{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,7]],"date-time":"2026-11-07T00:31:02Z","timestamp":1794011462464,"version":"4.8.0"},"reference-count":29,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2018,10,8]],"date-time":"2018-10-08T00:00:00Z","timestamp":1538956800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2018,10,8]],"date-time":"2018-10-08T00:00:00Z","timestamp":1538956800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Lyme borreliosis (LB) is the most commonly reported tick-borne disease\n                in Germany. In 9\/16 states, notification of erythema migrans (EM), acute\n                neuroborreliosis (NB) and Lyme arthritis (LA) is mandatory. We describe incidence\n                measures, time trends, geographical distribution and frequencies of manifestations\n                to better understand LB epidemiology and target prevention measures. We used cases\n                notified in the 9 states and confirmed by local health offices, 2013\u20132017, to\n                calculate incidences by time, place and person. Altogether, we observed 56,446\n                cases. Disease onset peaked yearly in July. Incidence ranged from 26\/100,000 (2015)\n                to 41\/100,000 (2013) with mean annual incidences 2013\u20132017 on district level between\n                0.5\/100,000 and 138\/100,000. Median age was 54 years with peaks in boys (5\u20139 years,\n                mean incidence 36\/100,000) and women (50\u201369 years, mean incidence 57\/100,000). 95%\n                experienced EM only, 2.7% NB and 2.1% LA. 54% were female, but more men had NB (56%)\n                and LA (53%, p\u2009&lt;\u20090.001). Hospitalisation was recorded for 10% of LA and 71% of NB\n                cases. LB remains an important public health concern in Germany with marked regional\n                variation. To facilitate early diagnosis and treatment, health authorities should\n                raise awareness among physicians and promote prevention strategies among the general\n                population: tick-bite-protection, prompt tick removal and medical\n                consultation.<\/jats:p>","DOI":"10.1038\/s41598-018-33136-0","type":"journal-article","created":{"date-parts":[[2018,10,2]],"date-time":"2018-10-02T14:54:20Z","timestamp":1538492060000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":101,"title":["Incidence of notified Lyme borreliosis in Germany,\n              2013\u20132017"],"prefix":"10.1038","volume":"8","author":[{"given":"Julia","family":"Enkelmann","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Merle","family":"B\u00f6hmer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Volker","family":"Fingerle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Siffczyk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Werber","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Littmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie-Susann","family":"Merbecks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carina","family":"Helmeke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sabine","family":"Schroeder","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Hell","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Uwe","family":"Schlotthauer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Florian","family":"Burckhardt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Klaus","family":"Stark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anika","family":"Schielke","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hendrik","family":"Wilking","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2018,10,8]]},"reference":[{"key":"33136_CR1","unstructured":"Lindgren, E. & Jaenson, T. G. T. Lyme borreliosis in Europe:\n                  influences of climate and climate change, epidemiology, ecology and adaption\n                  measures, http:\/\/www.euro.who.int\/__data\/assets\/pdf_file\/0006\/96819\/E89522.pdf (2006)."},{"key":"33136_CR2","first-page":"191","volume":"129","author":"J Piesman","year":"2004","unstructured":"Piesman, J. & Gern, L. Lyme borreliosis in Europe and North\n                  America. Parasitology 2004\n                  129, 191\u2013220 (2004).","journal-title":"Parasitology 2004"},{"key":"33136_CR3","doi-asserted-by":"publisher","first-page":"51","DOI":"10.1159\/000213070","volume":"37","author":"F Strle","year":"2009","unstructured":"Strle, F. & Stanek, G. Clinical manifestations and diagnosis of\n                  lyme borreliosis. Curr. Prob. Dermatol.\n                  37, 51\u2013110, https:\/\/doi.org\/10.1159\/000213070 (2009).","journal-title":"Curr. Prob. Dermatol."},{"issue":"9814","key":"33136_CR4","doi-asserted-by":"publisher","first-page":"461","DOI":"10.1016\/S0140-6736(11)60103-7","volume":"379","author":"Gerold Stanek","year":"2012","unstructured":"Stanek, G., Wormser, G. P. & Strle, F. Lyme borreliosis.