Department of Biosciences, Centre for Ecological and Evolutionary Synthesis (CEES), University of Oslo, Oslo, Norway.
Zoonotic, Food & Waterborne Infections, The Norwegian Public Health Institute, Oslo, Norway.
Zoonoses Public Health. 2023 Nov;70(7):647-655. doi: 10.1111/zph.13073. Epub 2023 Jul 17.
Lyme borreliosis, the most common vector-borne disease in Europe and North America, is attracting growing concern due to its expanding geographic range. The growth in incidence and geographic spread is largely attributed to climate and land-use changes that support the tick vector and thereby increase disease risk. Despite a wide range of symptoms displayed by Lyme borreliosis patients, the demographic patterns in clinical manifestations and seasonal case timing have not been thoroughly investigated and may result from differences in exposure, immunity and pathogenesis. We analysed 25 years of surveillance data from Norway, supplemented by population demography data, using a Bayesian modelling framework. The analyses aimed to detect differences in case seasonality and clinical manifestations of Lyme borreliosis across age and sex differentiated patient groups. The results showed a bimodal pattern of incidence over age, where children (0-9 years) had the highest incidence, young adults (20-29 years) had low incidence and older adults had a second incidence peak in the ages 70-79 years. Youth (0-19 years) presented with a higher proportion of neuroborreliosis cases and a lower proportion of arthritic manifestations compared to adults (20+ years). Adult males had a higher overall incidence than adult females and a higher proportion of arthritis cases. The seasonal timing of Lyme borreliosis consistently occurred around 4.4 weeks earlier in youth compared to adults, regardless of clinical manifestation. All demographic groups exhibited a shift towards an earlier seasonal timing over the 25-year study period, which appeared unrelated to changes in population demographics. However, the disproportionate incidence of Lyme borreliosis in seniors requires increased public awareness and knowledge about this high-risk group as the population continues to age concurrently with disease emergence. Our findings highlight the importance of considering patient demographics when analysing the emergence and seasonal patterns of vector-borne diseases using long-term surveillance data.
莱姆病是欧洲和北美的最常见的虫媒传染病，由于其地理范围不断扩大，正引起越来越多的关注。发病率和地理分布的增加主要归因于支持蜱虫并从而增加疾病风险的气候和土地利用变化。尽管莱姆病患者表现出广泛的症状，但临床表现和季节性发病时间的人口统计学模式尚未得到充分研究，这可能是由于暴露、免疫和发病机制的差异所致。我们使用贝叶斯建模框架分析了来自挪威的 25 年监测数据，并补充了人口统计学数据。分析旨在检测不同年龄和性别分组的莱姆病患者的发病季节和临床表现差异。结果显示，发病率随年龄呈双峰模式，儿童（0-9 岁）的发病率最高，年轻成年人（20-29 岁）的发病率较低，而 70-79 岁的老年人则出现第二次发病高峰。与成年人（20 岁以上）相比，年轻人（0-19 岁）表现出更高比例的神经莱姆病病例和较低比例的关节炎表现。成年男性的总发病率高于成年女性，关节炎病例的比例也更高。无论临床表现如何，莱姆病的发病季节始终比成年人提前约 4.4 周。所有年龄段的人群在 25 年的研究期间都表现出向更早季节性发病时间的转变，这与人口统计学变化无关。然而，老年人中莱姆病的不成比例发病率需要提高公众意识和知识，因为随着疾病的出现，人口老龄化与疾病同时发生。我们的研究结果强调了在使用长期监测数据分析虫媒传染病的出现和季节性模式时，考虑患者人口统计学因素的重要性。
