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. 2019 Jul 31;9(7):e025916.
doi: 10.1136/bmjopen-2018-025916.

Incidence of Lyme disease in the UK: a population-based cohort study

Victoria Cairns  1 , Christopher Wallenhorst  2 , Stephan Rietbrock  2 , Carlos Martinez  2
Affiliations

Incidence of Lyme disease in the UK: a population-based cohort study

Victoria Cairns et al. BMJ Open. .

Abstract

Objectives: The purpose of this study was to estimate the annual incidence of Lyme disease (LD) in the UK.

Design: This was a retrospective descriptive cohort study.

Setting: Study data were extracted from the Clinical Practice Research Datalink (CPRD), a primary care database covering about 8% of the population in the UK in 658 primary care practices.

Participants: Cohort of 8.4 million individuals registered with general practitioners with 52.4 million person-years of observation between 1 January 2001 and 31 December 2012.

Primary and secondary outcome measures: LD was identified from recorded medical codes, notes indicating LD, laboratory tests and use of specific antibiotics. Annual incidence rates and the estimated total number of LD cases were calculated separately for each UK region.

Results: The number of cases of LD increased rapidly over the years 2001 to 2012, leading to an estimated incidence rate of 12.1 (95% CI 11.1 to 13.2) per 100 000 individuals per year and a UK total of 7738 LD cases in 2012. LD was detected in every UK region with highest incidence rates and largest number of cases in Scotland followed by South West and South England. If the number of cases has continued to rise since the end of the study period, then the number in the UK in 2019 could be over 8000. : Conclusions : The incidence of LD is about threefold higher than previously estimated, and people are at risk throughout the UK. These results should lead to increased awareness of the need for preventive measures.

Trial registration number: This study was approved by the Independent Scientific Advisory Committee for CPRD research (Protocol number 13_210R).

Keywords: epidemiology; incidence; lyme borreliosis; lyme disease.

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Conflict of interest statement

Competing interests: CM, SR and CW are employees of the Institute for Epidemiology, Statistics and Informatics GmbH. The Institute for Epidemiology, Statistics and Informatics GmbH has received grants from Bayer, Bristol-Myers Squibb, CSL Behring and Merz Pharma outside the submitted work.

Figures

Figure 1
Figure 1
Diagnostic category of cases of Lyme disease between January 2001 and December 2012. 1: Subsequent recordings within 365 days after a previous LD recording have been considered as a continuous episode of LD. 2: A unique diagnosis group was determined for each episode of LD, using the highest rated diagnosis within the LD episode (applying the given hierarchy). ECM, erythema chronicum migrans; LD, Lyme disease; Rx, prescription.
Figure 2
Figure 2
Incidence rates of Lyme disease per 100 000 per year by region, 2010–2012. Incidence rates may vary across different parts of a region.
Figure 3
Figure 3
Estimated number of cases of Lyme disease in each region per calendar year South=South Central+South East Coast; East England=East+ East Midlands; North=North West+North East+Yorkshire and The Humber+Northern Ireland.
Figure 4
Figure 4
Estimated number of cases of Lyme disease in the UK per calendar year.
See this image and copyright information in PMC

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