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Lyme Disease in the United Kingdom

The following background data on Lyme disease in the United Kingdom were abstracted from Gideon www.GideonOnline.com and the Gideon e-book series.  [1,2] Primary references are available on request.

Time and Place:

Lyme disease is reported from East Anglia, Scotland, Wales, Yorkshire and Northern Ireland.  Highest incidence is associated with popular holiday destinations such as Exmoor, the New Forest, the South Downs, parts of Wiltshire and Berkshire, Thetford Forest, the Lake District, the Yorkshire moors and the Highlands and Islands of Scotland.  “Hot spots” for the disease include the New Forest and the Southwest region.  45% of reports originate in three contiguous counties in southern England:  Hampshire, Wiltshire and Dorset.  This area includes foci in and near the New Forest and Salisbury Plain. Other counties with a relatively high incidence include Devon and Somerset in southwestern England; and Norfolk in East Anglia.

Incidence:

Reporting rates in the United Kingdom are approximately 39% of true incidence (2011).  Case reports peak in the third quarter of each year, which accounts for 48% of all cases.

In the following graphs, I’ve contrasted case numbers and rates per 100,000 in the United Kingdom, with those reported in Ireland and the United States.  Note that highest disease incidence in the United Kingdom is reported from England and Wales;  and highest rates per 100,000 from Scotland.  Reported rates in the United States are approximately 2.5-fold those of Scotland.

lyme

Infections due to Borrelia burgdorferi, B. afzelii and B. garinii are identified.

Borrelia valaisiana and B. afzelii have been identified in ticks in Scotland.

 

Prevalence surveys:

23% of patients referred to an infectious disease unit for suspected Lyme disease (2006 to 2010)
2.3% of dog ticks in the United Kingdom (2009)
4.2% of ticks (Ixodes ricinus) in England (2014 publication)
0.5% of pet-dog ticks (2012 publication)
0% of tick larvae, 2.14% of nymphs and 0% of adults in South London parks (2015 publication)
8.6% of ticks in the Scottish Highlands (both B. afzelii and B. burgdorferi, 1997)
37% of ticks in wooded areas of southern Wales
8.6% of Highland ticks in Scotland (Borrelia burgdorferi, 1997)
5.6% of questing tick nymphs in Scotland (Borrelia burgdorferi, 2012 publication)
11.9% of grey squirrels in Scotland (Sciurus carolinensis, 2015 publication)

Seroprevalence surveys:

2.5% to 4.0% of blood donors in South England
0% to 0.5% of blood donors in the inner-city
25% of forestry workers in endemic areas (1989 publication)
14.3% of farmers in Northern Ireland (1990 publication)
6.5% of individuals in the Scottish Highlands (2004 to 2006)
23% of wild deer in England and Wales (2012 publication)

Reservoirs:

Grey squirrels (Sciurus carolinensis Gmelin) and pheasants (Phasianus colchicus Linneaus) 18 are important hosts for Ixodes ricinus, and may serve as amplifying hosts for Borrelia burgdorferi in this country.

Seropositive horses are found in most parts of the U.K.

Note featured on ProMed

References:
1. Berger SA. Lyme Disease: Global Status, 2016. 87 pages, 67 graphs, 1037 references. Gideon ebooks, https://www.gideononline.com/ebooks/disease/lyme-disease-global-status/

2. Berger SA. Infectious Diseases of the United Kingdom, 2016. 1317 pages, 971 graphs, 4,932 references. Gideon ebooks,

Infectious Diseases of the United Kingdom

Lyme Disease Rates in Finland

A recent report on ProMed that Lyme disease is an under-reported disease in Finland is disturbing.  Officially-reported rates have been increasing rapidly since the year 2000, and already exceed those of the United States by more than three-hundred percent !  [1,2]  See graph

Lyme-Finland

References:

