Lyme borreliosis incidence in Lombardy, Italy (2000–2015): Spatiotemporal analysis and environmental risk factors

Lyme borreliosis cases have been reported from Lombardy in northern Italy, where Ixodes ricinus is the main vector of Borrelia burgdorferi sensu lato. However, spatial and temporal variation in the incidence of Lyme borreliosis is not well understood. In the present study, based on new notified case...

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Veröffentlicht in:	Ticks and tick-borne diseases Jg. 10; H. 6; S. 101257
Hauptverfasser:	Zanzani, Sergio A., Rimoldi, Sara G., Manfredi, MariaTeresa, Grande, Romualdo, Gazzonis, Alessia L., Merli, Stefania, Olivieri, Emanuela, Giacomet, Vania, Antinori, Spinello, Cislaghi, Giuliana, Bestetti, Giovanna, Nan, Katiuscia, Sala, Vittorio, Gismondo, Maria R., Atzori, Chiara, De Faveri, Eleonora
Format:	Journal Article
Sprache:	Englisch
Veröffentlicht:	Netherlands Elsevier GmbH 01.10.2019
Schlagworte:	Adolescent Adult Aged Aged, 80 and over bacterial diseases of plants Borrelia burgdorferi Borrelia burgdorferi sensu lato Child Child, Preschool data collection economic resources Environment environmental factors Environmental risk factors Epidemiology factor analysis Female forests georeferencing Humans Incidence Infant Italy Italy - epidemiology Ixodes ricinus land cover Lyme borreliosis incidence Lyme disease Lyme Disease - epidemiology Lyme Disease - microbiology Male meadows Middle Aged pets plant pathogenic bacteria relative risk Retrospective Studies Risk Risk Factors Spatial analysis Spatio-Temporal Analysis taxonomy temporal variation tick bites ticks wildland-urban interface Young Adult Italy Borrelia burgdorferi sensu lato Spatial analysis Environmental risk factors Lyme borreliosis incidence Epidemiology
ISSN:	1877-959X, 1877-9603, 1877-9603
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Abstract	Lyme borreliosis cases have been reported from Lombardy in northern Italy, where Ixodes ricinus is the main vector of Borrelia burgdorferi sensu lato. However, spatial and temporal variation in the incidence of Lyme borreliosis is not well understood. In the present study, based on new notified cases of Lyme borreliosis from 2000 to 2015, an average of 1.24 new cases per million residents per year was documented. New cases, georeferenced at the municipal level, were analyzed by retrospective space-time analysis (using SaTScan v. 9.3.1); and land cover, extrapolated from a Corine Land Cover dataset (using QGIS 2.8.1), was used to implement an environmental risk factor analysis. Firstly, a temporal high-risk cluster was detected in Lombardy: the relative risk of Lyme borreliosis was 3.73 times higher during 2008–2015 compared with the entire study period. Moreover, in a spatiotemporal high-risk cluster with a circular base, land cover consisting of wildland-urban interface, meadow, forest and meadow-forest transition were significantly higher compared to low-risk areas. Results of the present study demonstrate that the incidence of Lyme borreliosis is increasing in Lombardy and that environmental conditions are suitable for I. ricinus ticks infected with B. burgdorferi s.l.: citizens and health systems should be aware of Lyme borreliosis to reduce tick bites with personal protective behaviors and to avoid misdiagnosis, particularly within the area including the observed high-risk cluster. Economic resources should be invested to inform about methods to prevent tick bites, how to check people and pets after frequenting risk areas, and ways of removing the biting ticks when they are found.
AbstractList	Lyme borreliosis cases have been reported from Lombardy in northern Italy, where Ixodes ricinus is the main vector of Borrelia burgdorferi sensu lato. However, spatial and temporal variation in the incidence of Lyme borreliosis is not well understood. In the present study, based on new notified cases of Lyme borreliosis from 2000 to 2015, an average of 1.24 new cases per million residents per year was documented. New cases, georeferenced at the municipal level, were analyzed by retrospective space-time analysis (using SaTScan v. 9.3.1); and land cover, extrapolated from a Corine Land Cover dataset (using QGIS 2.8.1), was used to implement an environmental risk factor analysis. Firstly, a temporal high-risk cluster was detected in Lombardy: the relative risk of Lyme borreliosis was 3.73 times higher during 2008-2015 compared with the entire study period. Moreover, in a spatiotemporal high-risk cluster with a circular base, land cover consisting of wildland-urban interface, meadow, forest and meadow-forest transition were significantly higher compared to low-risk areas. Results of the present study demonstrate that the incidence of Lyme borreliosis is increasing in Lombardy and that environmental conditions are suitable for I. ricinus ticks infected with B. burgdorferi s.l.: citizens and health systems should be aware of Lyme borreliosis to reduce tick bites with personal protective behaviors and to avoid misdiagnosis, particularly within the area including the observed high-risk cluster. Economic resources should be invested to inform about methods to prevent tick bites, how to check people and pets after frequenting risk areas, and ways of removing the biting ticks when they are found.Lyme borreliosis cases have been reported from Lombardy in northern Italy, where Ixodes ricinus is the main vector of Borrelia burgdorferi sensu lato. However, spatial and temporal variation in the incidence of Lyme borreliosis is not well understood. In the present