Estimating symptomatic Lyme borreliosis incidence in Europe using seroprevalence data

This study aimed to estimate the incidence of symptomatic Borrelia burgdorferi sensu lato (Bbsl) infections in nine European countries by adjusting public health Lyme borreliosis (LB) surveillance data for under-detection. The researchers utilized data from seroprevalence studies, estimates of symptomatic proportion, and duration of antibody detection in Bbsl-infected individuals to calculate under-detection multipliers for each country’s surveillance system. The prevalence of anti-Bbsl antibodies ranged from 2.3% in Romania to 9.4% in Germany. Under-detection multipliers varied significantly across surveillance systems, with values of 2.4-10.5 in countries reporting all LB cases and 54.6-722.2 in countries reporting only Lyme neuroborreliosis cases, assuming a 10-year duration of antibody detection. The estimated incidence of symptomatic Bbsl infection adjusted for under-detection was highest in Finland, Germany, Norway, Poland, and Switzerland (>220/100,000 population per year), intermediate in the Czech Republic and Denmark (190-220/100,000), and lowest in Ireland and Romania (<190/100,000). The study highlights the substantial burden of LB in...