Distribution and presentation of Lyme borreliosis in Scotland – analysis of data from a national testing laboratory

This study examines the distribution of laboratory-confirmed cases of Lyme borreliosis in Scotland and the clinical spectrum of presentations within NHS Highland.

Methods General demographic data (age/sex/referring Health Board) from all cases of Lyme borreliosis serologically confirmed by the National Lyme Borreliosis Testing Laboratory from 1 January 2008 to 31 December 2013 were analysed. Clinical features of confirmed cases were ascertained from questionnaires sent to referring clinicians within NHS Highland during the study period.

Is Tayside becoming a Scottish hotspot for Lyme borreliosis?

The epidemiology of Lyme borreliosis (LB) in Tayside was studied and compared with Highland (an area of high endemicity) and the rest of Scotland. From April 2001 to March 2008 the incidence of LB in Tayside rose from an estimated 2.57 to 5.84 per 100,000 population. In 2008/09 the incidence of LB in Tayside increased further to an estimated 13.85 per 100,000 population.

Lyme borreliosis in Scotland during two peak periods

The epidemiology of Lyme borreliosis (LB) and climatic conditions in Scotland were studied. Questionnaire data from all new seropositive patients from July to September 2007 and 2008 were examined along with demographic data from seropositive patients, rainfall and temperature data for these years. There were significantly more samples, seropositive patients and seropositive patients per patients tested in July to September 2008 than 2007.

Lyme carditis: a reversible cause of complete atrioventricular block

A 54-year-old American woman presented with an episode of syncope. This had occurred against a background of several days of dizziness and palpitations. Her medical history included Bell’s palsy, which had been diagnosed three weeks earlier. On examination, she had a resting bradycardia of 31 beats per minute and her electrocardiogram demonstrated third-degree atrioventricular (AV) block. She was referred to cardiology for consideration of permanent pacemaker implantation. Given her facial nerve palsy and AV block, a diagnosis of Lyme borreliosis was suspected.

Is Tayside becoming a Scottish hotspot for Lyme borreliosis?

The epidemiology of Lyme borreliosis (LB) in Tayside was studied and compared with Highland (an area of high endemicity) and the rest of Scotland. From April 2001 to March 2008 the incidence of LB in Tayside rose from an estimated 2.57 to 5.84 per 100,000 population. In 2008/09 the incidence of LB in Tayside increased further to an estimated 13.85 per 100,000 population.