  1. Berger S. Lyme Disease – Global Status, 2016. 83 pages, 66 graphs, 882 references. Gideon ebooks,  www.gideononline.com/ebooks/disease/lyme-disease-global-status/
  2. Berger S. Infectious Diseases of Finland, 2016. 482 pages, 130 graphs, 2,035 references. Gideon e-books

Lyme Disease in New York

The incidence of Lyme disese in New York State has changed little over the years, in contrast to increasing rates reported on a national level. [1,2] See graph

LymeUSvNY

References:
1. Berger SA. Infectious Diseases of the United States, 2014. 1145 pages, 478 graphs, 12,294 references. Gideon e-books, LymeUSvNY“>https://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Lyme Disease: Global Status, 2014. 77 pages, 66 graphs, 786 references. Gideon e-books, https://www.gideononline.com/ebooks/disease/lyme-disease-global-status/

Note featured on ProMED

United States: Recent Trends in Tick-borne Diseases

Since 1999, there has been a striking parallel among rates of reportable tick-borne diseases in the United States – see graph (Lyme disease expressed as cases per 100,000 for fit). [1,2]

References:
1. Berger SA. Infectious Diseases of the United States, 2012. 1089 pages, 467 graphs, 9760 references. Gideon e-books, https://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Gideon graph tool at https://www.gideononline.com/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

Lyme Disease in Canada

The following background information is abstracted from Gideon www.GideonOnline.com and the Gideon e-book series. [1,2]

Time and Place:
The first case of Lyme disease in Canada was reported from Quebec in 1984.
– Approximately 100 cases had been reported as of 1990 (67 of these from Ontario); 205 as of 1994 (105 of these autochthonous).
– As of 1997, cases were reported from New Brunswick, Quebec, Ontario, southern Manitoba and British Columbia.
– 280 cases were reported from Ontario during 1981 to 1998 (127 locally acquired); 172 during 1999 to 2004 (31 locally-acquired).
– 20 cases were reported in Alberta during 1989 to 2008.
– Nova Scotia reported its first locally-acquired case of Lyme disease in 2002.
– 93 cases were confirmed in British Columbia during 1997 to 2008 (true number estimated at 142).

Vectors and Reservoirs:
– The local vectors include the deer tick (Ixodes scapularis), western blacklegged tick (I. pacificus) and rabbit tick (Haemaphysalis leporispalustris – possibly an enzootic vector in Alberta).
– As of 2000, I. scapularis had been found in over 250 locations in Canada including Ontario, Newfoundland, Nova Scotia , New Brunswick, Quebec, Manitoba, Prince Edward Island and Saskatchewan; the Long Point Peninsula on Lake Erie (southern Ontario); Point Pelee National park and Rondeau Provincial Park on the north shore of Lake Erie; and Atlantic Canada.
– I. pacificus is found in the southern and coastal regions of British Columbia (Borrelia burgdorferi has also been found in Ixodes angustus in these areas), the Gulf Islands and Vancouver Island.
– Passerine birds appear to disperse infected ticks in Canada.
– An infected tick (Ixodes scapularis) was found on a bird (common yellowthroat = Geothlypis trichas) in Nova Scotia (1999).
– Borrelia burgdorferi has been identified in an additional avian tick species, Ixodes auritulus.
– Borrelia garinii has been identified in seabird ticks (Ixodes uriae) in Newfoundland. Ixodes uriae is a known parasite of deer mice (Peromyscus maniculatus) on the Gannet Island Archipelago, Newfoundland and Labrador.

