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Lyme neuroborreliosis epidemiology in Sweden 2010 to 2014: clinical microbiology laboratories are a better data source than the hospital discharge diagnosis register
Publ Hlth Agcy Sweden, Stockholm, Sweden;European Ctr Dis Prevent & Control ECDC, EPIET, Stockholm, Sweden.ORCID iD: 0000-0001-9921-5172
Publ Hlth Agcy Sweden, Stockholm, Sweden.
Karolinska Univ Hosp, Dept Clin Microbiol, Stockholm, Sweden;Karolinska Inst, Div Microbiol, Dept Lab Med, Stockholm, Sweden.
Publ Hlth Agcy Sweden, Stockholm, Sweden.
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2019 (English)In: Eurosurveillance, ISSN 1025-496X, E-ISSN 1560-7917, Vol. 24, no 20, p. 6-12, article id 1800453Article in journal (Refereed) Published
Abstract [en]

Background:

In a study from 2013 that prioritised communicable diseases for surveillance in Sweden, we identified Lyme borreliosis as one of the diseases with highest priority. In 2014, when the present study was designed, there were also plans to make neuroborreliosis notifiable within the European Union.

Aim:

We compared possibilities of surveillance of neuroborreliosis in Sweden through two different sources: the hospital discharge register and reporting from the clinical microbiology laboratories.

Methods:

We examined the validity of ICD-10 codes in the hospital discharge register by extracting personal identification numbers for all cases of neuroborreliosis, defined by a positive cerebrospinal fluid-serum anti-Borrelia antibody index, who were diagnosed at the largest clinical microbiology laboratory in Sweden during 2014. We conducted a retrospective observational study with a questionnaire sent to all clinical microbiology laboratories in Sweden requesting information on yearly number of cases, age group and sex for the period 2010 to 2014.

Results:

Among 150 neuroborreliosis cases, 67 (45%) had received the ICD-10 code A69.2 (Lyme borreliosis) in combination with G01.9 (meningitis in bacterial diseases classified elsewhere), the combination that the Swedish National Board of Health and Welfare recommends for neuroborreliosis. All 22 clinical laboratories replied to our questionnaire. Based on laboratory reporting, the annual incidence of neuroborreliosis in Sweden was 6.3 cases per 100,000 in 2014.

Conclusion:

The hospital discharge register was unsuitable for surveillance of neuroborreliosis, whereas laboratory-based reporting was a feasible alternative. In 2018, the European Commission included Lyme neuroborreliosis on the list of diseases under epidemiological surveillance.

Place, publisher, year, edition, pages
2019. Vol. 24, no 20, p. 6-12, article id 1800453
National Category
Public Health, Global Health, Social Medicine and Epidemiology Infectious Medicine
Identifiers
URN: urn:nbn:se:uu:diva-387276DOI: 10.2807/1560-7917.ES.2019.24.20.1800453ISI: 000468123200002PubMedID: 31115310OAI: oai:DiVA.org:uu-387276DiVA, id: diva2:1329453
Available from: 2019-06-24 Created: 2019-06-24 Last updated: 2019-06-24Bibliographically approved

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