title: Lyme disease in France: a primary care-based prospective study.
abstract: To estimate the incidence of Lyme borreliosis in France, describe its clinical presentations, and assess its potential risk factors, we conducted a nationwide prospective study in the French Sentinelles Network, consisting of 1178 general practitioners (GPs). Of these, 875 (74%), i.e. 1.6% of all French GPs, participated in the study from May 1999 to April 2000. Eighty-six cases of Lyme disease were reported and validated, of which 77 (90%) consisted of erythema migrans. At national level, the incidence was estimated at 9.4/100,000 inhabitants. Compared to the French general population, Lyme disease patients were older (P<10(-4)), more were living in rural areas (P<10(-3)), and amongst the working population, more were farmers (P<10(-3)) and fewer, salaried workers (P<0.005). Cervidae density correlated strongly with the estimated regional incidence of Lyme disease (r=0.82). Both incidence data and identified risk factors can help to target measures for its prevention and treatment.
authors.affiliation: WHO Collaborating Centre for Electronic Disease Surveillance, Inserm Unit 707, Pierre et Marie Curie University, Paris, France. laurent.letrilliart@wanadoo.fr
authors.forename: L
authors.initials: L
authors.lastname: Letrilliart
authors.forename: B
authors.initials: B
authors.lastname: Ragon
authors.forename: T
authors.initials: T
authors.lastname: Hanslik
authors.forename: A
authors.initials: A
authors.lastname: Flahault
mesh_terms: D000328:Adult; D000367:Age Factors; D000382:Agricultural Workers' Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology / Q000517:prevention & control; D025065:Borrelia burgdorferi; D005194:Family Practice / Q000706:statistics & numerical data; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D008193:Lyme Disease / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D012423:Rural Health