Use of Mass-Participation Outdoor Events to Assess Human Exposure to Tickborne Pathogens

Hall, Jessica L.; Alpers, Kathrin; Bown, Kevin; Martin, Stephen J.; Birtles, Richard J.

doi:10.3201/eid2303.161397

Cited by 22 publications

(33 citation statements)

References 27 publications

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“…The reasons for this are likely to be multiple and need to be further explored. They may include; a lower prevalence of Ixodes spp of ticks, a lower prevalence of Borrelia spp carriage by ticks (4.2% in southern England [31], 0-8.2% in northern England [32], and 10.2% in Scotland [33], compared to 13.6% across Europe [34]), and different levels of exposure of the general populace to ticks, possibly due to differences in occupational and/or recreational dispositions. One possible explanation is lower awareness about Lyme disease in the general population and primary care in the UK, compared to the rest of Europe.…”

Section: Discussionmentioning

confidence: 99%

A descriptive epidemiological study of the incidence of newly diagnosed Lyme disease cases in a UK primary care cohort, 1998–2016

et al. 2020

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Background: Primary care is likely to see the highest number of Lyme disease patients. Despite this, there is limited published data regarding Lyme disease patients accessing primary care in the UK. We aim to describe trends in the incidence of a new diagnosis, and demographics of patients identified in a primary care electronic health database. Methods: A descriptive epidemiological study of Lyme disease coded patients in UK primary care. 3725 patients coded for Lyme disease during 1998-2016 were identified within The Health Improvement Network (THIN). Incidence rates and the demographics of cases identified were described. Poisson regression was used to analyse socio-demographic characteristics of the cases. Results: There was an increase in annual crude incidence rates, peaking in 2015 at 5.47 (95% CI 4.85-6.14) cases per 100,000 population per year. Multivariable analysis showed there were significant differences in the ages of those affected, incidence of a new diagnosis rose as deprivation levels improved, and that there was a higher incidence of cases living in rural areas compared to urban areas. There was no significant difference between sexes for the UK. Cases were significantly more likely to identify with being white compared to the national population. Conclusions: An increasing incidence of patients newly coded with Lyme disease related Read codes was identified using data from a UK national primary care database. By comparing these incidence figures with national laboratory-confirmed surveillance data, a multiplication factor of 2.35 (95%CI 1.81-2.88) can be calculated in order to estimate the annual number of cases seen in primary care. The significant socio-demographic variables associated with a Lyme disease diagnosis likely reflect a complex interplay of socioeconomic issues, which needs to be further explored. Future work is needed to examine the treatment and management of patients within this database.

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Section: Discussionmentioning

confidence: 99%

A descriptive epidemiological study of the incidence of newly diagnosed Lyme disease cases in a UK primary care cohort, 1998–2016

et al. 2020

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“…This probably explains the finding of a 50% increased risk of non-melanoma skin cancers in Lyme neuroborreliosis patients. 25 …”

Section: Discussionmentioning

confidence: 99%

Long term survival, health, social functioning, and education in patients with European Lyme neuroborreliosis: nationwide population based cohort study

Obel

Dessau

Krogfelt

et al. 2018

BMJ

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ObjectiveTo estimate long term survival, health, and educational/social functioning in patients with Lyme neuroborreliosis compared with the general population.DesignNationwide population based cohort study using national registers.SettingDenmark.ParticipantsAll Danish residents diagnosed during 1986-2016 as having Lyme neuroborreliosis (n=2067), defined as a positive Borrelia burgdorferi intrathecal antibody test and a clinical diagnosis of Lyme borreliosis, and a comparison cohort from the general population matched on sex and date of birth (n=20 670).Main outcome measuresMortality rate ratios, incidence rate ratios of comorbidities, and differences in educational and social outcomes.ResultsMortality among patients with Lyme neuroborreliosis was not higher than in the general population (mortality rate ratio 0.90, 95% confidence interval 0.79 to 1.03). Lyme neuroborreliosis patients had increased risk of haematological (incidence rate ratio 3.07, 2.03 to 4.66) and non-melanoma skin cancers (1.49, 1.18 to 1.88). At diagnosis, Lyme neuroborreliosis patients had slightly higher employment and lower disability pension rates. After five years, patients and comparison cohort members had similar numbers of hospital contacts (difference −0.22, 95% confidence interval −0.45 to 0.02, in-hospital days/year; 0.37, −0.10 to 0.83, outpatient visits/year), employment rates (difference 1.5%, −2.1% to 5.1%), income (difference −1000, −20 000 to 18 000, Danish kroner), days of sick leave (difference −0.3, −3.5 to 3.0, per year), rates of receipt of a disability pension (difference −0.9%, −3.2% to 1.3%), and number of children (difference –0.10, −0.27 to 0.08). More patients were married (difference 4.8%, 2.2% to 7.4%) and had completed high school education (difference 7%, 1% to 12%).ConclusionA verified diagnosis of Lyme neuroborreliosis had no substantial effect on long term survival, health, or educational/social functioning. Nevertheless, the diagnosis decreased labour market involvement marginally and was associated with increased risk of haematological and non-melanoma skin cancers.

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“…Therefore, we suggest defining different LB prevention campaigns and public health policies for each activity. For an instance, activities such as gardening 16 can be linked to the residential exposure, whereas other activities such as scouting 13 , or outdoor sport 15 competitions could be linked to the recreational exposure. Note that a limitation of this work is that we are unable to provide a measure of occupational risk, but farmers 35 , veterinarians 36 , landscapers 37 , or forest workers 38 are known to have an elevated risk of LB infection.…”

Section: Discussionmentioning

confidence: 99%

“…Quantifying recreational pressure in nature is of interest in fields as diverse as public health, forestry management or environmental science. In public health, knowing the intensity of recreational activities might help delimiting locations that serve as an interface between natural elements and humans 13 , 15 – 17 . This can be useful to better design tick bite prevention campaigns in forested areas.…”

Section: Introductionmentioning

confidence: 99%

Using volunteered observations to map human exposure to ticks

Garcia‐Martí

Zurita-Milla

Harms

et al. 2018

Sci Rep

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Lyme borreliosis (LB) is the most prevalent tick-borne disease in Europe and its incidence has steadily increased over the last two decades. In the Netherlands alone, more than 20,000 citizens are affected by LB each year. Because of this, two Dutch citizen science projects were started to monitor tick bites. Both projects have collected nearly 50,000 geo-located tick bite reports over the period 2006–2016. The number of tick bite reports per area unit is a proxy of tick bite risk. This risk can also be modelled as the result of the interaction of hazard (e.g. tick activity) and human exposure (e.g. outdoor recreational activities). Multiple studies have focused on quantifying tick hazard. However, quantifying human exposure is a harder task. In this work, we make a first step to map human exposure to ticks by combining tick bite reports with a tick hazard model. Our results show human exposure to tick bites in all forested areas of the Netherlands. This information could facilitate the cooperation between public health specialists and forest managers to create better mitigation campaigns for tick-borne diseases, and it could also support the design of improved plans for ecosystem management.

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Use of Mass-Participation Outdoor Events to Assess Human Exposure to Tickborne Pathogens

Cited by 22 publications

References 27 publications

A descriptive epidemiological study of the incidence of newly diagnosed Lyme disease cases in a UK primary care cohort, 1998–2016

A descriptive epidemiological study of the incidence of newly diagnosed Lyme disease cases in a UK primary care cohort, 1998–2016

Long term survival, health, social functioning, and education in patients with European Lyme neuroborreliosis: nationwide population based cohort study

Using volunteered observations to map human exposure to ticks

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