{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T21:54:32Z","timestamp":1790373272400,"version":"4.1.0"},"reference-count":24,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2020,3,5]],"date-time":"2020-03-05T00:00:00Z","timestamp":1583366400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and objective: Lyme disease, also known as Lyme borreliosis (LB), is a tick-borne infectious disease caused by the spirochete bacteria Borrelia. The risk of infection depends on the geographical area, ecological factors, and human behavior. Clinical manifestations of Lyme borreliosis have a wide range, but the most frequent clinical symptom, which is also a diagnostic symptom, is a skin rash called erythema migrans (EM). The disease is very common worldwide. In Lithuania, the disease frequency is 99.9 cases per 100,000 population (Centre for Communicable Diseases and AIDS, Lithuania, 2017). The main aim of this study was to obtain the baseline characteristics of the disease regarding the infected Lithuanian population. Materials and Methods: We analyzed data from the Centre for Communicable Diseases and AIDS about all Lyme disease (A69.2) diagnosed patients over a three-year period (from 2014 to 2016) in Lithuania. Results: In 2014\u20132016, 7424 (crude incidence rate 85.4) cases with LB were diagnosed in Lithuania. Most of them (4633 (62.4%)) were identified in women. Older people were more likely to suffer from LB. Urban residents were 2.6 times more often affected that those living in villages. Tick bites were primarily observed in high season months, from May to September (90%), with the highest peak in July. There was a higher number of observed tick bites (p = 0.003) in the urban residents. Erythema migrans occurred in 75.6% LB cases, while other symptoms did not exceed a quarter of all LB cases. There were 7353 (99.6%) cases where LB was confirmed via clinical symptoms and\/or laboratory tests. Also, 1720 (23.2%) patients were tested for LB immunoglobulins. Conclusions: This study found a high incidence of Lyme disease in Lithuania. We elucidated the baseline characteristics regarding the infected Lithuanian population which may ease medical clinicians\u2019 work on new Lyme diagnoses.<\/jats:p>","DOI":"10.3390\/medicina56030115","type":"journal-article","created":{"date-parts":[[2020,3,6]],"date-time":"2020-03-06T09:26:41Z","timestamp":1583486801000},"page":"115","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":44,"title":["Epidemiology of Lyme Disease in a Highly Endemic European Zone"],"prefix":"10.3390","volume":"56","author":[{"given":"Agn\u0117","family":"Petrulionien\u0117","sequence":"first","affiliation":[{"name":"Clinic of Rheumatology, Orthopaedics Traumatology and Reconstructive Surgery, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daiva","family":"Radzi\u0161auskien\u0117","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arvydas","family":"Ambrozaitis","sequence":"additional","affiliation":[{"name":"Clinic of Infectious Diseases, Institute of Clinical Medicine, Faculty of Medicine, Vilnius University, 01513 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saulius","family":"\u010caplinskas","sequence":"additional","affiliation":[{"name":"Centre for Communicable Diseases and AIDS, Vilnius 10105, Lithuania"},{"name":"Institute of Educational Sciences and Social Work, Mykolas Romeris University, 08303 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Algimantas","family":"Paulauskas","sequence":"additional","affiliation":[{"name":"Department of Biology, Vytautas Magnus University, 44248 Kaunas, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Algirdas","family":"Venalis","sequence":"additional","affiliation":[{"name":"State Research Institute Centre for Innovative Medicine, 08410 Vilnius, Lithuania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,3,5]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"569","DOI":"10.20506\/rst.34.2.2380","article-title":"Lyme disease","volume":"34","author":"Chomel","year":"2015","journal-title":"Rev. Sci. Tech. (Int. Off. Epizoot.)"},{"key":"ref_2","first-page":"74","article-title":"An estimate of Lyme borreliosis incidence in Western Europe","volume":"39","author":"Sykes","year":"2017","journal-title":"J. Public Health (Oxf. Engl.)"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"296","DOI":"10.1016\/j.medmal.2019.05.006","article-title":"Lyme borreliosis and other tick-borne diseases. Guidelines from the French scientific societies","volume":"49","author":"Gocko","year":"2019","journal-title":"M\u00e9decine Mal. Infect."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Zanzani, S., Rimoldi, S.G., Manfredi, M., Grande, R., Gazzonis, A., Merli, S., Olivieri, E., Giacomet, V., Antinori, S., and Cislaghi, G. (2019). Lyme borreliosis incidence in Lombardy, Italy (2000\u20132015): Spatiotemporal analysis and environmental risk factors. Ticks Tick Borne Dis., 101257.","DOI":"10.1016\/j.ttbdis.2019.07.001"},{"key":"ref_5","doi-asserted-by":"crossref","unstructured":"Cairns, V., Wallenhorst, C., Rietbrock, S., and Martinez, C. (2019). Incidence of Lyme disease in the UK: A population-based cohort study. BMJ Open, 9.","DOI":"10.1136\/bmjopen-2018-025916"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"1282","DOI":"10.3201\/eid2308.161273","article-title":"Lyme Borreliosis in Finland, 1995\u20132014","volume":"23","author":"Sajanti","year":"2017","journal-title":"Emerg. Infect. Dis."