About the project
Tick borne diseases are increasing in Norway. Lyme borreliosis is the most common infection, while tick borne encephalitis (TBE) and granulocytic anaplasmosis are relatively rare. Public criticism of the Norwegian health care system has been raised due to perceived inadequate ability of diagnostics and treatment of these diseases. To optimize diagnostics and treatment, more knowledge of the national occurrence of the diseases is needed.
The most common form of borreliosis is the skin rash Erythema migrans, EM. This is mainly seen by general practitioners and is a clinical diagnosis without the need for serological testing. Also EM is not notifiable to the Norwegian Surveillance System for Communicable Diseases (MSIS), and the insidence is thus unknown. We will register the five year incidence of EM in the four most exposed counties, including a detailed geographical distribution.
There is disagreement about what antibiotic treatment that should be given. An RCT with the three most common antibiotics used, will support data for revision of national guidelines. Diagnosis of disseminated borreliosis, such as neuroborreliosis, requires a combination of patient history, clinical examination and microbiological testing. False positive and false negative results of serological tests are common. Better knowledge about seroprevalence in the background population is essential for evaluation of patients' test results. A serological survey of antibodies to Borrelia and TBE will be performed among the EM-patients included and the results will be compared to those for blood donors in Sogn og Fjordane County.
Some patients with borreliosis may develop a variety of severe symptoms - a post Lyme syndrome. This study will record subjective health complaints among EM-patients and compare them to blood donors. Associations between registered data from the cohorts and their subjective health complaints in time will be explored.
Study protocol (pdf)
Publications
Eliassen, Knut Eirik; Berild, Dag; Reiso, Harald; Grude, Nils; Christophersen, Karen Sofie; Finckenhagen, Cecilie; Lindbæk, Morten. Incidence and antibiotic treatment of erythema migrans in Norway 2005–2009. Ticks and Tick-borne Diseases 2017 ;Volum 8.(1) s. 1-8
Eliassen, Knut Eirik; Hjetland, Reidar; Reiso, Harald; Lindbæk, Morten; Tschudi-Madsen, Hedda. Symptom load and general function among patients with erythema migrans: a prospective study with a 1-year follow-up after antibiotic treatment in Norwegian general practice. Scandinavian Journal of Primary Health Care 2017 ;Volum 35.(1) s. 75-83