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[Doubling of the number of cases of tick bites and lyme borreliosis seen by general practitioners in the Netherlands].
Abstract: To obtain detailed information about the current geographical distribution and incidence of tick bites and Lyme borreliosis in the Netherlands and to identify regional differences in the ecological risk factors that might be involved. Methods: Retrospective questionnaire study. Methods: All Dutch general practitioner's (GP) practices. Methods: In April 2002, all GPs in the Netherlands were asked to complete a short questionnaire on the number of cases of tick bites and erythema migrans seen in 2001 and the size of their practice. Associations with possible risk factors were determined at the municipal level. Results were compared with the results of a similar study done in 1995. Results: The response of the GPs was 64.5% (4730/7330). Together, all GPs reported seeing approximately 61,000 patients in 2001 with tick bites and 12,000 patients with erythema migrans. The incidence of erythema migrans was estimated at 73 per 100,000 inhabitants. There were obvious risk areas. At the municipal level, tick bites and erythema migrans were positively associated with the area covered by forest, sandy soil, the number of roe deer and tourism. There was a negative association with the degree of urbanisation. Increases in tourism in areas with many ticks, new forests in urban regions and an increased number of horses were positively associated with the increase in tick bites and erythema migrans since 1994. Conclusions: The number of patients with tick bites and erythema migrans seen by GPs in the Netherlands had doubled between 1994 and 2001. This increase may be attributed partly to changes in ecological risk factors and human behaviour. The number of cases of Lyme borreliosis may be reduced by giving prophylactic information annually about ticks and ways to remove them, plus additional education of patients about the recognition of erythema migrans.
Publication Date: 2004-04-27 PubMed ID: 15106318 The Equine Research Bank provides access to a large database of publicly available scientific literature. Inclusion in the Research Bank does not imply endorsement of study methods or findings by Mad Barn.
- English Abstract
- Journal Article
Summary
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This research focused on discovering the current distribution and incidence of tick bites and Lyme borreliosis (Lyme disease) in the Netherlands. The study found that cases observed by general practitioners doubled between 1994 and 2001, likely due to changes in ecological factors and human behavior.
Methodology
- The researchers conducted a retrospective questionnaire study using all Dutch general practice clinics as the sampling pool.
- In April 2002, all Dutch general practitioners were asked to complete a questionnaire. It revealed the number of tick bite cases and instances of erythema migrans (a rash often seen in early stages of Lyme disease) they attended to in 2001, as well as their practice size.
- The team then endeavored to find associations with potential risk factors at the municipal level.
- The findings were compared to those of an identical study carried out in 1995.
Results
- A response rate of 64.5% was achieved, with 4730 out of a possible 7330 practitioners participating.
- Collectively, doctors reported seeing around 61,000 patients in 2001 suffering from tick bites and further 12,000 exhibiting erythema migrans.
- The research team estimated the incidence of erythema migrans to be 73 per 100,000 inhabitants.
- Certain areas with higher associated risk factors were identified. These regions were commonly characterized by a large forested area, sandy soil, high population of roe deer, and significant tourist activities.
- Negative associations were found between the incidence of tick bites/erythema migrans and the level of urbanization.
- The study also found a correlation between the upsurge in tick bites and erythema migrans since 1994 with certain factors. Increases in tourist activity, urban forestry projects, and horse populations correlated with a rise in reported cases.
Conclusions
- The study has determined a doubling in the instances of tick bites and erythema migrans seen by general practitioners between 1994 and 2001.
- The increase can be attributed, at least in part, to changes in ecological risk factors and human behavior.
- The researchers suggest that the number of Lyme disease cases can be reduced through preventative information about ticks and their removal. They also propose additional education for patients on recognizing erythema migrans.
Cite This Article
APA
den Boon S, Schellekens JF, Schouls LM, Suijkerbuijk AW, Docters van Leeuwen B, van Pelt W.
(2004).
[Doubling of the number of cases of tick bites and lyme borreliosis seen by general practitioners in the Netherlands].
Ned Tijdschr Geneeskd, 148(14), 665-670.
Publication
Researcher Affiliations
- Centrum voor Infectieziekten Epidemiologie, Rijksinstituut voor Volksgezondheid en Milieu, Postbus 1, 3720 BA Bilthoven.
