Background: Lyme borreliosis (LB) is the most commonly reported tick-borne infection in Europe and North America. In the last 15 years a 3-fold increase was observed in general practitioner consultations for LB in the Netherlands. To support prioritization of prevention and control efforts for LB, we estimated its burden expressed in Disability-Adjusted Life Years (DALYs). Methods: We used available incidence estimates for three LB outcomes: (i) erythema migrans (EM), (ii) disseminated LB and (iii) Lyme-related persisting symptoms. To generate DALYs, disability weights and duration per outcome were derived using a patient questionnaire including health-related quality of life as measured by the EQ-5D. Results: We estimated the total LB burden for the Netherlands in 2010 at 10.55 DALYs per 100 000 population (95% CI: 8.8012.43); i.e. 0.60 DALYs for EM, 0.86 DALYs for disseminated LB and 9.09 DALYs for Lyme-related persisting symptoms. Per patient this was 0.005 DALYs for EM, 0.113 for disseminated LB and 1.661 DALYs for a patient with Lyme-related persisting symptoms. In a sensitivity analysis the total LB burden ranged from 7.58 to 16.93 DALYs per 100 000 population. Conclusions: LB causes a substantial disease burden in the Netherlands. The vast majority of this burden is caused by patients with Lyme-related persisting symptoms. EM and disseminated Lyme have a more modest impact. Further research should focus on the mechanisms that trigger development of these persisting symptoms that patients and their physicians attribute to LB.

dx.doi.org/10.1093/eurpub/ckv091, hdl.handle.net/1765/91426
European Journal of Public Health
Erasmus MC: University Medical Center Rotterdam

van den Wijngaard, C.C, Hofhuis, A, Harms, M.G, Haagsma, J.A, Wong, A, de Wit, G.A, … van Pelt, W. (2015). The burden of Lyme borreliosis expressed in disability-adjusted life years. European Journal of Public Health, 25(6), 1071–1078. doi:10.1093/eurpub/ckv091