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Shafquat M, Angulo FJ, Pilz A, Moïsi JC, Stark JH. The Incidence of Lyme Borreliosis Among Children. Pediatr Infect Dis J 2023; 42:867-874. [PMID: 37406218 PMCID: PMC10501351 DOI: 10.1097/inf.0000000000004040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND First recognized in children in the United States, Lyme borreliosis (LB) is the most prevalent tickborne illness in North America and Europe. However, the incidence of LB in children, including geographic variation and difference from that in adults, is incompletely described. METHODS We compiled surveillance data from public health agency websites reporting age-stratified LB case data, which was combined with census data to derive incidence estimates. Additional incidence estimates were obtained through a systematic literature review. RESULTS We identified 18 surveillance systems and 15 published studies for derivation of LB incidence in children. National incidence of >10 cases in children per 100,000 per year were estimated for the United States and parts of Eastern, Western and Northern Europe. However, there was substantial variation in incidence among countries in some European regions. National incidence estimates from the literature largely aligned with estimates from surveillance. Surveillance-reported pediatric incidence was lower than adult incidence in adults in 8 countries, similar to adult incidence in 3 countries, and higher than adult incidence in 1 country. Among all pediatric age strata, the 5-9 years of age stratum had the highest proportion of pediatric cases in most countries. CONCLUSIONS As pediatric LB represents a substantial proportion of overall LB incidence across countries in Europe and North America, LB prevention and control efforts should target pediatric as well as adult populations. However, better data are needed to fully characterize the difference in incidence across geographic regions.
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Affiliation(s)
- Madiha Shafquat
- From the Vaccines, Antivirals, and Evidence Generation, Medical Affairs, Pfizer Biopharma Group, Collegeville, Pennsylvania
| | - Frederick J. Angulo
- From the Vaccines, Antivirals, and Evidence Generation, Medical Affairs, Pfizer Biopharma Group, Collegeville, Pennsylvania
| | - Andreas Pilz
- Vaccines, Antivirals, and Evidence Generation, Medical Affairs, Pfizer Biopharma Group, Vienna, Austria
| | - Jennifer C. Moïsi
- Vaccines, Antivirals, and Evidence Generation, Medical Affairs, Pfizer Biopharma Group, Paris, France
| | - James H. Stark
- From the Vaccines, Antivirals, and Evidence Generation, Medical Affairs, Pfizer Biopharma Group, Collegeville, Pennsylvania
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Remesar S, Díaz P, Venzal JM, Prieto A, Estrada-Peña A, López CM, Panadero R, Fernández G, Díez-Baños P, Morrondo P. Longitudinal Study of Infection with Borrelia spp. in Questing Ticks from North-Western Spain. Vector Borne Zoonotic Dis 2019; 19:785-792. [DOI: 10.1089/vbz.2019.2442] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Susana Remesar
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Pablo Díaz
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Jose Manuel Venzal
- Laboratorio de Vectores y Enfermedades Transmitidas, Facultad de Veterinaria, Universidad de la República, CENUR Litoral Norte, Salto, Uruguay
| | - Alberto Prieto
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Agustín Estrada-Peña
- Departamento de Sanidad Animal, Facultad de Veterinaria, Universidad de Zaragoza, Zaragoza, Spain
| | - Ceferino Manuel López
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Rosario Panadero
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Gonzalo Fernández
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Pablo Díez-Baños
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Patrocinio Morrondo
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
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Díaz P, Arnal JL, Remesar S, Pérez-Creo A, Venzal JM, Vázquez-López ME, Prieto A, Fernández G, López CM, Panadero R, Benito A, Díez-Baños P, Morrondo P. Molecular identification of Borrelia spirochetes in questing Ixodes ricinus from northwestern Spain. Parasit Vectors 2017; 10:615. [PMID: 29262835 PMCID: PMC5738910 DOI: 10.1186/s13071-017-2574-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 12/06/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND Ixodes ricinus, the predominant tick species in Europe, can transmit the causative agents of important human diseases such as Lyme borreliosis (LB), caused by Borrelia spirochetes. In northern Spain, LB is considered endemic; recently, a significant increase of the annual incidence of LB was reported in the northwestern (NW) region. METHODS In order to provide information on the prevalence of Borrelia spp., pooled and individually free-living I. ricinus from NW Spain were molecularly analyzed. Positive samples were characterized at the fla and Glpq genes and the rrfA-rrlB intergenic spacer region to identify Borrelia species/genospecies. RESULTS Borrelia burgdorferi (sensu lato) (s.l.) individual prevalence and MIR were significantly higher in adult females (32.3 and 16%) than in nymphs (18.8 and 6.2%) and adult males (15.6 and 8.4%). Five Borrelia genospecies belonging to the B. burgdorferi (s.l.) group were identified: B. garinii was predominant, followed by B. valaisiana, B. lusitaniae, B. afzelii and B. burgdorferi (sensu stricto) (s.s.). One species belonging to the tick-borne relapsing fever group (B. miyamotoi) was also found, showing low individual prevalence (1%), positive pool (0.7%) and MIR (0.1%) values. To our knowledge, this is the first citation of B. miyamotoi in free-living ticks from Spain. CONCLUSIONS The significant prevalences of B. burgdorferi (s.l.) genospecies detected in questing ticks from NW Spain are similar to those detected in northern and central European countries and higher to those previously found in Spain. These results together with the high incidence of LB in humans and the high seroprevalence of B. burgdorferi (s.l.) in roe deer shown in other studies reveal that the northwest area is one of the most risky regions for acquiring LB in Spain.
