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Abstract

BACKGROUND

Lyme borreliosis (LB) caused by sensu lato (Bbsl) spirochetes is the most common tick-borne infection in Europe and the incidence of LB has been increasing in many countries.

AIM

We examined changes in Bbsl seroprevalence in Finland over the past 50 years.

METHODS

We analysed samples collected from people aged ≥ 15 years in nationwide cross-sectional health surveys conducted over the years 1966–1972, 1978–1980, 2000–2001 and 2017. Samples were screened with an IgG ELISA assay and confirmed with an IgG bead immunoassay. We assessed factors associated with Bbsl seropositivity by generalised linear models.

RESULTS

Seroprevalence was highest in 1966–1972 (25.0%; 95% confidence interval (CI): 22.3–27.7%), while it was lower in 1978–1980 (16.6%; 95% CI: 14.3–18.9%), 2000–2001 (7.4%; 95% CI: 5.8–9.0%) and 2017 (3.4%; 95% CI: 2.3–4.5%). Male sex (p = 0.0014) and increasing age (p < 0.0001) were associated with higher seropositivity. The estimated probability of being seropositive was highest among residents from southern (least squares (LS) mean: 0.164; 95% CI: 0.139–0.192), central and eastern Finland (LS mean: 0.141; 95% CI: 0.116–0.170) and lowest in northern Finland (LS mean: 0.019; 95% CI: 0.014–0.028).

CONCLUSION

Our results show a decrease in the seroprevalence in Finnish people over time. Reasons for this decrease are not clear but could be related to urbanisation, increased awareness, effective diagnostics and prompt antibiotic treatments. Overall, this study demonstrates how repeated serosurveys can help in revealing trends and identifying potential risk groups.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
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2025-09-11
2026-04-16
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References

