Volume 27, Number 8—August 2021
Perspective
Comparison of Lyme Disease in the United States and Europe
Table 1
Lyme disease in the United States and Europe
Variable | United States | Europe |
---|---|---|
Tick vector |
Ixodes scapularis, I. pacificus |
I. ricinus, I. persulcatus |
Lyme borrelia |
Mostly Borrelia burgdorferi sensu stricto; B. mayonii may occur in the upper midwestern United States |
Mostly B. afzelii and B. garinii, but several other species cause human disease, including B. burgdorferi s.s., B. bavariensis, B. spielmanii, and B. lusitaniae |
Speed of tick transmission of Lyme borrelia |
Rarely before 36 h |
I. ricinus ticks may transmit B. afzelii within 24 h |
Predominant patient sex |
Male patients account for 56% of reported cases during 2001–2018; no manifestation is predominant among female patients |
Most cases of erythema migrans and acrodermatitis chronica atrophicans occur in women; neuroborreliosis and arthritis are predominant in men |
Coinfections | Risk depends on the geographic area; the most common co-infections are anaplasmosis and babesiosis. | Risk depends on the geographic area; the most common co-infection is tick-borne encephalitis |