Seroprevalence of Lyme Borreliosis in Europe: Results from a Systematic Literature Review (2005–2020)

Abstract

Background: Lyme borreliosis (LB), a tick bite-transmitted infection caused by Borrelia burgdorferi sensu lato ( Bbsl ) complex spirochetes, is the most common tickborne disease in Europe. Studies in European countries have reported LB seroprevalence (prevalence of antibodies to Bbsl infection) and diagnostic strategies used for testing. We conducted a systematic literature review to summarize contemporary LB seroprevalence in Europe. Methods: PubMed, Embase, and CABI Direct (Global Health) databases were searched from 2005 to 2020 to identify studies reporting LB seroprevalence in European countries. Reported single-tier and two-tier test results were summarized; algorithms (standard or modified) were used to interpret final test results from studies that used two-tier testing. Results: The search yielded 61 articles from 22 European countries. Studies used a range of diagnostic testing methods and strategies (48% single-tier, 46% standard two-tier, and 6% modified two-tier). In 39 population-based studies, of which 14 were nationally representative, seroprevalence estimates ranged from 2.7% (Norway) to 20% (Finland). There was substantial heterogeneity among studies in terms of design, cohort types, periods sampled, sample sizes, and diagnostics, which limited cross-study comparisons. Nevertheless, among studies that reported seroprevalence in persons with greater exposure to ticks, LB seroprevalence was higher among these groups than in the general population (40.6% vs. 3.9%). Furthermore, among studies that used two-tier testing, general population LB seroprevalence was higher in Western Europe (13.6%) and Eastern Europe (11.1%) than in Northern Europe (4.2%) and Southern Europe (3.9%). Conclusion: Despite variations in LB seroprevalence between and within European subregions and countries, high seroprevalence was observed in certain geographic regions and particular risk groups, suggesting significant disease burden and supporting the need for improved, targeted public health interventions such as vaccination. Harmonized approaches to serologic testing and more nationally representative seroprevalence studies are needed to better understand the prevalence of Bbsl infection in Europe.

Estimated Incidence of Symptomatic Lyme Borreliosis Cases in Lublin, Poland in 2021

“…A systematic literature review of seroprevalence studies conducted in Poland and published from 2005 to 2020, described elsewhere [14], failed to identify any nationwide seroprevalence studies in Poland. However, two representative seroprevalence studies conducted among adults in Lublin, one of the 16 provinces in Poland (Lublin adult population: 1.3 million in 2021), were identified [15,16].…”

Tick Activity, Host Range, and Tick-Borne Pathogen Prevalence in Mountain Habitats of the Western Carpathians, Poland

“…Additionally, this tick species serves as the main vector of tick-borne encephalitis virus (TBEV), which is responsible for tick-borne encephalitis (TBE) [ 2 , 3 ]. Countries located in the Carpathian region, such as Poland, Slovakia, and Romania, report a high incidence of tick-borne diseases, mainly LB [ 4 , 5 ].…”

Tick-borne zoonotic flaviviruses andBorreliainfections in wildlife hosts: what have field studies contributed?

“…Recent reviews on tick-borne Borrelia spp. and TBFV have focused on getting information on the biology of infection in vertebrate hosts [21][22][23][24][25][26][27][28] , reporting prevalence and clinical cases in human [29][30][31][32][33] and discussing diagnostic methodologies [34][35][36][37] , the role of non-vector transmissions for TBFV [38][39][40] , or on the importance of modelling TBP regarding climate change consequences 41,42 . Some reviews have focused on wildlife hosts for TBP but only at a national or continental scale [43][44][45][46] , or on reservoirs associated with the flavivirus genus in general, with little focus on TBFV 47 .…”