Lyme disease epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2], Ilan Dock, B.S.

Overview

Lyme disease is the most commonly reported vector-borne illness in the United States. In 2015, it was the sixth most common nationally notifiable disease. The number of people diagnosed with Lyme disease each year in the United States is around 30,000. This disease is concentrated heavily in the Northeast and upper Midwest. Lyme disease has a seasonal variation and incidence increases during months of May to August.

Epidemiology and Demographics

Incidence

  • Lyme disease is the most common tick-borne disease in North America and Europe, and one of the fastest-growing infectious diseases in the United States.
  • The number of people diagnosed with Lyme disease each year in the United States is around 30,000.[1]
  • In the United States, the incidence of Lyme disease is 8.1 per 100,000 individuals as per data collected by the Center for Disease Control (CDC) in 2016.[2]
  • In the fourteen states where Lyme disease is most common, the average was 40.4 cases for every 100,000 persons in the year 2015.[1][3]
  • Although Lyme disease has now been reported in the majority of states in the U.S, about 95% of all reported cases are confined to just five geographic areas including New England, Mid-Atlantic, East-North Central, South Atlantic, and West North-Central.[3]
Reported cases of Lyme disease in the United Stated from 2001 to 2015 - Source: CDC.gov

Seasonal Variation

Confirmed Lyme disease cases by month of disease onset–United States, 2001-2015 - Source: CDC.gov

Widespread disease and endemic regions

  • The number of reported cases of the disease has been increasing, as is the number of endemic regions in North America.
  • B. burgdorferi sensu lato has been maintained in enzootic cycles in California as well as other regions throughout North America, Europe, and North Africa. Indeed, the DNA of Borrelia has been detected in lizards, indicating that they can be infected.[6]
  • In Europe, cases of B. burgdorferi sensu lato infected ticks are found predominantly in Norway, Netherlands, Germany, France, Italy, Slovenia, and Poland, but have been isolated in almost every country on the continent. Lyme disease statistics for Europe can be found at the Eurosurveillance website.
  • B. burgdorferi sensu lato infested ticks are being found more frequently in Japan, as well as in northwest China and far eastern Russia.[7][8] Borrelia has been isolated in Mongolia as well.[9]
  • In South America, tick-borne disease recognition and occurrence is rising.
  • Ticks carrying B. burgdorferi sensu lato, as well as canine and human tick-borne disease, have been reported widely in Brazil, but the subspecies of Borrelia have not yet been defined.[10] The first reported case of Lyme disease in Brazil was in 1993 in Sao Paulo.[11]
  • B. burgdorferi sensu stricto antigens in patients have been identified in Colombia and Bolivia.
  • In Northern Africa, B. burgdorferi sensu lato has been identified in Morocco, Algeria, Egypt, and Tunisia.[12][13][14]
  • In Western and sub-Saharan Africa, tick-borne relapsing fever was first identified by the British physicians Joseph Dutton and John Todd in 1905. Borrelia in the manifestation of Lyme disease in this region is presently unknown but evidence indicates that Lyme disease may occur in humans in sub-Saharan Africa. The abundance of hosts and tick vectors would favor the establishment of Lyme infection in Africa.[15] In East Africa, two cases of Lyme disease have been reported in Kenya.[16]
  • In Australia there is no definitive evidence for the existence of B. burgdorferi or for any other tick-borne spirochete that may be responsible for a local syndrome being reported as Lyme disease.[17] Cases of neuroborreliosis have been documented in Australia but are often ascribed to travel to other continents. The existence of Lyme disease in Australia is controversial.
  • Data shows that Northern hemisphere temperate regions are most endemic for Lyme disease.[18][19]
Geographical distribution of Lyme disease - Source: WIKICOMMONS


Age

  • There's a higher incidence of infection among children and infants of less than a year to 15 years.
  • Another peak occurs in individuals between the ages of 40 to 55 years.

