Epidemiology of European Lyme borreliosis.

Lyme borreliosis occurs throughout Europe and is particularly prevalent in the east. In a small proportion of untreated cases serious sequelae may occur, but Lyme borreliosis alone does not cause death. Clinical and serological diagnosis can still be problematic and the various genomospecies may cause different disease manifestations as well as differing immunological responses. However, considerable progress has been made in standardising case definitions and serological testing and interpretation. Few countries have official reporting systems for Lyme borreliosis and most figures on incidence are extrapolated from serodiagnosis data and seroprevalence studies. Geographical variations in incidence seem to correlate with the prevalence of infected ticks, which are mainly associated with varied deciduous forest. The complex ecology of Lyme borreliosis makes it difficult to implement preventive measures, so improving public knowledge of risk factors and methods for personal protection remain the best option at present.