study, based on new notified cases of Lyme borreliosis from 2000 to 2015, an average of 1.24 new cases per million residents per year was documented. New cases, georeferenced at the municipal level, were analyzed by retrospective space-time analysis (using SaTScan v. 9.3.1); and land cover, extrapolated from a Corine Land Cover dataset (using QGIS 2.8.1), was used to implement an environmental risk factor analysis. Firstly, a temporal high-risk cluster was detected in Lombardy: the relative risk of Lyme borreliosis was 3.73 times higher during 2008-2015 compared with the entire study period. Moreover, in a spatiotemporal high-risk cluster with a circular base, land cover consisting of wildland-urban interface, meadow, forest and meadow-forest transition were significantly higher compared to low-risk areas. Results of the present study demonstrate that the incidence of Lyme borreliosis is increasing in Lombardy and that environmental conditions are suitable for I. ricinus ticks infected with B. burgdorferi s.l.: citizens and health systems should be aware of Lyme borreliosis to reduce tick bites with personal protective behaviors and to avoid misdiagnosis, particularly within the area including the observed high-risk cluster. Economic resources should be invested to inform about methods to prevent tick bites, how to check people and pets after frequenting risk areas, and ways of removing the biting ticks when they are found. Lyme borreliosis cases have been reported from Lombardy in northern Italy, where Ixodes ricinus is the main vector of Borrelia burgdorferi sensu lato. However, spatial and temporal variation in the incidence of Lyme borreliosis is not well understood. In the present study, based on new notified cases of Lyme borreliosis from 2000 to 2015, an average of 1.24 new cases per million residents per year was documented. New cases, georeferenced at the municipal level, were analyzed by retrospective space-time analysis (using SaTScan v. 9.3.1); and land cover, extrapolated from a Corine Land Cover dataset (using QGIS 2.8.1), was used to implement an environmental risk factor analysis. Firstly, a temporal high-risk cluster was detected in Lombardy: the relative risk of Lyme borreliosis was 3.73 times higher during 2008–2015 compared with the entire study period. Moreover, in a spatiotemporal high-risk cluster with a circular base, land cover consisting of wildland-urban interface, meadow, forest and meadow-forest transition were significantly higher compared to low-risk areas. Results of the present study demonstrate that the incidence of Lyme borreliosis is increasing in Lombardy and that environmental conditions are suitable for I. ricinus ticks infected with B. burgdorferi s.l.: citizens and health systems should be aware of Lyme borreliosis to reduce tick bites with personal protective behaviors and to avoid misdiagnosis, particularly within the area including the observed high-risk cluster. Economic resources should be invested to inform about methods to prevent tick bites, how to check people and pets after frequenting risk areas, and ways of removing the biting ticks when they are found.
ArticleNumber	101257
Author	Bestetti, Giovanna Sala, Vittorio Olivieri, Emanuela De Faveri, Eleonora Nan, Katiuscia Antinori, Spinello Giacomet, Vania Merli, Stefania Grande, Romualdo Rimoldi, Sara G. Gazzonis, Alessia L. Cislaghi, Giuliana Gismondo, Maria R. Zanzani, Sergio A. Manfredi, MariaTeresa Atzori, Chiara
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Cites_doi	10.1016/j.ttbdis.2017.06.002 10.1556/ComEc.7.2006.2.6 10.1186/1756-3305-5-61 10.7589/0090-3558-45.3.748 10.3201/eid1608.100152 10.1080/03610929708831995 10.1016/j.ttbdis.2014.12.006 10.4269/ajtmh.14-0181 10.2807/ese.16.27.19906-en 10.1371/journal.pone.0210280 10.3201/eid2108.141878 10.1016/S0140-6736(11)60103-7 10.4269/ajtmh.13-0733 10.1016/j.ttbdis.2014.09.004 10.1128/AEM.00610-10 10.1088/1748-9326/11/4/043001 10.4997/JRCPE.2015.304 10.1111/j.1365-2915.2009.00813.x 10.1007/s10493-008-9132-3 10.2105/AJPH.88.9.1377 10.1016/j.ttbdis.2013.07.003 10.1098/rstb.2016.0117 10.1136/ard.44.8.570 10.1007/s10393-006-0065-1 10.1196/annals.1428.093 10.1098/rstb.2001.0893 10.1007/s10393-008-0171-3 10.2807/1560-7917.ES2014.19.34.20883
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Keywords	Borrelia burgdorferi sensu lato Spatial analysis Environmental risk factors Lyme borreliosis incidence Epidemiology
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Snippet	Lyme borreliosis cases have been reported from Lombardy in northern Italy, where Ixodes ricinus is the main vector of Borrelia burgdorferi sensu lato. However,...
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SubjectTerms	Adolescent Adult Aged Aged, 80 and over bacterial diseases of plants Borrelia burgdorferi Borrelia burgdorferi sensu lato Child Child, Preschool data collection economic resources Environment environmental factors Environmental risk factors Epidemiology factor analysis Female forests georeferencing Humans Incidence Infant Italy Italy - epidemiology Ixodes ricinus land cover Lyme borreliosis incidence Lyme disease Lyme Disease - epidemiology Lyme Disease - microbiology Male meadows Middle Aged pets plant pathogenic bacteria relative risk Retrospective Studies Risk Risk Factors Spatial analysis Spatio-Temporal Analysis taxonomy temporal variation tick bites ticks wildland-urban interface Young Adult
Title	Lyme borreliosis incidence in Lombardy, Italy (2000–2015): Spatiotemporal analysis and environmental risk factors
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