Gender

  • On average, there is a higher incidence among males than females.
  • However, among people aged 70 and higher, females tend to have a higher incidence of infection.
Peaks occur in males between the ages of less than one year to 15 and 40 to 55 years. Female patients are at a slightly higher risk than male patients above the age of 70. - Source: CDC.gov

Race

References

  1. 1.0 1.1 "Lyme disease data tables | Lyme Disease | CDC".
  2. "Data and Statistics | Lyme Disease | CDC".
  3. 3.0 3.1 "Data and Statistics | Lyme Disease | CDC".
  4. Schwartz, Ira; Fish, Durland; Daniels, Thomas J. (1997). "Prevalence of the Rickettsial Agent of Human Granulocytic Ehrlichiosis in Ticks from a Hyperendemic Focus of Lyme Disease". New England Journal of Medicine. 337 (1): 49–50. doi:10.1056/NEJM199707033370111. ISSN 0028-4793.
  5. Falco RC, McKenna DF, Daniels TJ, Nadelman RB, Nowakowski J, Fish D; et al. (1999). "Temporal relation between Ixodes scapularis abundance and risk for Lyme disease associated with erythema migrans". Am J Epidemiol. 149 (8): 771–6. PMID 10206627.
  6. Swanson KI, Norris DE (2007). "Detection of Borrelia burgdorferi DNA in lizards from Southern Maryland". Vector Borne Zoonotic Dis. 7 (1): 42–9. doi:10.1089/vbz.2006.0548. PMID 17417956.
  7. Li M, Masuzawa T, Takada N; et al. (1998). "Lyme disease Borrelia species in northeastern China resemble those isolated from far eastern Russia and Japan". Appl. Environ. Microbiol. 64 (7): 2705–9. PMID 9647853.
  8. Masuzawa T (2004). "Terrestrial distribution of the Lyme borreliosis agent Borrelia burgdorferi sensu lato in East Asia". Jpn. J. Infect. Dis. 57 (6): 229–35. PMID 15623946.
  9. Walder G, Lkhamsuren E, Shagdar A; et al. (2006). "Serological evidence for tick-borne encephalitis, borreliosis, and human granulocytic anaplasmosis in Mongolia". Int. J. Med. Microbiol. 296 Suppl 40: 69–75. doi:10.1016/j.ijmm.2006.01.031. PMID 16524782.
  10. Mantovani E, Costa IP, Gauditano G, Bonoldi VL, Higuchi ML, Yoshinari NH (2007). "Description of Lyme disease-like syndrome in Brazil. Is it a new tick borne disease or Lyme disease variation?". Braz. J. Med. Biol. Res. 40 (4): 443–56. PMID 17401487.
  11. Yoshinari NH, Oyafuso LK, Monteiro FG; et al. (1993). "Lyme disease. Report of a case observed in Brazil". Revista do Hospital das Clínicas (in Portuguese). 48 (4): 170–4. PMID 8284588.
  12. Bouattour A, Ghorbel A, Chabchoub A, Postic D (2004). "Lyme borreliosis situation in North Africa". Archives de l'Institut Pasteur de Tunis (in French). 81 (1–4): 13–20. PMID 16929760.
  13. Dsouli N, Younsi-Kabachii H, Postic D; et al. (2006). "Reservoir role of lizard Psammodromus algirus in transmission cycle of Borrelia burgdorferi sensu lato (Spirochaetaceae) in Tunisia". J. Med. Entomol. 43 (4): 737–42. PMID 16892633.
  14. Helmy N (2000). "Seasonal abundance of Ornithodoros (O.) savignyi and prevalence of infection with Borrelia spirochetes in Egypt". Journal of the Egyptian Society of Parasitology. 30 (2): 607–19. PMID 10946521.
  15. Fivaz BH, Petney TN (1989). "Lyme disease--a new disease in southern Africa?". Journal of the South African Veterinary Association. 60 (3): 155–8. PMID 2699499.
  16. Jowi JO, Gathua SN (2005). "Lyme disease: report of two cases". East African medical journal. 82 (5): 267–9. PMID 16119758.
  17. Piesman J, Stone BF (1991). "Vector competence of the Australian paralysis tick, Ixodes holocyclus, for the Lyme disease spirochete Borrelia burgdorferi". Int. J. Parasitol. 21 (1): 109–11. PMID 2040556.
  18. Grubhoffer L, Golovchenko M, Vancová M, Zacharovová-Slavícková K, Rudenko N, Oliver JH (2005). "Lyme borreliosis: insights into tick-/host-borrelia relations". Folia Parasitol. 52 (4): 279–94. PMID 16405291.
  19. Higgins R (2004). "Emerging or re-emerging bacterial zoonotic diseases: bartonellosis, leptospirosis, Lyme borreliosis, plague". Rev. - Off. Int. Epizoot. 23 (2): 569–81. PMID 15702720.
  20. "Racial Disparities in Nationally Notifiable Diseases --- United States, 2002".

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