\n                    The Lancet\n                  Vol 379, 461\u2013473 (2012).","journal-title":"The Lancet"},{"key":"33136_CR5","first-page":"1","volume":"2016","author":"AC Steere","year":"2016","unstructured":"Steere, A. C. et al. Lyme\n                  borreliosis. Nat. Rev. Dis. Prim. Volume 2\n                  2016, 1\u201318 (2016).","journal-title":"Nat. Rev. Dis. Prim. Volume 2"},{"key":"33136_CR6","doi-asserted-by":"publisher","first-page":"e0184357","DOI":"10.1371\/journal.pone.0184357","volume":"12","author":"P Comstedt","year":"2017","unstructured":"Comstedt, P., Schuler, W., Meinke, A. & Lundberg, U. The novel\n                  Lyme borreliosis vaccine VLA15 shows broad protection against Borrelia species\n                  expressing six different OspA serotypes. PloS\n                    one\n                  12, e0184357, https:\/\/doi.org\/10.1371\/journal.pone.0184357 (2017).","journal-title":"PloS one"},{"key":"33136_CR7","doi-asserted-by":"publisher","first-page":"677","DOI":"10.7326\/l16-0409","volume":"165","author":"LTLD Hu","year":"2016","unstructured":"Hu, L. T. Lyme Disease. Ann. Int.\n                    Med.\n                  165, 677, https:\/\/doi.org\/10.7326\/l16-0409 (2016).","journal-title":"Ann. Int. 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Ticks Tick Borne Dis.\n                  6, 56\u201362 (2015).","journal-title":"Ticks Tick Borne Dis."},{"key":"33136_CR13","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2012\/595427","volume":"2012","author":"I. M\u00fcller","year":"2012","unstructured":"M\u00fcller, I. et al. Evaluating\n                  Frequency, Diagnostic Quality and Cost of Lyme Borreliosis Testing in Germany: A\n                  Retrospective Model Analysis. Clin. Dev. Immunol.\n                    2012, Article ID 595427, https:\/\/doi.org\/10.1155\/2012\/595427 (2012).","journal-title":"Clinical and Developmental Immunology"},{"key":"33136_CR14","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1016\/j.ttbdis.2013.10.010","volume":"(5)","author":"H Wilking","year":"2014","unstructured":"Wilking, H. & Stark, K. Trends in surveillance data on human\n                  Lyme borreliosis from six federal states in eastern Germany, 2009\u20132012. Ticks Tick Borne Dis.\n                  (5), 219\u2013224 (2014).","journal-title":"Ticks Tick Borne Dis."},{"key":"33136_CR15","unstructured":"Robert Koch-Institut. SurvStat@RKI 2. 0, https:\/\/survstat.rki.de\/Content\/Query\/Create.aspx, accessed 02.02.2018, Inquiry of German notification data on\n                  tick-borne encephalitis (2018)."},{"key":"33136_CR16","unstructured":"Hellenbrand, W. FSME: Risikogebiete in Deutschland (as of: April\n                  2017), translated: Tick borne encephalitis: high risk regions in Germany.\n                    Epidemiologisches Bulleting, Nr. 17\n                  (2017)."},{"issue":"12","key":"33136_CR17","doi-asserted-by":"publisher","first-page":"865","DOI":"10.1089\/vbz.2012.1194","volume":"13","author":"S Mulder","year":"2013","unstructured":"Mulder, S., van Vliet, A. J. H., Bron, W. A., Gassner, F. &\n                  Takken, W. High Risk of Tick Bites in Dutch Gardens. 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Washington, DC (National Academies Press,\n                  2011)."}],"updated-by":[{"DOI":"10.1038\/s41598-021-92398-3","type":"correction","label":"Correction","source":"publisher","updated":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000}}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-33136-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-33136-0","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-33136-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,21]],"date-time":"2022-12-21T10:31:13Z","timestamp":1671618673000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-018-33136-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,10,8]]},"references-count":29,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2018,12]]}},"alternative-id":["33136"],"URL":"https:\/\/doi.org\/10.1038\/s41598-018-33136-0","relation":{},"ISSN":["2045-2322"],"issn-type":[{"value":"2045-2322","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,10,8]]},"assertion":[{"value":"22 May 2018","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"17 September 2018","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"8 October 2018","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 June 2021","order":4,"name":"change_date","label":"Change Date","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"Correction","order":5,"name":"change_type","label":"Change Type","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"A Correction to this paper has been published:","order":6,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"https:\/\/doi.org\/10.1038\/s41598-021-92398-3","URL":"https:\/\/doi.org\/10.1038\/s41598-021-92398-3","order":7,"name":"change_details","label":"Change Details","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"V.F. is the head of the German National Reference Centre for\n                  Borrelia, Expert\/head of Borrelia round robin testing (PCR, serology) for QCMID\n                  and INSTAND, a member of ESGBOR and ESCMID and an expert witness. V.F. has\n                  received honoraria\/travel expenses for providing advanced training for medical\n                  personnel from DiaSorin, Seramun, Mikrogen and research funding from RKI, ESCMID\n                  and INSTAND.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"14976"}}