Spatial and seasonal determinants of Lyme borreliosis incidence in France, 2016 to 2021.

Wen Fu, Camille Bonnet, Alexandra Septfons, Julie Figoni, Jonas Durand, Pascale Frey-Klett, Denis Rustand, Benoît Jaulhac, Raphaëlle Métras

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1 Scopus citations


Background: Lyme borreliosis (LB) is the most widespread hard tick-borne zoonosis in the northern hemisphere. Existing studies in Europe have focused mainly on acarological risk assessment, with few investigations exploring human LB occurrence. Aim: We explored the determinants of spatial and seasonal LB variations in France from 2016 to 2021 by integrating environmental, animal, meteorological and anthropogenic factors, and then mapped seasonal LB risk predictions. Methods: We fitted 2016-19 LB national surveillance data to a two-part spatio-temporal statistical model. Spatial and temporal random effects were specified using a Besag-York-Mollie model and a seasonal model, respectively. Coefficients were estimated in a Bayesian framework using integrated nested Laplace approximation. Data from 2020-21 were used for model validation. Results: A high vegetation index (≥ 0.6) was positively associated with seasonal LB presence, while the index of deer presence (> 60%), mild soil temperature (15-22 °C), moderate air saturation deficit (1.5-5 mmHg) and higher tick bite frequency were associated with increased incidence. Prediction maps show a higher risk of LB in spring and summer (April-September), with higher incidence in parts of eastern, midwestern and south-western France. Conclusion: We present a national level spatial assessment of seasonal LB occurrence in Europe, disentangling factors associated with the presence and increased incidence of LB. Our findings yield quantitative evidence for national public health agencies to plan targeted prevention campaigns to reduce LB burden, enhance surveillance and identify further data needs. This approach can be tested in other LB endemic areas.
Original languageEnglish (US)
JournalEuro surveillance
Issue number14
StatePublished - Apr 6 2023

Bibliographical note

KAUST Repository Item: Exported on 2023-04-10
Acknowledgements: WF is funded by a Sorbonne University PhD fellowship, JD is supported by a grant overseen by the French National Research Agency (ANR) as part of the Investissements d’Avenir program (ANR-11-LABX-0002-01, Lab of Excellence ARBRE). RM acknowledges the support of Agence Nationale de la Recherche under the ANRJCJC MoZArt project, grant number ANR-22-CE35-0003. We are grateful to the Réseau Sentinelles, for providing the LB surveillance data, and all the Sentinelles general practitioners participated in the surveillance activities in France. We are also grateful to the CiTIQUE team members who initiated and are running this participatory research: Jean-François Cosson and Gwenaël Vourc’h from INRAE; Annick Brun-Jacob from Lorraine University; Irene Carravieri, Julien Marchand and Cyril Galley from CPIE Nancy-Champenoux, and all citizens who participated to CiTIQUE. We thank Oliver Steichen and Pierre-Yves Boëlle for their useful discussions.

ASJC Scopus subject areas

  • Virology
  • Epidemiology
  • Public Health, Environmental and Occupational Health


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