Lyme borreliosis and other tick-borne diseases. Guidelines from the French scientific societies

Gocko, Xavier; Lenormand, C.; Lemogne, Cédric; Bouiller, Kévin; Jf, Gehanno; Perrot, Serge; Eldin, Carole; T, De Broucker; Roblot, P.; Toubiana, Julie; Sellal, François; Vuillemet, F.; Sordet, Christelle; Fantin, Bruno; Lina, Gérard; Sobas, C; Jaulhac, B.; Figoni, Julie; Chirouze, Catherine; Hansmann, Yves; Hentgen,; Caumes, Éric; Dieudonné, Maël; Picone, Olivier; Bodaghi, Bahram; Jp, Gangneux; Degeilh, B.; Saunier, A.; Sotto, Albert; Raffetin, A.; Jj, Monsuez; Michel, C; Boulanger, Nathalie; Cathébras, P.; Tattevin, Pierre

doi:10.1016/j.medmal.2019.05.006

Cited by 23 publications

(17 citation statements)

References 69 publications

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“…The calculated population-weighted average incidence rate for the regional burden of LB in Western Europe is 22.05 cases per 100,000 persons per year [2]. For example, in France, the annual incidence rate was 53/100,000 between 2009 and 2017 [3]. In Northern Italy (Lombardy), there were only 1.24 new cases per 1 million residents between 2000 and 2015 [4].…”

Section: Introductionmentioning

confidence: 99%

Epidemiology of Lyme Disease in a Highly Endemic European Zone

et al. 2020

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Background and objective: Lyme disease, also known as Lyme borreliosis (LB), is a tick-borne infectious disease caused by the spirochete bacteria Borrelia. The risk of infection depends on the geographical area, ecological factors, and human behavior. Clinical manifestations of Lyme borreliosis have a wide range, but the most frequent clinical symptom, which is also a diagnostic symptom, is a skin rash called erythema migrans (EM). The disease is very common worldwide. In Lithuania, the disease frequency is 99.9 cases per 100,000 population (Centre for Communicable Diseases and AIDS, Lithuania, 2017). The main aim of this study was to obtain the baseline characteristics of the disease regarding the infected Lithuanian population. Materials and Methods: We analyzed data from the Centre for Communicable Diseases and AIDS about all Lyme disease (A69.2) diagnosed patients over a three-year period (from 2014 to 2016) in Lithuania. Results: In 2014–2016, 7424 (crude incidence rate 85.4) cases with LB were diagnosed in Lithuania. Most of them (4633 (62.4%)) were identified in women. Older people were more likely to suffer from LB. Urban residents were 2.6 times more often affected that those living in villages. Tick bites were primarily observed in high season months, from May to September (90%), with the highest peak in July. There was a higher number of observed tick bites (p = 0.003) in the urban residents. Erythema migrans occurred in 75.6% LB cases, while other symptoms did not exceed a quarter of all LB cases. There were 7353 (99.6%) cases where LB was confirmed via clinical symptoms and/or laboratory tests. Also, 1720 (23.2%) patients were tested for LB immunoglobulins. Conclusions: This study found a high incidence of Lyme disease in Lithuania. We elucidated the baseline characteristics regarding the infected Lithuanian population which may ease medical clinicians’ work on new Lyme diagnoses.

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Section: Introductionmentioning

confidence: 99%

Epidemiology of Lyme Disease in a Highly Endemic European Zone

et al. 2020

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“…An update in the recommendations in several European countries shows that the scientific community is listening and wants to improve the management of the illness [8,12,13,20,[39][40][41][42]. Post-treatment Lyme disease syndrome has been recognised [7,13,20]. France has taken a multidisciplinary approach to care, with a focus on listening to patients and recognising their symptoms [7,8,13] In 2019, five reference centres for tick-borne diseases, as well as associated centres, had been appointed by the Ministry of Health in France.…”

Section: Improved Physician Education and Updated Scientific Guidelinesmentioning

confidence: 99%

“…Post-treatment Lyme disease syndrome has been recognised [7,13,20]. France has taken a multidisciplinary approach to care, with a focus on listening to patients and recognising their symptoms [7,8,13] In 2019, five reference centres for tick-borne diseases, as well as associated centres, had been appointed by the Ministry of Health in France. Patients that we interviewed in this study who had received care from specialised facilities were satisfied.…”

