title: Epidemiology of Lyme Disease, Nova Scotia, Canada, 2002-2013.
abstract: Ixodes scapularis ticks, which transmit Borrelia burgdorferi, the causative agent of Lyme disease (LD), are endemic to at least 6 regions of Nova Scotia, Canada. To assess the epidemiology and prevalence of LD in Nova Scotia, we analyzed data from 329 persons with LD reported in Nova Scotia during 2002-2013. Most patients reported symptoms of early localized infection with rash (89.7%), influenza-like illness (69.6%), or both; clinician-diagnosed erythema migrans was documented for 53.2%. In a separate serosurvey, of 1,855 serum samples screened for antibodies to B. burgdorferi, 2 were borderline positive (both with an indeterminate IgG on Western blot), resulting in an estimated seroprevalence of 0.14% (95% CI 0.02%-0.51%). Although LD incidence in Nova Scotia has risen sharply since 2002 and is the highest in Canada (16/100,000 population in 2013), the estimated number of residents with evidence of infection is low, and risk is localized to currently identified LD-endemic regions.
authors.forename: Todd F
authors.initials: TF
authors.lastname: Hatchette
authors.forename: B Lynn
authors.initials: BL
authors.lastname: Johnston
authors.forename: Emily
authors.initials: E
authors.lastname: Schleihauf
authors.forename: Angela
authors.initials: A
authors.lastname: Mask
authors.forename: David
authors.initials: D
authors.lastname: Haldane
authors.forename: Michael
authors.initials: M
authors.lastname: Drebot
authors.forename: Maureen
authors.initials: M
authors.lastname: Baikie
authors.forename: Teri J
authors.initials: TJ
authors.lastname: Cole
authors.forename: Sarah
authors.initials: S
authors.lastname: Fleming
authors.forename: Richard
authors.initials: R
authors.lastname: Gould
authors.forename: Robbin
authors.initials: R
authors.lastname: Lindsay
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D025065:Borrelia burgdorferi / Q000302:isolation & purification*; D002648:Child; D002675:Child, Preschool; D004199:Disease Vectors; D005260:Female; D006801:Humans; D007223:Infant; D018884:Ixodes / Q000469:parasitology / Q000472:pathogenicity*; D008193:Lyme Disease / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009674:Nova Scotia / Q000453:epidemiology; D016036:Seroepidemiologic Studies; D013987:Ticks
keywords: Borrelia burgdorferi; Canada; Lyme disease; Nova Scotia; epidemiology; seroprevalence; ticks; vector-borne infections