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Surveillance Open Access
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Abstract

Background

In a study from 2013 that prioritised communicable diseases for surveillance in Sweden, we identified Lyme borreliosis as one of the diseases with highest priority. In 2014, when the present study was designed, there were also plans to make neuroborreliosis notifiable within the European Union.

Aim

We compared possibilities of surveillance of neuroborreliosis in Sweden through two different sources: the hospital discharge register and reporting from the clinical microbiology laboratories.

Methods

We examined the validity of ICD-10 codes in the hospital discharge register by extracting personal identification numbers for all cases of neuroborreliosis, defined by a positive cerebrospinal fluid–serum anti- antibody index, who were diagnosed at the largest clinical microbiology laboratory in Sweden during 2014. We conducted a retrospective observational study with a questionnaire sent to all clinical microbiology laboratories in Sweden requesting information on yearly number of cases, age group and sex for the period 2010 to 2014.

Results

Among 150 neuroborreliosis cases, 67 (45%) had received the ICD-10 code A69.2 (Lyme borreliosis) in combination with G01.9 (meningitis in bacterial diseases classified elsewhere), the combination that the Swedish National Board of Health and Welfare recommends for neuroborreliosis. All 22 clinical laboratories replied to our questionnaire. Based on laboratory reporting, the annual incidence of neuroborreliosis in Sweden was 6.3 cases per 100,000 in 2014.

Conclusion

The hospital discharge register was unsuitable for surveillance of neuroborreliosis, whereas laboratory-based reporting was a feasible alternative. In 2018, the European Commission included Lyme neuroborreliosis on the list of diseases under epidemiological surveillance.

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/content/10.2807/1560-7917.ES.2019.24.20.1800453
2019-05-16
2019-12-07
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.20.1800453
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References