Prevalence surveys:
12.5% I. scapularis, including 10.1% of ticks collected from humans (2006 publication)
8% of I. scapularis nymphs recovered from northward migrating birds in non-endemic areas of Eastern Canada (2005 to 2006)
11.4% of ticks collected from songbirds (2004 to 2006)
67% of tick pools collected at Turkey Point Provincial Park, Ontario (2005 to 2006)
29.5% of ticks infesting songbirds, nationwide (2011 publication)

References:
1. Berger SA. Infectious Diseases of Canada, 2012. 496 pages, 107 graphs, 3130 references. Gideon e-books, https://www.gideononline.com/ebooks/country/infectious-diseases-of-canada/
2. Berger SA. Lyme Disease: Global Status, 2012. 73 pages, 65 graphs, 593 references. Gideon e-books, https://www.gideononline.com/ebooks/disease/lyme-disease-global-status/

Lyme Disease – Incidence by States

Although most cases of Lyme disease in the United States were initially reported by New York, Pennsylvania and Connecticut, disease incidence in these states has not paralled a steady increase in national rates since the 1990’s (see graph). [1-3]

References:
1. Berger SA. Infectious Diseases of the United States, 2012. 1089 pp, 467 graphs, 9760 references. Gideon e-books, https://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Lyme Disease: Global Status, 2012. 73 pp, 65 graphs, 593 references. Gideon e-books, https://www.gideononline.com/ebooks/disease/lyme-disease-global-status/
3. Gideon graph tool at https://www.gideononline.com/wp-content/uploads/Gideon-Graphs.pps

Tick-borne Diseases in the United States

Nine tick-borne infections affect humans in the United States. Data on a national level are available for Lyme disease, Powassan encephalitis, Rocky Mountain spotted fever, Tularemia, Granulocytic ehrlichiosis (Anaplasmosis) and Human monocytic ehrlichiosis. Statistics for three diseases (Babesiosis, Relapsing fever and Colorado tick fever) are not published. The following graph compares reporting trends for tick-borne infections (Lyme disease displayed as cases/100,000 for fit). [1,2]

Note an apparent parallel increase for some diseases during 2000 to 2008, followed by a dip during 2009 to 2010. Assuming a statistical association between these data, explanations might include changes in tick populations as a whole, or trends in human-tick contact over time.

References:
1. Berger SA. Infectious Diseases of the United States, 2012. 1089 pp, 467 graphs, 9760 references. Gideon e-books, https://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Gideon graph tool at https://www.gideononline.com/wp-content/uploads/Gideon-Graphs.pps

Lyme Disease in the United Kingdom

The incidence of Lyme disease has been increasing in the United Kingdom since reporting began, with highest rates in Scotland. In the following graph I’ve contrasted these rates with those of the Uhnited States. [1]

Reference:
1. Gideon graph tool at https://www.gideononline.com/wp-content/uploads/Gideon-Graphs.pps

Note featured on ProMED

Tick-borne Encephalitis (correction)

In a previous post, I noted that “highest rates [of Tick-borne encephalitis] are reported in Germany and the Czech Republic.” The statement should read, “highest rates …. in Slovenia and the Czech Republic.” Not surprisingly, Slovenia and the Czech Republic also report the highest rates of Lyme borreliosis, another tick-borne illness. In the following graph, rates for the United States are added for comparison. [1,2]

References:
1. Berger SA. Infectious Diseases of Slovenia, 2011. 377 pp., 114 graphs, 931 references. Gideon e-books, https://www.gideononline.com/ebooks/country/infectious-diseases-of-slovenia/
2. Berger SA. Lyme disease: Global Status, 2011. 68 pp., 61 graphs, 496 references. Gideon e-books, https://www.gideononline.com/ebooks/disease/lyme-disease-global-status/

Lyme Disease in Pennsylvania

Although the incidence of Lyme disease the United States has been steadily increasing since 1993, case numbers for Pennsylvania, New York and Connecticut (the three states with highest disease rates) have not changed substatially. [1,2] See graph

References:
1. Berger SA. Infectious Diseases of the United States, 2011. 1030 pp, 464 graphs, 8237 references. Gideon E-books, https://www.gideononline.com/ebooks/country/infectious-diseases-of-the-united-states/
2. Berger SA. Lyme Disease: Global Status, 2011. 68 pages, 61 graphs, 496 references. Gideon E-books, https://www.gideononline.com/ebooks/disease/lyme-disease-global-status/

Update: Posted in ProMED

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