Combining primary care surveillance and a meta-analysis to estimate the incidence of the clinical manifestations of Lyme borreliosis in Belgium, 2015–2017

Geebelen, Laurence; Cauteren, Dieter Van; Devleesschauwer, Brecht; Moreels, Sarah; Tersago, Katrien; Oyen, Herman Van; Speybroeck, Niko; Lernout, Tinne

doi:10.1016/j.ttbdis.2018.12.007

Cited by 17 publications

(18 citation statements)

References 50 publications

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“…The overall incidence of LNB in Denmark between 1996-2015 was 2.6 per 100,000 individuals per year. This was of the same magnitude as has been estimated in earlier studies from Denmark as well as in Belgium but higher than in Germany and France (Enkelmann et al, 2018;Geebelen et al, 2019;Septfons et al, 2019). The incidence was however half the IR described from the neighboring country Sweden that reported an overall incidence of 6.3 per 100,000 for 2014.…”

Section: Discussionsupporting

confidence: 73%

Changes in Lyme neuroborreliosis incidence in Denmark, 1996 to 2015

Tetens

Haahr

Dessau

et al. 2020

Ticks and Tick-borne Diseases

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Section: Discussionsupporting

confidence: 73%

Changes in Lyme neuroborreliosis incidence in Denmark, 1996 to 2015

Tetens

Haahr

Dessau

et al. 2020

Ticks and Tick-borne Diseases

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“…2 Widespread musculoskeletal pain expressed as muscle pain (1) or joint pain (2) at more than one place of the body, fatigue (3), or cognitive difficulties expressed as memory problems (4), difficulties concentrating (5) or problems finding words (6). 3 The impact on daily activities had to be present during at least 6 months, but not necessarily start within 6 months. 4 Causes explaining the new occurrence or worsening of a symptom reported by the patient as cause for the symptom (e.g.…”

Section: No Yesmentioning

confidence: 99%

“…The most common manifestation is an erythema migrans (EM), an early-localized infection, possibly accompanied with flu-like symptoms. When left untreated, early disseminated LB or late LB may develop, amongst others, as multiple erythema migrans (MEM), Lyme neuroborreliosis (LNB), Lyme arthritis (LA), Lyme carditis or acrodermatitis chronica atrophicans (ACA) [1][2][3]. In addition to these objectively identifiable manifestations, it has been reported that a subset of patients continued to experience non-specific symptoms, even despite adequate antibiotic treatment.…”

Section: Introductionmentioning

confidence: 99%

Non-specific symptoms and post-treatment Lyme disease syndrome in patients with Lyme borreliosis: a prospective cohort study in Belgium (2016–2020)

Geebelen

Lernout²,

Devleesschauwer³

et al. 2022

BMC Infect Dis

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Background Patients with Lyme borreliosis (LB) may report persisting non-specific symptoms such as fatigue, widespread musculoskeletal pain or cognitive difficulties. When present for more than 6 months and causing a reduction in daily activities, this is often referred to as post-treatment Lyme disease syndrome (PTLDS). This study aimed to compare the occurrence of symptoms between LB patients and controls, to estimate the proportion of LB patients developing PTLDS and to identify risk factors. Methods A prospective cohort study was set up including three subpopulations: patients with an erythema migrans (EM) (i) or disseminated/late LB (ii) and a non-LB control group (iii). At 6- and 12-months follow-up, the occurrence of several symptoms, including six symptoms used to define PTLDS, i.e. muscle pain, joint pain, fatigue, memory problems, difficulties concentrating and problems finding words, and impact on daily activities, was compared between LB patients and controls. Finally, the proportion of LB patients developing PTLDS as defined by the Infectious Disease Society of America was estimated, including a time frame for symptoms to be present. Results Although the risk of presenting PTLDS-related symptoms was significantly higher in EM patients (n = 120) compared to controls (n = 128) at 6 months follow-up, the risk of presenting at least one of these symptoms combined with impact on daily activities was not significantly higher in EM patients, at either 6- or 12-months follow-up. A significant association was found between disseminated/late LB (n = 15) and the occurrence of any PTLDS-symptom with an impact on daily activities at both time points. The proportion of patients with PTLDS was estimated at 5.9% (95% CI 2.7–12.9) in EM patients and 20.9% (95% CI 6.8–64.4) in patients with disseminated/late LB (RR = 3.53, 95% CI 0.98–12.68, p = 0.053). No significant risk factors were identified, which may be explained by small sample sizes. Conclusions In our study, PTLDS was present in both LB cohorts, yet with a higher percentage in disseminated/late LB patients. Additional research is needed into risk factors for and causes of this syndrome. In addition, development and validation of standardized methods to assess the PTLDS case definition, easily applicable in practice, is of great importance.

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“…Lyme neuroborreliosis (LNB) is caused by infection with the spirochete Borrelia burgdorferi sensu lato complex ( B burgdorferi ) and is the most frequent tick-borne central nervous system (CNS) infection in Europe with incidence rates estimated to be 3.2-6.3 per 100,000/year. 1 - 7 …”

Section: Introductionmentioning

confidence: 99%

Neurofilament Light in Cerebrospinal Fluid is Associated With Disease Staging in European Lyme Neuroborreliosis

Mens

Fjordside

Gynthersen

et al. 2022

J Cent Nerv Syst Dis

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Background Drivers of differences in disease presentation and symptom duration in Lyme neuroborreliosis (LNB) are currently unknown. Objectives We hypothesized that neurofilament light (NfL) in cerebrospinal fluid (CSF) would predict disease location and sequelae in a historic LNB cohort. Design Using a cross-sectional design and archived CSF samples from 185 patients diagnosed with LNB, we evaluated the content of NfL in the total cohort and in a subgroup of 84 patients with available clinical and paraclinical information. Methods Individuals were categorized according to disease location: a. Central nervous system (CNS) with stroke (N=3), b. CNS without stroke (N=11), c. Peripheral nervous system (PNS) with cranial nerve palsy (CNP) (N=40) d. PNS without CNP (N=30). Patients with hospital follow-up more than 6 months after completed antibiotic therapy were categorized as having LNB associated sequelae (N=15). Results At diagnosis concentration of NfL exceeded the upper reference level in 60% (105/185), especially among individuals above 30 years. Age-adjusted NfL was not found to be associated with symptom duration. Age-adjusted NfL was significantly higher among individuals with CNS involvement. Category a. (stroke) had significantly higher NfL concentrations in CSF compared to all other categories, category b. (CNS involvement without stroke) had significantly higher values compared to the categories of PNS involvement. We found no significant difference between the categories with PNS involvement (with or without CNP). Significantly higher NfL was found among patients with follow-up in hospital setting. Conclusion Comparison of NfL concentrations between the 4 groups of LNB disease manifestations based on clinical information revealed a hierarchy of neuron damage according to disease location and suggested evolving mechanisms with accelerated injury especially when disease is complicated by stroke. Higher values of NfL among patients with need of follow-up in hospital setting suggest NfL could be useful to identify rehabilitative needs.

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Combining primary care surveillance and a meta-analysis to estimate the incidence of the clinical manifestations of Lyme borreliosis in Belgium, 2015–2017

Cited by 17 publications

References 50 publications

Changes in Lyme neuroborreliosis incidence in Denmark, 1996 to 2015

Changes in Lyme neuroborreliosis incidence in Denmark, 1996 to 2015

Non-specific symptoms and post-treatment Lyme disease syndrome in patients with Lyme borreliosis: a prospective cohort study in Belgium (2016–2020)

Neurofilament Light in Cerebrospinal Fluid is Associated With Disease Staging in European Lyme Neuroborreliosis

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