  1. Laaksonen M, Sajanti E, Sormunen JJ, Penttinen R, Hänninen J, Ruohomäki K, et al. Crowdsourcing-based nationwide tick collection reveals the distribution of Ixodes ricinus and I. persulcatus and associated pathogens in Finland. Emerg Microbes Infect. 2017;6(5):e31.  https://doi.org/10.1038/emi.2017.17  PMID: 28487561 
  2. Steere AC, Strle F, Wormser GP, Hu LT, Branda JA, Hovius JWR, et al. Lyme borreliosis. Nat Rev Dis Primers. 2016;2(1):16090.  https://doi.org/10.1038/nrdp.2016.90  PMID: 27976670 
  3. Angulo FJ, Colby E, Lebech AM, Lindgren PE, Moniuszko-Malinowska A, Strle F, et al. Incidence of symptomatic Lyme borreliosis in nine European countries. Int J Infect Dis. 2024;149:107242.  https://doi.org/10.1016/j.ijid.2024.107242  PMID: 39306075 
  4. Stanek G, Strle F, Gray J, Wormser GP. History and characteristics of Lyme borreliosis. In: Gray J, Kahl O, Lane RS, Stanek G (editors). Lyme borreliosis: biology, epidemiology and control. Wallingford; CABI Digital Library: 2002. p. 1-28. Available from: https://www.cabidigitallibrary.org/doi/book/10.1079/9780851996325.0000
  5. Sykes RA, Makiello P. An estimate of Lyme borreliosis incidence in Western Europe. J Public Health (Oxf). 2017;39(1):74-81. PMID: 26966194 
  6. Burn L, Tran TMP, Pilz A, Vyse A, Fletcher MA, Angulo FJ, et al. Incidence of Lyme borreliosis in Europe from national surveillance systems (2005-2020). Vector Borne Zoonotic Dis. 2023;23(4):156-71.  https://doi.org/10.1089/vbz.2022.0071  PMID: 37071405 
  7. 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 
  8. Kalish RA, McHugh G, Granquist J, Shea B, Ruthazer R, Steere AC. Persistence of immunoglobulin M or immunoglobulin G antibody responses to Borrelia burgdorferi 10-20 years after active Lyme disease. Clin Infect Dis. 2001;33(6):780-5.  https://doi.org/10.1086/322669  PMID: 11512082 
  9. Dong Y, Zhou G, Cao W, Xu X, Zhang Y, Ji Z, et al. Global seroprevalence and sociodemographic characteristics of Borrelia burgdorferi sensu lato in human populations: a systematic review and meta-analysis. BMJ Glob Health. 2022;7(6):e007744.  https://doi.org/10.1136/bmjgh-2021-007744  PMID: 35697507 
  10. van Beek J, Sajanti E, Helve O, Ollgren J, Virtanen MJ, Rissanen H, et al. Population-based Borrelia burgdorferi sensu lato seroprevalence and associated risk factors in Finland. Ticks Tick Borne Dis. 2018;9(2):275-80.  https://doi.org/10.1016/j.ttbdis.2017.10.018  PMID: 29153461 
  11. Cuellar J, Dub T, Sane J, Hytönen J. Seroprevalence of Lyme borreliosis in Finland 50 years ago. Clin Microbiol Infect. 2020;26(5):632-6.  https://doi.org/10.1016/j.cmi.2019.10.003  PMID: 31622667 
  12. Knekt P, Rissanen H, Järvinen R, Heliövaara M. Cohort Profile: The Finnish Mobile Clinic Health Surveys FMC, FMCF and MFS. Int J Epidemiol. 2017;46(6):1760-1761i.  https://doi.org/10.1093/ije/dyx092  PMID: 29040560 
  13. Heistaro S. Methodology report: Health 2000 Survey. Helsinki: National Public Health Institute; 2008. Available from: https://www.julkari.fi/handle/10024/78185
  14. Borodulin K, Sääksjärvi K. FinHealth 2017 Study - Methods. Helsinki: Finnish Institute for Health and Welfare; 2019. Available from: https://www.julkari.fi/bitstream/handle/10024/139084/URN_ISBN_978-952-343-449-3.pdf
  15. Dessau RB, Møller JK, Kolmos B, Henningsson AJ. Multiplex assay (Mikrogen recomBead) for detection of serum IgG and IgM antibodies to 13 recombinant antigens of Borrelia burgdorferi sensu lato in patients with neuroborreliosis: the more the better? J Med Microbiol. 2015;64(Pt 3):224-31.  https://doi.org/10.1099/jmm.0.000009  PMID: 25587083 
  16. Kříž B, Malý M, Balátová P, Kodym P, Kurzová Z, Daniel M, et al. A serological study of antibodies to Anaplasma phagocytophilum and Borrelia burgdorferi sensu lato in the sera of healthy individuals collected two decades apart. Acta Parasitol. 2018;63(1):33-9.  https://doi.org/10.1515/ap-2018-0004  PMID: 29351070 