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Affiliation(s)
- Pablo Díaz
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | | | - Susana Remesar
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Ana Pérez-Creo
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - José Manuel Venzal
- Laboratorio de Vectores y enfermedades transmitidas, Facultad de Veterinaria, CENUR Litoral Norte, Universidad de la República, Salto, Uruguay
| | | | - Alberto Prieto
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Gonzalo Fernández
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Ceferino Manuel López
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Rosario Panadero
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | | | - Pablo Díez-Baños
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
| | - Patrocinio Morrondo
- Departamento de Patología Animal (Grupo INVESAGA), Facultad de Veterinaria, Universidade de Santiago de Compostela, Lugo, Spain
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Vázquez-López ME, Fernández G, Díaz P, Díez-Morrondo C, Pego-Reigosa R, Coira-Nieto A. [Usefulness of serological studies for the early diagnosis of Lyme disease in Primary Health Care Centres]. Aten Primaria 2017; 50:16-22. [PMID: 28476293 PMCID: PMC6836939 DOI: 10.1016/j.aprim.2017.01.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2016] [Revised: 12/12/2016] [Accepted: 01/02/2017] [Indexed: 11/07/2022] Open
Abstract
Objetivo Determinar la utilidad del diagnóstico precoz de la enfermedad de Lyme (EL) en los Centros de Atención Primaria (CAP) empleando el ELISA como técnica de cribado serológico. Métodos Se realiza un estudio retrospectivo (2006-2013) consistente en la determinación mediante ELISA de la seropositividad a Borrelia de 2.842 personas consideradas en riesgo de padecer EL. Se estudia la relación entre el hábitat y la zona de residencia de las personas con seropositividad a Borrelia, según la procedencia de las muestras (CAP/Hospital). Resultados El 15,2% de los sueros resultaron positivos frente a Borrelia spp. La seropositividad fue significativamente superior en las muestras remitidas desde los CAP que desde el Hospital y en los habitantes del rural y la montaña frente al área urbana y la meseta. El porcentaje de seropositividad se incrementó con el transcurso de los años. Los médicos de Atención Primaria detectaron mayor porcentaje de enfermos de Lyme en Fase I y tras la instauración del tratamiento no se observaron secuelas. Conclusiones El papel del médico de atención primaria es primordial en el diagnóstico precoz de la EL, constatándose un mayor porcentaje de seropositivos entre las muestras remitidas desde los CAP con predominio del diagnóstico en Fase I de enfermedad y la resolución sin secuelas. La detección de anticuerpos específicos frente a Borrelia, mediante ELISA, es una prueba útil para el cribado de pacientes en riesgo de EL.
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Affiliation(s)
| | - Gonzalo Fernández
- Unidad de Epidemiología, Zoonosis y Salud Pública, Facultad de Veterinaria, Universidad de Santiago de Compostela, Lugo, España
| | - Pablo Díaz
- Unidad de Epidemiología, Zoonosis y Salud Pública, Facultad de Veterinaria, Universidad de Santiago de Compostela, Lugo, España
| | | | | | - Amparo Coira-Nieto
- Servicio de Microbiología, Hospital Universitario Lucus Agusti, Lugo, España
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