Increasing spread of Lyme disease in Europe

The existence of Lyme disease in Greece remains controversial. In a recent study “Serological evidence of possible Borrelia afzelii lyme disease in Greece,” Karageorgou and colleagues examined patients throughout Greece suspected for Lyme disease by enzyme-linked immunosorbent assay (ELISA) and by western blotting for Borrelia burgdorferi sensu lato species.

“We found one patient positive for Borrelia burgdorferi and two patients positive for Borrelia afzelii specific antibodies. Both B. afzelii patients were suffering with neurological manifestations and had never traveled abroad,” the authors wrote.¹

Their findings indicate evidence of two autochthonous Lyme disease cases in Greece, possibly caused by B. afzelii.

“Suggestions that Lyme disease exists in Greece remain controversial and no study to date has definitively identified the presence of a Borrelia spp. that infects humans.”

In another study, Olafsdotti and Askling reviewed the possible reasons behind the growing number of cases in the U.S. and abroad.² “Reasons for poor progress in limiting the disease are manyfold” and include:

1. The surveillance system for Lyme disease remains highly variable, despite European Union surveillance to standardize definition.
2. “There are still substantial diagnostic gaps for the disease given its varied and unusual presentation.”
3. “Absence of reliable assays for acute infection.”
4. “Difficulty in differentiating past disease from current disease.”
5. “An inability to monitor treatment response.”

Furthermore, the poor prognosis in limiting the disease is expected to be worse with climate change, wrote the authors.

The authors stressed the need to overcome diagnostic challenges, develop better surveillance strategies and policies for Lyme disease, as well as identify a safe and effective vaccine against Borrelia burgdorferi.

Karageorgou et al. concludes, “We demonstrate the possibility of the presence of B. afzelii in Greece. Therefore, we need to raise awareness of Lyme disease among healthcare providers and ensure that B. afzelii, and possibly also other Lyme borrelia species must be taken into account. The true underlying rate of Lyme disease in Greece remains unknown.”