What is Lyme disease?
Lyme borreliosis, commonly known as Lyme disease, is a zoonosis caused by a bacterium belonging to the spirochete complex Borrelia burgdorferi sensu latoIt is transmitted by the bite of hard ticks, mainly the species Ixodes ricinus in Europe. Known as the “black-legged tick” or “sheep tick”, these blood-sucking mites thrive mainly in wooded areas and tall grass.
It is considered the most important tick-borne disease in Europe.
Distribution
In Europe, it is considered the most widespread zoonosis and, with an estimated 650,000 to 850,000 cases each year, the incidence is highest in Central Europe. In Spain, the data obtained reveal a progressive increase in the number of cases over the last fifteen years. However, the available figures are inaccurate, as the disease is underdiagnosed. and there are no harmonised epidemiological criteria between countries or regions for its surveillance (in Spain it is included in the list of notifiable diseases for regional endemic surveillance by Order SSI/445/2015), although it is described in more than 80 countries worldwide and is endemic in North America, many regions of Asia, Europe and especially Spain, and recognised as an occupational disease for farmers, forestry workers and scientific field researchers.
It is distributed throughout the Spanish territory, with a higher incidence in the northern half of the peninsula, during the spring and summer months (from April to October).
Disease burden
According to reports to the Spanish National Epidemiological Surveillance Network (National Epidemiological Surveillance NetworkRENAVE) between 2015 and 2020, a total of 99 cases were recorded in the territory. The autonomous communities with the highest number of cases are Aragon (36 cases), Galicia (26 cases) and the Basque Country (24 cases).
In Spain, a descriptive analysis of data from hospitalized patients with Lyme disease, registered between 2005 and 2019 in the Specialized Health Care Registry (Specialized Health Care Registry – Minimum Basic Data Set for Hospital DischargesRAE-CMBD), was carried out. During this period, 1 865 patients with this disease were registered, representing an increase in hospitalizations of 191.80%. The average rate of hospitalized patients over the entire period was 0.28 per 100,000 inhabitants. The majority of admissions were men (58.71%, hospitalization rate of 0.32) and, by age group, people over 65 years of age (34.48%, hospitalization rate of 0.52). The autonomous communities with the highest number of hospitalizations for this diagnosis were Asturias (16.38%, hospitalization rate of 1.99) and then Galicia (13.46%, hospitalization rate of 0.66). There was a general increase in admissions in all the autonomous communities, with the exception of Extremadura where they decreased, as well as an extension of the territorial distribution of the disease.
Why now ?
In its report on ecosystems and human well-being, the WHO states that trends such as deforestation or climate change affect insects that carry diseases such as malaria or Lyme disease. Other international scientific communities, such as the Harvard Medical School Centre, warn that in sixty years, the geographical areas where ticks are found will have increased by 123%.
It’s time to act
For all these reasons, and in accordance with the European Parliament’s motion for a resolution of 5 November 2018 [2018/2274 (RSP)]the following courses of action are proposed:
- Dedicate funds to research into early detection and future treatment of Lyme disease.
- Support information systems enabling the exchange of epidemiological data, particularly on the distribution and prevalence of pathogenic and non-pathogenic genotypes.
- Strengthening international cooperation for Lyme disease research.
- Establish a commission to collect as much information as possible on Lyme disease detection methods and treatments administered in the Member States, in order to facilitate cooperation and the exchange of good practices in surveillance, diagnosis and treatment and to implement harmonised surveillance programmes.
- Take individual tick prevention and control measures to stop the spread of Lyme disease.
- Develop empirical recommendations for clinical and laboratory diagnosis.
- Establish ICD codes to differentiate between early and advanced stages of Lyme disease.
- Publish recommendations based on best practices within the European Union regarding the training of family and community medicine professionals, in order to facilitate diagnosis and early detection.
- Implement innovative projects that can contribute to better data collection and greater effectiveness of educational measures and awareness campaigns.
Julia María Ruiz Redondo. Regional Nurse Advisor Inspector of the SEMG for the Autonomous Community of Castilla-La Mancha. Coordinator of the SEMG National Working Group on Public Health. Director of the Master in International Public Health at the TECH University of Technology (TECH Universidad Tecnológica).
This article was translated fromUnivadis.es using multiple editorial tools, including AI, in the process. The content was reviewed by the editorial staff before publication.
