Lyme disease in France: a primary care-based prospective study

Letrilliart, Laurent; Ragon, Brittany Knick; Hanslik, Thomas; Flahault, Antoine

doi:10.1017/s0950268805004413

Cited by 53 publications

(39 citation statements)

References 23 publications

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“…A single study in Alsace revealed the presence of B. burgdorferi sensu lato in 11% of 2,223 nymphs collected in August 1989 (6). This northeastern region of France is reported as a region where LB is highly endemic (24). Moreover, a prospective study conducted in Alsace from 2001 to 2003 (18) estimated the LB incidence between 180 and 232 cases per 100,000 inhabitants per year and recorded high local variations between cantons (administrative divisions of a department in France).…”

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confidence: 99%

Prevalence of Borrelia burgdorferi Sensu Lato and Anaplasmataceae Members in Ixodes ricinus Ticks in Alsace, a Focus of Lyme Borreliosis Endemicity in France

Ferquel¹,

Garnier²,

Marie³

et al. 2006

Appl Environ Microbiol

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Due to the high Lyme borreliosis incidence in Alsace, in northeastern France, we investigated in 2003-2004 three cantons in this region in order to determine the density of Ixodes ricinus ticks infected by Borrelia burgdorferi sensu lato and Anaplasmataceae. The peak density of nymphs infected by B. burgdorferi sensu lato at Munster and Guebwiller, where the disease incidence was high, was among the highest reported in Europe (105 and 114 per 100 m 2 , respectively). In contrast, the peak density of infected nymphs was low in the canton of Dannemarie (5/100 m 2 ), where the disease incidence was low. The two main species detected in ticks were Borrelia afzelii, more frequent in nymphs, and Borrelia garinii, more frequent in adult ticks. The rates of tick infection by Anaplasma phagocytophilum were 0.4% and 1.2% in nymphs and adults, respectively.Lyme borreliosis (LB) is a worldwide disease due to bacteria belonging to the complex Borrelia burgdorferi sensu lato (31) and transmitted in Europe by the bite of Ixodes ricinus ticks (10), which is also involved in the transmission of other pathogens, particularly members of the Anaplasmataceae family (7). A phytoecological mapping of I. ricinus in France revealed a very large distribution of this tick (12). Moreover, the infestation of ticks by B. burgdorferi sensu lato has been reported in the whole French territory (11) and more precisely in restricted areas (1,29,30,32,39). A single study in Alsace revealed the presence of B. burgdorferi sensu lato in 11% of 2,223 nymphs collected in August 1989 (6). This northeastern region of France is reported as a region where LB is highly endemic (24). Moreover, a prospective study conducted in Alsace from 2001 to 2003 (18) estimated the LB incidence between 180 and 232 cases per 100,000 inhabitants per year and recorded high local variations between cantons (administrative divisions of a department in France). On the basis of this study (18), we selected two cantons in the Haut-Rhin department where the LB incidence was high and one canton where the incidence was low, in order to establish a correlation between the LB incidence and the density of infected ticks. We conducted a twoyear survey in 2003 and 2004 of the I. ricinus population density and the B. burgdorferi sensu lato infection rate. Because Anaplasma phagocytophilum is maintained in the same tick, the infection rate of I. ricinus ticks by members of Anaplasmataceae was also determined.The study was carried out in the Parc Régional des Ballons des Vosges, in northeastern France. By the drawing of lots, five and three sampling sites were designated, respectively, in the north part of the Parc (Munster canton) and in the south part (Guebwiller canton), where a high LB incidence of 250 cases/ 100,000 inhabitants was recorded (18). These sites are at an altitude of 400 to 700 m, largely covered by dense and continuous forests, and the climate is defined as continental. One sampling site was designated a "negative control site" in the Dannemarie canton, where the LB inci...

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confidence: 99%

Prevalence of Borrelia burgdorferi Sensu Lato and Anaplasmataceae Members in Ixodes ricinus Ticks in Alsace, a Focus of Lyme Borreliosis Endemicity in France

Ferquel¹,

Garnier²,

Marie³

et al. 2006

Appl Environ Microbiol

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“…A French national primary care-based prospective study estimated an overall national incidence rate of 9.4/100,000 (Letrilliart et al, 2005), whereas data from the Alsace study suggested a regional rate of 180-232/100,000, which varied from 30 to 511/100,000 between individual cantons in the region. Erythema migrans was the only manifestation of disease in 90% of the cases; a further 5% had evidence of neuroborreliosis.…”

Section: Regional Clinical Surveillance and Prospective Studiesmentioning

confidence: 99%

The Emergence and Epidemiology of Lyme Borreliosis in Europe and North America

Sood

O’Çonnell²,

Weber³

2011

Lyme Borreliosis in Europe and North America

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“…L'agent infectieux en cause est une bactérie spiralée de la famille des Spirochaetaceae : Borrelia burgdoferi sensu lato. La France fait partie des zones d'endémie de la maladie et l'incidence nationale a été estimée à 9,4/100 000 habitants [3], avec des variations selon les régions, les incidences les plus élevées étant dans le Limousin et surtout en Alsace (> 30/100 000 habitants) [4]. Chez l'enfant, il n'existe aucune donnée en France.…”

Section: Résuméunclassified

“…Au terme de ces différentes étapes, nous avions une réponse pour chacun des 70 pédiatres de ville du Bas-Rhin. La définition des cas de borréliose de Lyme devait correspondre aux critères Eucalb (European Union Concerted Action on Lyme Borreliosis) [3,5]. Ces critères (Tableau I) accompagnaient le questionnaire.…”

Section: Méthodesunclassified

“…Les données sur les patients regroupaient : les caractéristiques sociodémographiques (âge, sexe, lieu de rési-dence), les circonstances de la contamination (date, mode, activité, contexte), les manifestations cliniques détaillées de la maladie, les résultats des examens complémentaires à visée diagnostique (bactériologique ou autres), la prise en charge thérapeutique (type de traitement, durée) et l'évolution. Tous les dossiers ont été revus et seuls les cas répondant aux critères Eucalb [3,5] de la borréliose de Lyme ont été retenus. …”

Section: Méthodesunclassified

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