite. Future studies should determine the incidence, clinical course and burden of this emerging tick-borne disease in other parts of Western Europe.

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“…The prevalence of Lyme borreliosis (LB) syndromes were the following: EM (94.02%), LA (3.18%), LC (0.39%) LD (0.09%), and NB (2.28%), which was similar to other endemic Europe countries. For example, in France, the mean yearly incidence rate of LB was 53/100,000 (2011–2016), and the LB syndromes were EM (94%), LA (2.5%), and LD (acrodermatitis 0.89% and borrelial lymphocitoma 0.59%) [ 7 ]; in Germany, the incidence of Lyme borreliosis ranged from 26/100,000 (2015) to 41/100,000 (2013), with 95% experiencing EM only, 2.7% NB, and 2.1% LA [ 8 ].…”

Section: Discussionmentioning

confidence: 99%

Lyme Disease among Patients at an Ambulatory Unit in a Highly Endemic Country: Lithuania

et al. 2021

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Background and objectives: Lyme disease is the most common tick-borne infectious disease in Europe, caused by the spirocheta bacteria of Borrelia burgdorferi. Several genospecies of B. burgdorferi are pathogenic to humans. B. burgdorferi sensu stricto, which is prevalent in North America, causes reactive arthritis, whereas B. garinii and B. afzelii, common in Europe, can affect the skin, heart, or nervous system; it has been shown that the clinical symptoms of the disease may be very different. The objective of this study was to identify the baseline characteristics of Lyme disease and to elucidate the frequency of different Lyme disease syndromes in Lithuania. Materials and Methods: Patients who were diagnosed with Lyme disease during an ambulatory visit to the Center of Infectious Diseases, Vilnius University Santaros clinics, from 2014 to 2016, were enrolled in this study. A retrospective material analysis was conducted. Results: In total, 1005 patients were enrolled with the following prevalence of clinical syndromes: erythema migrans (EM), 945 (94.02%); Lyme arthritis, 32 (3.18%); neuroborreliosis, 23 (2.28%); Lyme carditis, 4 (0.39%); and acrodermatitis, 1 (0.09%). Erythema migrans was dominant among middle-aged women, with a rash appearing mainly on the lower extremities. Lyme arthritis mainly manifested among middle-aged women as an oligoarthritis, mostly affecting the knee joint. Neuroborreliosis was seen more often in middle-aged women than men and the main symptom was nervus facialis neuropathy. Lyme carditis, manifested as an atrioventricular block, with a male/female ratio of 3:1, and the median age was 51. Acrodermatitis was diagnosed in a 61-year-old woman, as a painful, red rash on the hand. Conclusions: According to the prevalence of B. garinii and B. afzelii in Europe, previously it was thought that Lyme disease presented as erythema migrans, and less frequently as neuroborreliosis; however, this study revealed that other syndromes may also be seen. In addition, we revealed that the longer it takes for erythema migrans to appear, the greater the likelihood of Lyme arthritis developing.

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Epidemiology of Lyme borreliosis through two surveillance systems: the national Sentinelles GP network and the national hospital discharge database, France, 2005 to 2016

Cited by 36 publications

References 30 publications

Exploratory Space–Time Analyses of Reported Lyme Borreliosis Cases in France, 2016–2019

Exploratory Space–Time Analyses of Reported Lyme Borreliosis Cases in France, 2016–2019

Assessment of Borrelia miyamotoi in febrile patients and ticks in Alsace, an endemic area for Lyme borreliosis in France

Lyme Disease among Patients at an Ambulatory Unit in a Highly Endemic Country: Lithuania

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