Table 3.
Key indicators used at the national level in countries that monitor Lyme disease (N = 29)
| Countries | Case definitions (n = 18) | Positive laboratory tests (n = 4) | Medical patient consultations (n = 3) | Public participatory website/app (n = 5) | Unclear / Not reported (n = 3) & Notes | ||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| EM (clinical signs onlya) | EM (clinical + laba) | EM (othersa) | LNB (clinical + lab) | Other (clinical + lab) | Tick bites + EM | Other “late” clinical manifestations | Tick bites | Clinical manifestations | |||
| EU COUNTRIES THAT HAVE A POLICY OR SYSTEM (n = 22) | |||||||||||
| Belgium [11] | X | X | X | X | |||||||
| Bulgaria [45] | X | X | X | ||||||||
| Croatia [46] | X | X | X | ||||||||
| Czech Republic [14] | X | X | X | ||||||||
| Denmark [15] | X | ||||||||||
| Estonia | Unclear / No national definition found (legislation only specifies ICD-10 code A69.2)[16] | ||||||||||
| Finland [17] | X | ||||||||||
| France [18] | X | X | X | X | |||||||
| Germany [20] | X | X | X | In at least 9/16 states | |||||||
| Hungary [22] | X | X | |||||||||
| Ireland [23] | X | ||||||||||
| Italy | Unclear / No national definition found | ||||||||||
| Latvia [25] | X | Refers to the list of EU case definitions, so LNB | |||||||||
| Lithuania | Unclear / No national definition found (legislation only specifies ICD-10 code A69.2)[26] | ||||||||||
| Luxembourg [47] | Unclear if lab tests required | X | |||||||||
| Netherlands [5] | X | X | X | ||||||||
| Poland [48] | X | X | X | ||||||||
| Portugal [30] | X | ||||||||||
| Romania [31] | X | X | X | ||||||||
| Slovakia [32, 49] | X | X | X | Cases clearly reported using ICD-10 codes A69.2, G63.0 and M01.2 [49] | |||||||
| Slovenia [50] | X | X | X | ||||||||
| Spain [34] | X | Some autonomous communities also have a case definition | |||||||||
| Subtotal EU | 4 | 6 | 1 | 15 | 9 | 3 | 2 | 0 | 3 | 2 | |
| OTHER EUROPEAN COUNTRIES (n = 5) | |||||||||||
| Iceland [51] | No clinical nor lab information required | ||||||||||
| Liechtenstein | X | ||||||||||
| Norway [36] | Multiple EMs only | X | X | ||||||||
| Switzerland [37] | X | X | X | ||||||||
| UK [38] | X | ||||||||||
| Subtotal Europe | 4 | 7 | 1 | 16 | 10 | 4 | 3 | 1 | 5 | 2 | |
| Canada [52] | X | X | X | Some provinces record EM without lab | |||||||
| USA [53] | Confirmed with exposure in high incidence state or with lab and exposure in low incidence state | X | X | ||||||||
| TOTAL | 4 | 8 | 2 | 18 | 12 | 4 | 3 | 1 | 5 | 2 | |
App: mobile application; EFTA: European Free Trade Association; EU: European Union; EM: erythema migrans; Lab: laboratory; LNB: Lyme neuroborreliosis
a The three EM categories are mutually exclusive
No government-led system or policy was found in Austria, Cyprus, Greece, Malta and Sweden