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Antibodies against Borrelia burgdorferi sensu lato among Adults, Germany, 2008–2011 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC

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Antibodies against Borrelia burgdorferi sensu lato among Adults, Germany, 2008–2011 - Volume 21, Number 1—January 2015 - Emerging Infectious Disease journal - CDC


Volume 21, Number 1—January 2015


Antibodies against Borrelia burgdorferi sensu lato among Adults, Germany, 2008–2011

Hendrik WilkingComments to Author , Volker Fingerle, Christiane Klier, Michael Thamm, and Klaus Stark
Author affiliations: Robert Koch-Institut, Berlin, Germany (H. Wilking, M. Thamm,. K. Stark)German National Reference Centre for Borrelia, Oberschleißheim, Germany (V. Fingerle, C. Klier)


To assess Borrelia burgdorferi sensu lato (the cause of Lyme borreliosis) seropositivity in Germany, we tested serum samples from health survey (2008–2011) participants. Seroprevalence was 5.8% among women and 13.0% among men; infection risk was highest among persons >60 years of age. Public health interventions, including education about risk factors and preventive measures, are needed.
Lyme borreliosis, the most common tickborne disease in the Northern Hemisphere, is caused by infection with spirochetes of the Borrelia burgdorferi sensu lato (s.l.) complex. Five genospecies are known to be pathogenic for humans: B. burgdorferi sensu stricto (s.s.), B. afzelii, B. garinii, B. bavariensis, and B. spielmanii (1). In Europe, the bacterium is transmitted to humans through the bite of Ixodes ricinus ticks; in eastern Europe, I. persulcatus ticks can also transmit the bacterium.
In Europe, where the most common clinical manifestation of Lyme borreliosis is erythema migrans, followed by Lyme neuroborreliosis and Lyme arthritis (2), data are sparse regarding B. burgdorferi s.l. infection rates and risk factors (3). Persons of all ages are at risk for infection; however, surveillance data and prospective studies in Europe and the United States suggest that children and the elderly are particularly at risk (46). Population-based surveillance data suggest that Lyme borreliosis is endemic in eastern Germany: annual incidence is 20–35 cases/100,000 inhabitants (7). Regional differences in incidence are observed, but data cannot be easily compared because of reporting biases and differences in infection awareness.
The limited representativeness and comparability of Lyme borreliosis surveillance data are well documented (8). Under such conditions, population-based serosurveys with high representativeness can provide valid estimates of the force of infection (rate at which susceptible persons acquire Lyme borreliosis) and the lifetime risk for infection; however, seroprevalence estimates do not necessarily represent cases of clinical disease. In a population-based seroprevalence study among 1- to 17-year-old children in Germany, seroprevalence increased cumulatively by age (9). We present data on the prevalence and determinants of B. burgdorferi s.l. seropositivity among adults in Germany during 2008–2011.

Dr. Wilking is an infectious disease epidemiologist in the unit for Gastrointestinal Infections, Zoonoses and Tropical Infections at the Robert Koch Institute. His research interests include population-based disease studies.


We thank Mona Askar for carefully reviewing the manuscript.
This project was funded by the Robert Koch Institute.


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Technical Appendix

Suggested citation for this article: Wilking H, Fingerle V, Klier C, Thamm M, Stark K. Antibodies against Borrelia burgdorferi sensu lato among adults, Germany, 2008–2011. Emerg Infect Dis. 2015 Jan [date cited]. http://dx.doi.org/10.3201/eid2101.140009
DOI: 10.3201/eid2101.140009

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