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      Epidemiology of Lyme Disease, Nova Scotia, Canada, 2002–2013

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          Abstract

          Nova Scotia has the highest reported incidence in Canada, but risk is localized to identified disease-endemic regions.

          Abstract

          Ixodes scapularis ticks, which transmit Borrelia burgdorferi, the causative agent of Lyme disease (LD), are endemic to at least 6 regions of Nova Scotia, Canada. To assess the epidemiology and prevalence of LD in Nova Scotia, we analyzed data from 329 persons with LD reported in Nova Scotia during 2002–2013. Most patients reported symptoms of early localized infection with rash (89.7%), influenza-like illness (69.6%), or both; clinician-diagnosed erythema migrans was documented for 53.2%. In a separate serosurvey, of 1,855 serum samples screened for antibodies to B. burgdorferi, 2 were borderline positive (both with an indeterminate IgG on Western blot), resulting in an estimated seroprevalence of 0.14% (95% CI 0.02%–0.51%). Although LD incidence in Nova Scotia has risen sharply since 2002 and is the highest in Canada (16/100,000 population in 2013), the estimated number of residents with evidence of infection is low, and risk is localized to currently identified LD-endemic regions.

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          Surveillance for Lyme disease--United States, 1992-2006.

          Rendi M Bacon, Kiersten J. Kugeler, Paul S. Mead (2008)
          Lyme disease is a multisystem disease that occurs in North America, Europe, and Asia. In the United States, the etiologic agent is Borrelia burgdorferi sensu stricto, a spirochete transmitted to humans by infected Ixodes scapularis and I. pacificus ticks. The majority of patients with Lyme disease develop a characteristic rash, erythema migrans (EM), accompanied by symptoms of fever, malaise, fatigue, headache, myalgia, or arthralgia. Other manifestations of infection can include arthritis, carditis, and neurologic deficits. Lyme disease can be treated successfully with standard antibiotic regimens. 1992--2006. U.S. health departments report cases of Lyme disease voluntarily to CDC as part of the National Notifiable Disease Surveillance System. Variables collected include patient age, sex, race, county and state of residence, date of illness onset, and reported signs and symptoms. During 1992--2006, a total of 248,074 cases of Lyme disease were reported to CDC by health departments in the 50 states, the District of Columbia, and U.S. territories; the annual count increased 101%, from 9,908 cases in 1992 to 19,931 cases in 2006. During this 15-year period, 93% of cases were reported from 10 states (Connecticut, Delaware, Massachusetts, Maryland, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island, and Wisconsin). Incidence was highest among children aged 5--14 years, and 53% of all reported cases occurred among males. More than 65% of patients with EM had illness onset in June and July, compared with 37% of patients with arthritis. Lyme disease is the most commonly reported vectorborne illness in the United States. The geographic distribution of cases is highly focused, with the majority of reported cases occurring in the northeastern and north-central states. During 1992--2006, the number of reported cases more than doubled. A disproportionate increasing trend was observed in children and in young males compared with other demographic groups. The results presented in this report underscore the continued emergence of Lyme disease and the need for tick avoidance and early treatment interventions. Public health practitioners can use the data presented in this report to target prevention campaigns to populations with increasing incidence (i.e., children and young males).
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            Human Borrelia miyamotoi infection in the United States.

            Peter Krause, Sukanya Narasimhan, Gary Wormser … (2013)
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              Recommendations for test performance and interpretation from the Second National Conference on Serologic Diagnosis of Lyme Disease.

              (1995)
              Article 0 comments Cited 85 times – based on 0 reviews     Review now
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                Author and article information

                Journal
                Journal ID (nlm-ta): Emerg Infect Dis
                Journal ID (iso-abbrev): Emerging Infect. Dis
                Journal ID (publisher-id): EID
                Title: Emerging Infectious Diseases
                Publisher: Centers for Disease Control and Prevention
                ISSN (Print): 1080-6040
                ISSN (Electronic): 1080-6059
                Publication date (Print): October 2015
                Volume: 21
                Issue: 10
                Pages: 1751-1758
                Affiliations
                [1]Nova Scotia Health Authority, Halifax, Nova Scotia, Canada (T.F. Hatchette, B.L. Johnston, D. Haldane);
                [2]Dalhousie University, Halifax (T.F. Hatchette, B.L. Johnston, D. Haldane); Public Health Agency of Canada, Ottawa, Ontario, Canada (E. Schleihauf, A. Mask);
                [3]Public Health Agency of Canada, Winnipeg, Manitoba, Canada (M. Drebot, R. Lindsay) Government of Nunavut, Iqaluit, Nunavut, Canada (M. Baikie);
                [4]Nova Scotia Department of Health and Wellness, Halifax (T.J. Cole, S. Fleming);
                [5]York Region Public Health, Newmarket, Ontario, Canada (R. Gould)
                Author notes
                Address for correspondence: Todd F. Hatchette, Division of Microbiology, Department of Pathology and Laboratory Medicine, QE II Health Science Center, Rm 315 Mackenzie Bldg, 5788 University Ave, Halifax, NS B3H 1V8, Canada; email: todd.hatchette@ 123456nshealth.ca
                Article
                Publisher ID: 14-1640
                DOI: 10.3201/eid2110.141640
                PMC ID: 4593424
                PubMed ID: 26401788
                SO-VID: 675a8f36-67cc-49e8-a883-27ae329322a6
                History
                Categories
                Subject: Research
                Subject: Research
                Subject: Epidemiology of Lyme Disease, Nova Scotia, Canada, 2002–2013

                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: lyme disease,nova scotia,canada,seroprevalence,borrelia burgdorferi,epidemiology,vector-borne infections,ticks
                Data availability:
                ScienceOpen disciplines: Infectious disease & Microbiology
                Keywords: lyme disease, nova scotia, canada, seroprevalence, borrelia burgdorferi, epidemiology, vector-borne infections, ticks

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