The burden of Lyme borreliosis expressed in disability-adjusted life years

Wijngaard, Cees C. van den; Hofhuis, Agnetha; Harms, Margriet; Haagsma, Juanita A.; Wong, Albert; Wit, G. Ardine de; Havelaar, Arie H.; Lugnér, Anna K.; Suijkerbuijk, Anita; Pelt, Wilfrid van

doi:10.1093/eurpub/ckv091

Cited by 53 publications

(49 citation statements)

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“…Such incidence estimates of the complete range of LB manifestations would also facilitate expressing the disease burden of LB in disability-adjusted life years (DALYs) (e.g. healthy life-years lost), and cost-of-illness, to allow policymakers to compare with other infectious and non-infectious diseases [11,31,32]. …”

Section: Discussionmentioning

confidence: 99%

“…LB-related persisting symptoms (if developed after a documented episode of LB defined as post-Lyme disease syndrome by the Infectious Diseases Society of America [34]) is a growing concern, underlined by a survey in the Netherlands where annual incidence was estimated at 5.5 new cases per 100,000 population in 2010, and disease burden at 86% of the total burden due to LB [11,31]. It concerns long-lasting, often severe and sometimes disabling symptoms that physicians and patients attribute to LB [34].…”

Section: Discussionmentioning

confidence: 99%

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Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area

et al. 2017

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area

et al. 2017

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“…LB has the 12th highest disease burden when compared to the comprehensive DALY estimates for 32 other infectious diseases, largely based upon the 'Burden of Communicable Disease in Europe' (BCoDE)-project. This disease burden attributed to LB demonstrates the need for continued prevention and control efforts [173].…”

Section: Incidencementioning

confidence: 99%

Attention for Lyme prevention

Beaujean

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“…While many patients recover fully with early antibiotic therapy, at least 10-20% of patients experience persistent symptoms following the conventionally recommended course of 2-4 weeks of antibiotics (12–14), and a recent retrospective analysis documented 63% of patients experienced persistent symptoms after receiving antibiotic treatment for Lyme disease (15). Patients who experience persistent symptoms have significant and ongoing disability (16, 17) and increased health care costs and utilization (15). B. burgdorferi can evade the immune system response (18, 19) and multiple studies have shown that the bacteria is capable of persisting in diverse tissues across a variety of animal models despite aggressive and prolonged antibiotic therapy (20–23).…”

Section: Introductionmentioning

confidence: 99%

Evaluation of Natural and Botanical Medicines for Activity against Growing and Non-growing Forms ofB. burgdorferi

Feng

Leone²,

Schweig³

et al. 2019

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Lyme disease is the most common vector-borne disease in the US. Although the current recommended Lyme antibiotic treatment can cure the majority of Lyme disease patients, about 10-20% patients continue to suffer from persisting symptoms. There have been various anecdotal reports on the use of herbal extracts for treating patients with persisting symptoms with varying degree of improvements. However, it is unclear whether the effect of the herb products is due to their direct antimicrobial activity or their effect on host immune system. In the present study, we investigated the antimicrobial effects of 12 commonly used botanical medicines and 3 other natural antimicrobial agents for potential anti-Borrelia burgdorferi activity in vitro. Primary criteria for selecting compounds for the present study included agents that had shown significant anti-borrelial effects in previous studies, have favorable safety profiles, and can be absorbed systemically. Among them, 9 natural product extracts at 1% were found to have good activity against the stationary phase B. burgdorferi culture compared to the control antibiotics doxycycline and cefuroxime. These active herbs include Cryptolepis sanguinolenta, Juglans nigra (Black walnut), Polygonum cuspidatum (Japanese knotweed), Artemesia annua (Sweet wormwood), Uncaria tomentosa (Cat’s claw), Cistus incanus, and Scutellaria baicalensis (Chinese skullcap). In contrast, Stevia rebaudiana, Andrographis paniculata, Grapefruit seed extract, colloidal silver, monolaurin, and antimicrobial peptide LL37 had little or no activity against stationary phase B. burgdorferi. The minimum inhibitory concentration (MIC) values of Artemesia annua, Juglans nigra, and Uncaria tomentosa were quite high for growing B. burgdorferi, despite their strong activity against the non-growing stationary phase B. burgdorferi cells. On the other hand, the top two active herbs, Cryptolepis sanguinolenta and Polygonum cuspidatum, showed strong activity against both growing B. burgdorferi (MIC=0.03%-0.06% and 0.25%-0.5% respectively) and non-growing stationary phase B. burgdorferi. In subculture studies, only 1% Cryptolepis sanguinolenta extract caused complete eradication, while current Lyme antibiotics doxycycline and cefuroxime and other active herbs including Polygonum cuspidatum, Artemesia annua, Juglans nigra and Uncaria tomentosa could not eradicate B. burgdorferi stationary phase cells as many spirochetes were visible after 21-day subculture. Further studies are needed to identify the active ingredients of the effective herbs and evaluate their combinations for more effective eradication of B. burgdorferi in vitro and in vivo. The implications of these findings for more effective treatment of persistent Lyme disease are discussed.

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The burden of Lyme borreliosis expressed in disability-adjusted life years

Cited by 53 publications

References 20 publications

Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area

Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area

Attention for Lyme prevention

Evaluation of Natural and Botanical Medicines for Activity against Growing and Non-growing Forms ofB. burgdorferi

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