Section: Improved Physician Education and Updated Scientific Guidelinesmentioning

confidence: 99%

“…According to French, European, and American guidelines, the diagnosis of a confirmed LB is based on tick exposure, specific clinical manifestations, and a positive serological test according to a two-tiered approach (initial ELISA test followed by a Western blot confirmation test) for the disseminated stage [ 8 , 11 , 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

“…Antibiotic therapy is recommended for all the stages of the disease, with different molecules and durations according to the stage of the disease, and not exceeding 28 days [ 8 , 13 , 14 ]. Five blind randomised clinical trials found no evidence that prolonged antibiotic treatment was beneficial; on the other hand, severe adverse events were observed [ 15 , 16 , 17 , 18 , 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Perceptions, Representations, and Experiences of Patients Presenting Nonspecific Symptoms in the Context of Suspected Lyme Borreliosis

et al. 2021

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Background: Some subjective symptoms may be reported at all stages of Lyme borreliosis (LB) and may persist for several months after treatment. Nonspecific symptoms without any objective manifestation of LB are sometimes attributed by patients to a possible tick bite. The aim of our study was to explore the perceptions, representations, and experiences that these patients had of their disease and care paths. Methods: We performed a qualitative study through individual interviews (October 2017–May 2018), based on grounded theory, following the COREQ checklist. A balanced sample of patients with diverse profiles was recruited at consultations with general practitioners and infectious disease physicians. Results: Twelve patients were interviewed. Data saturation was reached at the twelfth interview. For codes, 293 were identified, and classified into 5 themes: (1) the experience of disabling nonspecific symptoms, especially pain, causing confusion and fear, (2) long and difficult care paths for the majority of the patients, experienced as an obstacle course, (3) a break with the previous state of health, causing a negative impact on every sphere of the patient’s life, (4) empowerment of the patients and the self-management of their disease, and (5) the strong expression of a desire for change, with better listening, greater recognition of the symptoms, and simpler care paths. Conclusions: This study allows for the understanding of a patient’s behaviours and the obstacles encountered, the way they are perceived, and the necessary solutions. The patients’ expectations identified here could help physicians better understand the doctor–patient relationship in these complex management situations, which would reduce the burden of the disease. The current development of specialised reference centres could help meet the patients’ demands and those of family physicians.

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The evolving story of Borrelia burgdorferi sensu lato transmission in Europe

Steinbrink

Brugger

Margos³

et al. 2022

Parasitol Res

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Beside mosquitoes, ticks are well-known vectors of different human pathogens. In the Northern Hemisphere, Lyme borreliosis (Eurasia, LB) or Lyme disease (North America, LD) is the most commonly occurring vector-borne infectious disease caused by bacteria of the genus Borrelia which are transmitted by hard ticks of the genus Ixodes. The reported incidence of LB in Europe is about 22.6 cases per 100,000 inhabitants annually with a broad range depending on the geographical area analyzed. However, the epidemiological data are largely incomplete, because LB is not notifiable in all European countries. Furthermore, not only differ reporting procedures between countries, there is also variation in case definitions and diagnostic procedures. Lyme borreliosis is caused by several species of the Borrelia (B.) burgdorferi sensu lato (s.l.) complex which are maintained in complex networks including ixodid ticks and different reservoir hosts. Vector and host influence each other and are affected by multiple factors including climate that have a major impact on their habitats and ecology. To classify factors that influence the risk of transmission of B. burgdorferi s.l. to their different vertebrate hosts as well as to humans, we briefly summarize the current knowledge about the pathogens including their astonishing ability to overcome various host immune responses, regarding the main vector in Europe Ixodes ricinus, and the disease caused by borreliae. The research shows, that a higher standardization of case definition, diagnostic procedures, and standardized, long-term surveillance systems across Europe is necessary to improve clinical and epidemiological data.

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Lyme borreliosis and other tick-borne diseases. Guidelines from the French scientific societies

Cited by 23 publications

References 69 publications

Epidemiology of Lyme Disease in a Highly Endemic European Zone

Epidemiology of Lyme Disease in a Highly Endemic European Zone

Perceptions, Representations, and Experiences of Patients Presenting Nonspecific Symptoms in the Context of Suspected Lyme Borreliosis

The evolving story of Borrelia burgdorferi sensu lato transmission in Europe

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