MeSH Terms
- Animals
- Arachnid Vectors / microbiology
- Bites and Stings / epidemiology
- Bites and Stings / microbiology
- Bites and Stings / prevention & control
- Erythema Chronicum Migrans / epidemiology
- Family Practice
- Humans
- Incidence
- Life Style
- Lyme Disease / epidemiology
- Lyme Disease / prevention & control
- Netherlands / epidemiology
- Retrospective Studies
- Risk Factors
- Surveys and Questionnaires
- Ticks / microbiology
Citations
This article has been cited 11 times.- Houben E, de Jong H, Penning-van Beest F, Kuiper J, Holthuis E, Blum M, Skufca J, Riera-Montes M, Gessner BD, Pilz A, Vyse AJ, Begier E, Dzingina M, Herings R, Stark JH. Incidence of Lyme Borreliosis in the Dutch General Practice Population: A Large-Scale Population-Based Cohort Study Across the Netherlands Between 2015 and 2019. Vector Borne Zoonotic Dis 2023 Apr;23(4):230-236.
- van Gorkom T, Sankatsing SUC, Voet W, Ismail DM, Muilwijk RH, Salomons M, Vlaminckx BJM, Bossink AWJ, Notermans DW, Bouwman JJM, Kremer K, Thijsen SFT. An Enzyme-Linked Immunosorbent Spot Assay Measuring Borrelia burgdorferi B31-Specific Interferon Gamma-Secreting T Cells Cannot Discriminate Active Lyme Neuroborreliosis from Past Lyme Borreliosis: a Prospective Study in the Netherlands. J Clin Microbiol 2018 Apr;56(4).
- van den Wijngaard CC, Hofhuis A, Simões M, Rood E, van Pelt W, Zeller H, Van Bortel W. Surveillance perspective on Lyme borreliosis across the European Union and European Economic Area. Euro Surveill 2017 Jul 6;22(27).
- Beaujean DJ, Crutzen R, Gassner F, Ameling C, Wong A, van Steenbergen JE, Ruwaard D. Comparing the effect of a leaflet and a movie in preventing tick bites and Lyme disease in The Netherlands. BMC Public Health 2016 Jun 10;16:495.
- Hofhuis A, Bennema S, Harms M, van Vliet AJ, Takken W, van den Wijngaard CC, van Pelt W. Decrease in tick bite consultations and stabilization of early Lyme borreliosis in the Netherlands in 2014 after 15 years of continuous increase. BMC Public Health 2016 May 23;16:425.
- Newitt S, Elliot AJ, Morbey R, Durnall H, Pietzsch ME, Medlock JM, Leach S, Smith GE. The use of syndromic surveillance to monitor the incidence of arthropod bites requiring healthcare in England, 2000-2013: a retrospective ecological study. Epidemiol Infect 2016 Aug;144(11):2251-9.
- Hofhuis A, Harms M, Bennema S, van den Wijngaard CC, van Pelt W. Physician reported incidence of early and late Lyme borreliosis. Parasit Vectors 2015 Mar 15;8:161.
- Vanthomme K, Bossuyt N, Boffin N, Van Casteren V. Incidence and management of presumption of Lyme borreliosis in Belgium: recent data from the sentinel network of general practitioners. Eur J Clin Microbiol Infect Dis 2012 Sep;31(9):2385-90.
- Braks M, van der Giessen J, Kretzschmar M, van Pelt W, Scholte EJ, Reusken C, Zeller H, van Bortel W, Sprong H. Towards an integrated approach in surveillance of vector-borne diseases in Europe. Parasit Vectors 2011 Oct 3;4:192.
- Sprong H, Wielinga PR, Fonville M, Reusken C, Brandenburg AH, Borgsteede F, Gaasenbeek C, van der Giessen JW. Ixodes ricinus ticks are reservoir hosts for Rickettsia helvetica and potentially carry flea-borne Rickettsia species. Parasit Vectors 2009 Sep 4;2(1):41.
- Wielinga PR, Gaasenbeek C, Fonville M, de Boer A, de Vries A, Dimmers W, Akkerhuis Op Jagers G, Schouls LM, Borgsteede F, van der Giessen JW. Longitudinal analysis of tick densities and Borrelia, Anaplasma, and Ehrlichia infections of Ixodes ricinus ticks in different habitat areas in The Netherlands. Appl Environ Microbiol 2006 Dec;72(12):7594-601.
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