Hart Eilish, Tulloch John, Bailey Daniel, Brooks Tim, Harvala Heli, Simmonds Peter, Vivancos Roberto, French Neil, Semper Amanda
National Institute for Health and Social Care Research Health Protection Research Unit in Emerging and Zoonotic Infections, UK; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK; Diagnostics & Pathogen Characterisation, UK Health Security Agency, Porton Down, UK.
National Institute for Health and Social Care Research Health Protection Research Unit in Emerging and Zoonotic Infections, UK; Institute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, UK.
Ticks Tick Borne Dis. 2025 Jan;16(1):102439. doi: 10.1016/j.ttbdis.2025.102439. Epub 2025 Jan 23.
Estimates of Lyme disease incidence in England are based on reporting of cases with a laboratory-confirmed diagnosis only, underestimating total cases. In 2017 - 2018, two independent reviews commissioned by the UK Government highlighted the lack of official data on Lyme disease prevalence and incidence as a critical knowledge gap.
To estimate the prevalence of IgG antibodies in the English adult population specific for Borrelia burgdorferi sensu lato (Bbsl), the causative agent of Lyme disease.
The prevalence of Bbsl-specific antibodies in the English population was estimated in a cross-sectional cohort, selected from an archive of residual NHS blood donor plasma samples (age range 17 - 84, collected between 2021 - 2022). 10,000 samples were randomly selected proportionate to the population size of each of the nine English administrative regions. 9,994 samples were tested using a standard two-tiered testing strategy, with an IgG/IgM ELISA followed by an IgG immunoblot (array) test for any sera with positive or indeterminate reactivity in the ELISA.
Out of the 9,994 samples tested, 482 were seroreactive by screening ELISA. After two-tier testing, 49 were confirmed positive. Regional and demographic differences in seroprevalence were observed after two-tier testing, but due to the low overall seroprevalence, were not significant upon multivariable analysis.
The seroprevalence of Borrelia burgdorferi sensu lato-specific IgG in the English adult population (2021 - 2022), determined using two-tier testing was estimated at 0.49 % (95 % CI 0.36 - 0.65). This is lower than neighbouring UK nation Scotland and other northern European countries.
英国莱姆病发病率的估计仅基于实验室确诊病例的报告，这低估了病例总数。2017 - 2018年，英国政府委托进行的两项独立审查强调，缺乏莱姆病患病率和发病率的官方数据是一个关键的知识空白。
估计英国成年人群中针对莱姆病病原体伯氏疏螺旋体狭义种（Bbsl）的IgG抗体患病率。
从英国国民健康服务体系（NHS）剩余献血者血浆样本档案中选取一个横断面队列（年龄范围17 - 84岁，采集于2021 - 2022年），估计英国人群中Bbsl特异性抗体的患病率。根据英国九个行政区各自的人口规模，随机抽取10,000份样本。9,994份样本采用标准的两级检测策略进行检测，先用IgG/IgM酶联免疫吸附测定（ELISA），然后对ELISA中反应呈阳性或不确定的任何血清进行IgG免疫印迹（阵列）检测。
在检测的9,994份样本中，有482份通过筛查ELISA呈血清反应阳性。经过两级检测后，49份被确认为阳性。两级检测后观察到血清阳性率存在地区和人口统计学差异，但由于总体血清阳性率较低，多变量分析后差异不显著。
采用两级检测法确定的2021 - 2022年英国成年人群中伯氏疏螺旋体狭义种特异性IgG的血清阳性率估计为0.49%（95%置信区间0.36 - 0.65）。这低于邻国英国的苏格兰以及其他北欧国家。