  1. Stanek G, Wormser GP, Gray J, Strle F. Lyme borreliosis. Lancet. 2012;379(9814):461-73.  https://doi.org/10.1016/S0140-6736(11)60103-7  PMID: 21903253 
  2. Jaenson TG, Tälleklint L. Incompetence of roe deer as reservoirs of the Lyme borreliosis spirochete. J Med Entomol. 1992;29(5):813-7.  https://doi.org/10.1093/jmedent/29.5.813  PMID: 1404260 
  3. Stanek G, Fingerle V, Hunfeld KP, Jaulhac B, Kaiser R, Krause A, et al. Lyme borreliosis: clinical case definitions for diagnosis and management in Europe. Clin Microbiol Infect. 2011;17(1):69-79.  https://doi.org/10.1111/j.1469-0691.2010.03175.x  PMID: 20132258 
  4. van den Wijngaard CC, Hofhuis A, Simões M, Rood E, van Pelt W, Zeller H, et al. Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area. Euro Surveill. 2017;22(27):30569.  https://doi.org/10.2807/1560-7917.ES.2017.22.27.30569  PMID: 28703098 
  5. European Centre for Disease Prevention and Control (ECDC). Second expert consultation of tick-borne diseases with emphasis on Lyme borreliosis and tick-borne encephalitis. Stockholm: ECDC; 2011. https://ecdc.europa.eu/sites/portal/files/media/en/publications/Publications/Tick-borne-diseases-meeting-report.pdf
  6. Dessau RB, Espenhain L, Mølbak K, Krause TG, Voldstedlund M. Improving national surveillance of Lyme neuroborreliosis in Denmark through electronic reporting of specific antibody index testing from 2010 to 2012. Euro Surveill. 2015;20(28):21184.  https://doi.org/10.2807/1560-7917.ES2015.20.28.21184  PMID: 26212143 
  7. MacDonald E, Vestrheim DF, White RA, Konsmo K, Lange H, Aase A, et al. Are the current notification criteria for Lyme borreliosis in Norway suitable? Results of an evaluation of Lyme borreliosis surveillance in Norway, 1995-2013. BMC Public Health. 2016;16(1):729.  https://doi.org/10.1186/s12889-016-3346-9  PMID: 27495236 
  8. Berglund J, Eitrem R, Ornstein K, Lindberg A, Ringér A, Elmrud H, et al. An epidemiologic study of Lyme disease in southern Sweden. N Engl J Med. 1995;333(20):1319-27.  https://doi.org/10.1056/NEJM199511163332004  PMID: 7566023 
  9. Bennet L, Halling A, Berglund J. Increased incidence of Lyme borreliosis in southern Sweden following mild winters and during warm, humid summers. Eur J Clin Microbiol Infect Dis. 2006;25(7):426-32.  https://doi.org/10.1007/s10096-006-0167-2  PMID: 16810531 
  10. Smittskyddsinstitutet. Laboratoriediagnostik av borreliainfektion. [Laboratory diagnostics of Borrelia infection]. Solna: Folkhälsomyndigheten; 2013. Swedish. Available from: https://www.folkhalsomyndigheten.se/publicerat-material/publikationsarkiv/l/laboratoriediagnostik-av-borreliainfektion/
  11. Läkemedelsverket. Läkemedelsbehandling av borreliainfektion. [Treatment of Borrelia infection]. Uppsala: Läkemedelsverket; 2009. Swedish. Available from: https://lakemedelsverket.se/borrelia
  12. Dahl V, Tegnell A, Wallensten A. Communicable diseases prioritized according to their public health relevance, Sweden, 2013. PLoS One. 2015;10(9):e0136353.  https://doi.org/10.1371/journal.pone.0136353  PMID: 26397699 
  13. Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C, et al. External review and validation of the Swedish national inpatient register. BMC Public Health. 2011;11(1):450.  https://doi.org/10.1186/1471-2458-11-450  PMID: 21658213 
  14. Obel N, Dessau RB, Krogfelt KA, Bodilsen J, Andersen NS, Møller JK, et al. Long term survival, health, social functioning, and education in patients with European Lyme neuroborreliosis: nationwide population based cohort study. BMJ. 2018;361:k1998.  https://doi.org/10.1136/bmj.k1998  PMID: 29848547 
  15. Södermark L, Sigurdsson V, Näs W, Wall P, Trollfors B. Neuroborreliosis in Swedish children: a population-based study on incidence and clinical characteristics. Pediatr Infect Dis J. 2017;36(11):1052-6.  https://doi.org/10.1097/INF.0000000000001653  PMID: 28654563 
  16. Gustafson R, Jaenson TG, Gardulf A, Mejlon H, Svenungsson B. Prevalence of Borrelia burgdorferi sensu lato infection in Ixodes ricinus in Sweden. Scand J Infect Dis. 1995;27(6):597-601.  https://doi.org/10.3109/00365549509047074  PMID: 8685640 
  17. Rizzoli A, Hauffe H, Carpi G, Vourc H G, Neteler M, Rosa R. Lyme borreliosis in Europe. Euro Surveill. 2011;16(27):19906. PMID: 21794218 
  18. Paradowska-Stankiewicz I, Chrześcijańska I. Lyme disease in Poland in 2015. Przegl Epidemiol. 2017;71(4):513-7. PMID: 29415529 
  19. Sajanti E, Virtanen M, Helve O, Kuusi M, Lyytikäinen O, Hytönen J, et al. Lyme Borreliosis in Finland, 1995-2014. Emerg Infect Dis. 2017;23(8):1282-8.  https://doi.org/10.3201/eid2308.161273  PMID: 28726624 
  20. Smith R, Takkinen J. Lyme borreliosis: Europe-wide coordinated surveillance and action needed? Euro Surveill. 2006;11(6):E060622.1. PMID: 16819127 
  21. European Commission. Commission implementing decision (EU) 2018/945 of 22 June 2018 on the communicable diseases and related special health issues to be covered by epidemiological surveillance as well as relevant case definitions. Official Journal of the European Union. Luxembourg: Publications Office of the European Union. 6 jul 2018:L 170/1. Available from: https://eur-lex.europa.eu/legal-content/EN/TXT/PDF/?uri=CELEX:32018D0945&from=EN#page=29
  22. Mygland A, Ljostad U, Fingerle V, Rupprecht T, Schmutzhard E, Steiner I. EFNS guidelines on the diagnosis and management of European Lyme neuroborreliosis. Eur J Neurol. 2010;17(1):8-16.
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