  17. Böhm S, Woudenberg T, Stark K, Böhmer MM, Katz K, Kuhnert R, et al. Seroprevalence, seroconversion and seroreversion of Borrelia burgdorferi-specific IgG antibodies in two population-based studies in children and adolescents, Germany, 2003 to 2006 and 2014 to 2017. Euro Surveill. 2023;28(34):2200855.  https://doi.org/10.2807/1560-7917.ES.2023.28.34.2200855  PMID: 37616114 
  18. Hoeve-Bakker BJA, van den Berg OE, Doppenberg HS, van der Klis FRM, van den Wijngaard CCVD, Kluytmans JAJW, et al. Twenty years of Lyme borreliosis in the Netherlands: temporal trends in seroprevalence and risk factors. Microorganisms. 2024;12(11):2185.  https://doi.org/10.3390/microorganisms12112185  PMID: 39597574 
  19. Burn L, Pilz A, Vyse A, Gutiérrez Rabá AV, Angulo FJ, Tran TMP, et al. Seroprevalence of Lyme borreliosis in Europe: results from a systematic literature review (2005-2020). Vector Borne Zoonotic Dis. 2023;23(4):195-220.  https://doi.org/10.1089/vbz.2022.0069  PMID: 37071401 
  20. Marques AR, Strle F, Wormser GP. Comparison of Lyme disease in the United States and Europe. Emerg Infect Dis. 2021;27(8):2017-24.  https://doi.org/10.3201/eid2708.204763  PMID: 34286689 
  21. Jaenson TGT, Jaenson DGE, Eisen L, Petersson E, Lindgren E. Changes in the geographical distribution and abundance of the tick Ixodes ricinus during the past 30 years in Sweden. Parasit Vectors. 2012;5(1):8.  https://doi.org/10.1186/1756-3305-5-8  PMID: 22233771 
  22. Sormunen JJ, Klemola T, Vesterinen EJ, Vuorinen I, Hytönen J, Hänninen J, et al. Assessing the abundance, seasonal questing activity, and Borrelia and tick-borne encephalitis virus (TBEV) prevalence of Ixodes ricinus ticks in a Lyme borreliosis endemic area in Southwest Finland. Ticks Tick Borne Dis. 2016;7(1):208-15.  https://doi.org/10.1016/j.ttbdis.2015.10.011  PMID: 26548608 
  23. Stanek G, Strle F. The History, Epidemiology, Clinical Manifestations and Treatment of Lyme Borreliosis. In: Hunfeld K-P, Gray J (editors). Lyme Borreliosis. Dordrecht: Springer; 2022. p. 77-105. Available from: https://link.springer.com/chapter/10.1007/978-3-030-93680-8_4
  24. Pietikäinen A, Glader O, Kortela E, Kanerva M, Oksi J, Hytönen J. Borrelia burgdorferi specific serum and cerebrospinal fluid antibodies in Lyme neuroborreliosis. Diagn Microbiol Infect Dis. 2022;104(3):115782.  https://doi.org/10.1016/j.diagmicrobio.2022.115782  PMID: 35970019 
  25. Marangoni A, Sambri V, Accardo S, Cavrini F, Mondardini V, Moroni A, et al. A decrease in the immunoglobulin G antibody response against the VlsE protein of Borrelia burgdorferi sensu lato correlates with the resolution of clinical signs in antibiotic-treated patients with early Lyme disease. Clin Vaccine Immunol. 2006;13(4):525-9.  https://doi.org/10.1128/CVI.13.4.525-529.2006  PMID: 16603623 
  26. Dessau RB, van Dam AP, Fingerle V, Gray J, Hovius JW, Hunfeld KP, et al. To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis: a position paper of ESGBOR, the ESCMID study group for Lyme borreliosis. Clin Microbiol Infect. 2018;24(2):118-24.  https://doi.org/10.1016/j.cmi.2017.08.025  PMID: 28887186 
  27. Laaksonen M, Klemola T, Feuth E, Sormunen JJ, Puisto A, Mäkelä S, et al. Tick-borne pathogens in Finland: comparison of Ixodes ricinus and I. persulcatus in sympatric and parapatric areas. Parasit Vectors. 2018;11(1):556.  https://doi.org/10.1186/s13071-018-3131-y  PMID: 30355331 
  28. Wahlberg P, Carlsson SA, Granlund H, Jansson C, Lindén M, Nyberg C, et al. TBE in Aland Islands 1959-2005: Kumlinge disease. Scand J Infect Dis. 2006;38(11-12):1057-62.  https://doi.org/10.1080/00365540600868297  PMID: 17148077 
  29. Eloranta J, Ojala J. Modern Finnish Economic History. In: Hamilton JH (editor). Oxford Research Encyclopedia of Economics and Finance. Oxford: Oxford University Press; 2022. Available from: https://oxfordre.com/economics/display/10.1093/acrefore/9780190625979.001.0001/acrefore-9780190625979-e-678