},{"key":"ref_7","first-page":"201","article-title":"Clinical spectrum of Lyme disease","volume":"38","author":"Valadez","year":"2018","journal-title":"Eur. J. Clin. Microbiol. Infect. Dis."},{"key":"ref_8","first-page":"118","article-title":"To test or not to test? Laboratory support for the diagnosis of Lyme borreliosis: A position paper of ESGBOR, the ESCMID study group for Lyme borreliosis","volume":"24","author":"Dessau","year":"2018","journal-title":"Clin. Microbiol. Infect. Off. Publ. Eur. Soc. Clin. Microbiol. Infect. Dis."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"875","DOI":"10.1016\/j.ncl.2016.05.005","article-title":"Epidemiology of Lyme Neuroborreliosis","volume":"34","author":"Younger","year":"2016","journal-title":"Neurol. Clin."},{"key":"ref_10","first-page":"109","article-title":"Infezioni zoonosiche trasmesse da zecche: Aspetti clinici e diagnostici in medicina umana","volume":"46","author":"Sambri","year":"2004","journal-title":"Parassitologia"},{"key":"ref_11","first-page":"403","article-title":"Le infezioni trasmesse dal morso di zecca","volume":"95","author":"Calza","year":"2004","journal-title":"Recenti Progress. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.medmal.2019.01.007","article-title":"Ticks and tick-borne diseases","volume":"49","author":"Boulanger","year":"2019","journal-title":"M\u00e9decine Mal. Infect."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"221","DOI":"10.1126\/science.364.6437.221","article-title":"Lyme disease research gets a needed boost","volume":"364","year":"2019","journal-title":"Science (New York N.Y.)"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1016\/S0140-6736(11)60103-7","article-title":"Lyme borreliosis","volume":"379","author":"Stanek","year":"2012","journal-title":"Lancet"},{"key":"ref_15","first-page":"63","article-title":"Lyme disease in Iceland\u2014Epidemiology from 2011 to 2015","volume":"105","author":"Vigfusson","year":"2019","journal-title":"Laeknabladid"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1016\/j.gaceta.2015.01.008","article-title":"Epidemiolog\u00eda de la enfermedad de Lyme en un \u00e1rea sanitaria del noroeste de Espa\u00f1a","volume":"29","author":"Morrondo","year":"2015","journal-title":"Gac. Sanit."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"19906","DOI":"10.2807\/ese.16.27.19906-en","article-title":"Lyme borreliosis in Europe","volume":"16","author":"Rizzoli","year":"2011","journal-title":"Euro Surveill"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.ttbdis.2016.06.006","article-title":"Incidence and antibiotic treatment of erythema migrans in Norway 2005\u20132009","volume":"8","author":"Eliassen","year":"2017","journal-title":"Ticks Tick Borne Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1089\/vbz.2006.0533","article-title":"Effect of gender on clinical and epidemiologic features of Lyme borreliosis","volume":"7","author":"Bennet","year":"2007","journal-title":"Vector Borne Zoonotic Dis. (Larchmt. N.Y.)"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"219","DOI":"10.1016\/j.ttbdis.2013.10.010","article-title":"Trends in surveillance data of human Lyme borreliosis from six federal states in eastern Germany, 2009\u20132012","volume":"5","author":"Wilking","year":"2014","journal-title":"Ticks Tick Borne Dis."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"e028064","DOI":"10.1136\/bmjopen-2018-028064","article-title":"The demographics and geographic distribution of laboratory-confirmed Lyme disease cases in England and Wales (2013\u20132016): An ecological study","volume":"9","author":"Tulloch","year":"2019","journal-title":"BMJ Open"},{"key":"ref_22","first-page":"268","article-title":"Epidemiological patterns of tick-borne encephalitis in Lithuania and clinical features in adults in the light of the high incidence in recent years: A retrospective study","volume":"25","author":"Jasionis","year":"2017","journal-title":"Eur. J. Neurol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"121","DOI":"10.1016\/j.medmal.2018.11.011","article-title":"Review of European and American guidelines for the diagnosis of Lyme borreliosis","volume":"49","author":"Eldin","year":"2019","journal-title":"M\u00e9decine Mal. Infect."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1186\/s13071-018-2744-5","article-title":"Control of Lyme borreliosis and other Ixodes ricinus-borne diseases","volume":"11","author":"Sprong","year":"2018","journal-title":"Parasites Vectors"}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/3\/115\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T09:04:37Z","timestamp":1760173477000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/56\/3\/115"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,3,5]]},"references-count":24,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2020,3]]}},"alternative-id":["medicina56030115"],"URL":"https:\/\/doi.org\/10.3390\/medicina56030115","relation":{},"ISSN":["1648-9144"],"issn-type":[{"value":"1648-9144","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,3,5]]}}}