4.2 Article

Incidence of Lyme Borreliosis in Germany: Exploring Observed Trends Over Time Using Public Surveillance Data, 2016-2020

Journal

VECTOR-BORNE AND ZOONOTIC DISEASES
Volume 23, Issue 4, Pages 237-246

Publisher

MARY ANN LIEBERT, INC
DOI: 10.1089/vbz.2022.0046

Keywords

Lyme borreliosis; tick-borne disease; surveillance; spatial epidemiology; incidence; Germany

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The incidence, time trends, seasonality, and geographic distribution of Lyme borreliosis (LB) in Germany were analyzed using publicly reported surveillance data. From 2016 to 2020, a total of 63,940 LB cases were reported, with 94.7% clinically diagnosed and 5.3% laboratory-confirmed. The incidence rates were mostly stable over time, with an average annual incidence of 37.2/100,000 person-years. The risk of LB varied significantly by geographic area and age group, highlighting the need for targeted prevention interventions and reduction strategies.
Background: Public surveillance of Lyme borreliosis (LB) occurs in 9 out of 16 federal states of Germany and remains a critical facet of disease epidemiology and trends. We describe the incidence, time trends, seasonality, and geographic distribution of LB in Germany using publicly reported surveillance data.Methods: We obtained LB cases and incidence (2016-2020) from the online platform SurvStat@RKI 2.0, maintained by the Robert Koch Institute (RKI). Data included clinically diagnosed and laboratory-confirmed LB reported by nine out of 16 federal states of Germany where LB notification is mandatory.Results: During 2016-2020, the nine federal states reported 63,940 LB cases, of which 60,570 (94.7%) were clinically diagnosed, and 3370 (5.3%) also had laboratory confirmation, with an average of 12,789 cases annually. Incidence rates were mostly stable over time. The average annual LB incidence was 37.2/100,000 person-years and varied by spatial level, ranging from 22.9 to 64.6/100,000 person-years among nine states; from 16.8 to 85.6/100,000 person-years among 19 regions; and from 2.9 to 172.8/100,000 person-years among 158 counties. Incidence was lowest among persons 20-24 years old (16.1/100,000 person-years) and highest among those 65-69 years old (60.9/100,000 person-years). Most cases were reported between June and September, with a peak in July of every year.Conclusion: The risk of LB varied substantially at the smallest geographic unit and by age group. Our results underscore the importance of presenting LB data at the most spatially granular unit and by age to allow implementation of efficient preventive interventions and reduction strategies.

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