  30. Kugeler KJ, Mead PS, Schwartz AM, Hinckley AF. Changing trends in age and sex distributions of Lyme disease-United States, 1992-2016. Public Health Rep. 2022;137(4):655-9.  https://doi.org/10.1177/00333549211026777  PMID: 34185610 
  31. Wilking H, Stark K. Trends in surveillance data of human Lyme borreliosis from six federal states in eastern Germany, 2009-2012. Ticks Tick Borne Dis. 2014;5(3):219-24.  https://doi.org/10.1016/j.ttbdis.2013.10.010  PMID: 24656810 
  32. Heeb L, Fritschi N, Marten A, Welzel T, Ritz N, Heininger U. Borrelia burgdorferi infections in children and adolescents in Switzerland - a seroprevalence study 2023/2024 (BOBUINCA). Infection. 2025;53(3):893-903.  https://doi.org/10.1007/s15010-024-02387-7  PMID: 39325354 
  33. Hjetland R, Nilsen RM, Grude N, Ulvestad E. Seroprevalence of antibodies to Borrelia burgdorferi sensu lato in healthy adults from western Norway: risk factors and methodological aspects. APMIS. 2014;122(11):1114-24.  https://doi.org/10.1111/apm.12267  PMID: 24730472 
  34. Wilking H, Fingerle V, Klier C, Thamm M, Stark K. Antibodies against Borrelia burgdorferi sensu lato among adults, Germany, 2008-2011. Emerg Infect Dis. 2015;21(1):107-10.  https://doi.org/10.3201/eid2101.140009  PMID: 25531140 
  35. Bennet L, Stjernberg L, Berglund J. Effect of gender on clinical and epidemiologic features of Lyme borreliosis. Vector Borne Zoonotic Dis. 2007;7(1):34-41.  https://doi.org/10.1089/vbz.2006.0533  PMID: 17417955 
  36. Sormunen JJ, Andersson T, Aspi J, Bäck J, Cederberg T, Haavisto N, et al. Monitoring of ticks and tick-borne pathogens through a nationwide research station network in Finland. Ticks Tick Borne Dis. 2020;11(5):101449.  https://doi.org/10.1016/j.ttbdis.2020.101449  PMID: 32723639 
  37. Klemola T, Sormunen JJ, Mojzer J, Mäkelä S, Vesterinen EJ. High tick abundance and diversity of tick-borne pathogens in a Finnish city. Urban Ecosyst. 2019;22(5):817-26.  https://doi.org/10.1007/s11252-019-00854-w 
  38. Hjetland R, Reiso H, Ihlebæk C, Nilsen RM, Grude N, Ulvestad E. Subjective health complaints are not associated with tick bites or antibodies to Borrelia burgdorferi sensu lato in blood donors in western Norway: a cross-sectional study. BMC Public Health. 2015;15(1):657.  https://doi.org/10.1186/s12889-015-2026-5  PMID: 26169496 
  39. Hoeve-Bakker BJA, Kerkhof K, Heron M, Thijsen SFT, van Gorkom T. Evaluation of different standard and modified two-tier testing strategies for the laboratory diagnosis of Lyme borreliosis in a European setting. Eur J Clin Microbiol Infect Dis. 2024;43(12):2397-406.  https://doi.org/10.1007/s10096-024-04956-y  PMID: 39375250 
Repeated cross-sectional surveys show a decreasing trend in Borrelia burgdorferi sensu lato seroprevalence over a 50-year period, Finland, 1966 to 2017
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Maija+Lamppu&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Lamppu Maija</a>, <a href="/search?value1=Tero+Klemola&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Klemola Tero</a>, <a href="/search?value1=Eero+Vesterinen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Vesterinen Eero</a>, <a href="/search?value1=Timoth%C3%A9e+Dub&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Dub Timothée</a>, <a href="/search?value1=Annukka+Pietik%C3%A4inen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Pietikäinen Annukka</a>, <a href="/search?value1=Jukka+Hyt%C3%B6nen&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Hytönen Jukka</a></span>. Repeated cross-sectional surveys show a decreasing trend in Borrelia burgdorferi sensu lato seroprevalence over a 50-year period, Finland, 1966 to 2017. <a href="/content/ecdc">Euro Surveill.</a> 2025;30(36):pii=2500171. <a href="https://doi.org/10.2807/1560-7917.ES.2025.30.36.2500171" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2025.30.36.2500171</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 06 Mar 2025;&nbsp;&nbsp; <span class="generated">Accepted</span>: 18 Jun 2025 </span> </p>
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