Infectious Disease
Incidence and seroprevalence of Lyme disease in high-risk occupational groups in North America and Europe Emma Viscidi* Emma Viscidi Elizabeth Devore Rhonda Bohn
Background and Objectives: Lyme disease, a tick bite–transmitted infection caused by Borrelia burgdorferi complex spirochetes, is the most common tick-borne illness in North America and Europe. A 2021 systematic literature review and meta-analysis found that 14% of the world’s population is B. burgdorferi seropositive. Previous studies have reported higher risk of Lyme disease in certain occupational groups; however, contemporary data synthesizing findings on the burden in high-risk occupational groups is needed. The purpose of this research is to describe the incidence and seroprevalence of Lyme disease in high-risk occupational groups in contemporary studies from North America and Europe.
Methods: A targeted literature search was conducted to identify relevant subject headings and text words (incidence, seroprevalence, Lyme disease, and high-risk populations). Results were limited to English-language human studies of adult populations in North America and Europe published between 2013 and 2023.
Results: Thirteen studies were identified that met the inclusion criteria and employed robust, population-based study designs. All studies explicitly defined the underlying study population and described sampling strategies aimed at ascertaining a representative sample of that study population. In 3 United States studies that reported on Lyme disease among soldiers, higher prevalence or incidence rates were observed in soldiers compared with the general United States population. In studies conducted in European countries, foresters, farmers, and other outdoor workers had higher seroprevalence than the general populations in those countries (Figure).
Conclusion: There is evidence that specific occupational groups, such as farmers, foresters, and soldiers, are at higher risk for Lyme disease. These occupational groups may be a desirable target population for Lyme disease clinical trials and preventive vaccines.
