Underreporting of Lyme and Other Tick‐Borne Diseases in Residents of a High‐Incidence County, Minnesota, 2009

Schiffman, Elizabeth; McLaughlin, Colleen C.; Ray, J. A.; Kemperman, Melissa; Hinckley, Alison F.; Friedlander, Hannah; Neitzel, David F.

doi:10.1111/zph.12291

Cited by 32 publications

(22 citation statements)

References 11 publications

(18 reference statements)

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“…The higher incidence observed for Lyme disease diagnoses in MarketScan compared with cases identified through public health surveillance can be explained in large part by underreporting (16,17). However, variability in seasonal, demographic, and geographic distributions between data from these 2 systems suggest that some proportion of Lyme disease diagnoses captured through MarketScan are the result of misdiagnosis or miscoding.…”

Section: Discussionmentioning

confidence: 96%

Use of Commercial Claims Data for Evaluating Trends in Lyme Disease Diagnoses, United States, 2010–2018

Schwartz¹,

Kugeler²,

Nelson³

et al. 2021

Emerg. Infect. Dis.

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We evaluated MarketScan, a large commercial insurance claims database, for its potential use as a stable and consistent source of information on Lyme disease diagnoses in the United States. The age, sex, and geographic composition of the enrolled population during 2010–2018 remained proportionally stable, despite fluctuations in the number of enrollees. Annual incidence of Lyme disease diagnoses per 100,000 enrollees ranged from 49 to 88, ≈6–8 times higher than that observed for cases reported through notifiable disease surveillance. Age and sex distributions among Lyme disease diagnoses in MarketScan were similar to those of cases reported through surveillance, but proportionally more diagnoses occurred outside of peak summer months, among female enrollees, and outside high-incidence states. Misdiagnoses, particularly in low-incidence states, may account for some of the observed epidemiologic differences. Commercial claims provide a stable data source to monitor trends in Lyme disease diagnoses, but certain important characteristics warrant further investigation.

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Section: Discussionmentioning

confidence: 96%

Use of Commercial Claims Data for Evaluating Trends in Lyme Disease Diagnoses, United States, 2010–2018

Schwartz¹,

Kugeler²,

Nelson³

et al. 2021

Emerg. Infect. Dis.

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“…Human AN was initially described from northern Minnesota and Wisconsin in 1994 [36]; the annual number of reported cases from those two states increased from 79 in 2000 to 1217 in 2010, but has since stabilized somewhat, with an average of 1312 cases (995-1504) reported each year from 2011 to 2017 [2,3,37]. This leveling in the number of cases reported annually may be due, in part, to underreporting in some highly endemic areas [38]. However, while disease caused by Ap remains endemic in these two states, the finding in the present paper of decreasing trends in canine seroprevalence for antibodies to Anaplasma spp.…”

Section: Discussionmentioning

confidence: 99%

Trends in canine seroprevalence to Borrelia burgdorferi and Anaplasma spp. in the eastern USA, 2010–2017

et al. 2019

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Background Borrelia burgdorferi and Anaplasma phagocytophilum are tick-borne infections transmitted by Ixodes scapularis in the eastern USA; both agents cause disease in dogs and people. To characterize changes in seroprevalence over time, Cochran Armitage trend tests were used to evaluate percent positive test results for antibodies to B. burgdorferi and Anaplasma spp. in approximately 20 million canine tests from 2010–2017 in 25 states and 905 counties in the eastern USA. Results A significant decreasing trend in seroprevalence to B. burgdorferi was evident in eight states along the mid-Atlantic coast from Virginia to New Hampshire, and in Wisconsin. In contrast, a continued increasing trend was evident in five northeastern and Midwestern states where Lyme borreliosis is endemic or emerging, as well as in three southern states where endemicity has not yet been widely established. Similarly, seroprevalence to Anaplasma spp. showed a significant, although smaller, decreasing trend in five states along the mid-Atlantic coast from Virginia to Connecticut and Rhode Island, as well as in Minnesota and Wisconsin in the Midwest; despite the fact that those trends were significant they were weak. However, a strong increasing trend was evident in Massachusetts and three states in northern New England as well as in Pennsylvania. Conclusions As expected, seroprevalence continued to increase in regions where Lyme borreliosis and anaplasmosis are more newly endemic. However, the declining seroprevalence evident in other areas was not anticipated. Although the reasons for the decreasing trends are not clear, our finding may reflect shifting ecologic factors that have resulted in decreased infection risk or the combined positive influence of canine vaccination, tick control, and routine testing of dogs in regions where these infections have long been endemic. Analysis of trends in canine test results for tick-borne infections continues to be a valuable tool to understand relative geographical and temporal risk for these zoonotic agents.

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“…Lyme disease is the most common arthropod-borne disease in the United States, with *30,000 cases reported to the Centers for Disease Control and Prevention (CDC) every year (CDC 2017). However, several studies conducted by the CDC and others suggest the number of diagnosed cases of Lyme disease is actually 10-fold higher (Hinckley et al 2014, Nelson et al 2015, Schiffman et al 2016. In the United States, most cases occur in just 12 of the 50 states, with a concentration in New England, Mid-Atlantic, and Upper Midwest regions (CDC 2017).…”

Section: Worldwide Burden Of Lyme Diseasementioning

confidence: 99%

Brave New Worlds: The Expanding Universe of Lyme Disease

Stone

Tourand

Brissette

2017

Vector-Borne and Zoonotic Diseases

102

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Projections around the globe suggest an increase in tick-vectored disease incidence and distribution, and the potential for emergence of novel tick-borne pathogens. Lyme disease is the most common reported tick-borne illness in the Unites States and is prevalent throughout much of central Europe. In recent years, the worldwide burden of Lyme disease has increased and extended into regions and countries where the disease was not previously reported. In this review, we discuss the trends for increasing Lyme disease, and examine the factors driving Lyme disease expansion, including the effect of climate change on the spread of vector Ixodid ticks and reservoir hosts; and the impacts of increased awareness on disease reporting and diagnosis. To understand the growing threat of Lyme disease, we need to study the interplay between vector, reservoir, and pathogen. In addition, we need to understand the contributions of climate conditions to changes in disease risk.

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Underreporting of Lyme and Other Tick‐Borne Diseases in Residents of a High‐Incidence County, Minnesota, 2009

Cited by 32 publications

References 11 publications

Use of Commercial Claims Data for Evaluating Trends in Lyme Disease Diagnoses, United States, 2010–2018

Use of Commercial Claims Data for Evaluating Trends in Lyme Disease Diagnoses, United States, 2010–2018

Trends in canine seroprevalence to Borrelia burgdorferi and Anaplasma spp. in the eastern USA, 2010–2017

Brave New Worlds: The Expanding Universe of Lyme Disease

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