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Incidence of Lyme disease in the UK: a population-based cohort study
  1. Victoria Cairns1,
  2. Christopher Wallenhorst2,
  3. Stephan Rietbrock2,
  4. Carlos Martinez2
  1. 1 Retired, Oxford, UK
  2. 2 Epidemiology, Institute for Epidemiology, Statistics and Informatics GmbH, Frankfurt, Germany
  1. Correspondence to Dr Carlos Martinez; publications{at}


Objectives The purpose of this study was to estimate the annual incidence of Lyme disease (LD) in the UK.

Design This was a retrospective descriptive cohort study.

Setting Study data were extracted from the Clinical Practice Research Datalink (CPRD), a primary care database covering about 8% of the population in the UK in 658 primary care practices.

Participants Cohort of 8.4 million individuals registered with general practitioners with 52.4 million person-years of observation between 1 January 2001 and 31 December 2012.

Primary and secondary outcome measures LD was identified from recorded medical codes, notes indicating LD, laboratory tests and use of specific antibiotics. Annual incidence rates and the estimated total number of LD cases were calculated separately for each UK region.

Results The number of cases of LD increased rapidly over the years 2001 to 2012, leading to an estimated incidence rate of 12.1 (95% CI 11.1 to 13.2) per 100 000 individuals per year and a UK total of 7738 LD cases in 2012. LD was detected in every UK region with highest incidence rates and largest number of cases in Scotland followed by South West and South England. If the number of cases has continued to rise since the end of the study period, then the number in the UK in 2019 could be over 8000.

Conclusions The incidence of LD is about threefold higher than previously estimated, and people are at risk throughout the UK. These results should lead to increased awareness of the need for preventive measures.

Trial registration number This study was approved by the Independent Scientific Advisory Committee for CPRD research (Protocol number 13_210R).

  • lyme disease
  • lyme borreliosis
  • epidemiology
  • incidence

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  • Contributors Conception or design: VC, CM, CW and SR. Data acquisition and analysis: VC, CM, CW and SR. Data interpretation: VC, CM, CW and SR. Drafting of the manuscript: VC and CM. Critical revision of the manuscript for important intellectual content: VC, CM, CW and SR. Final approval of the version to be submitted: VC, CM, CW and SR. Responsibility: CM takes full responsibility for integrity of data and analyses.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests CM, SR and CW are employees of the Institute for Epidemiology, Statistics and Informatics GmbH. The Institute for Epidemiology, Statistics and Informatics GmbH has received grants from Bayer, Bristol-Myers Squibb, CSL Behring and Merz Pharma outside the submitted work.

  • Ethics approval The study was approved by the Independent Scientific Advisory Committee for CPRD for Clinical Practice Research Datalink research (research No 13_210R). No further ethics approval was required for the analysis of the data. The CPRD Group has obtained ethical approval from a multicentre research ethics committee for all purely observational research using CPRD data, namely, studies that do not include patient involvement (the vast majority of CPRD studies).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data sharing statement The study data were extracted from the Clinical Practice Research Datalink (CPRD). CPRD data cannot be shared because of licensing restrictions.

  • Patient consent for publication Not required.

  • Map disclaimer The depiction of boundaries on the map(s) in this article do not imply the expression of any opinion whatsoever on the part of BMJ (or any member of its group) concerning the legal status of any country, territory, jurisdiction or area or of its authorities. The map(s) are provided without any warranty of any kind, either express or implied.

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