Principal Research Associate Moderna, Inc. Cambridge, United States
Background: Lyme disease, caused by the Borrelia burgdorferi sensu lato (B. burgdorferi) bacterial species complex, is a tick-borne disease with worldwide distribution but high variability in incidence by location. There is currently no human vaccine available for Lyme disease and little is known about the global seroprevalence in humans.
Objectives: To conduct a literature review to compile and describe country- and region-specific seroprevalence of B. burgdorferi antibodies in human populations, including population geographic, sociodemographic, and clinical characteristics.
Methods: We conducted a targeted literature review to identify published studies reporting the seroprevalence of B. burgdorferi in humans. PubMed and EMBASE (Ovid) were searched using a combination of keywords to represent Lyme disease and prevalence. Over 100 papers were identified. Records were limited to English language publications in the preceding 11 years (2012-2023). Publications that reported seroprevalence in human populations were included.
Results: A total of 65 seroprevalence studies were identified from North America, Europe, and Asia. The testing methodology and seropositive criteria varied by study. Seroprevalence estimates ranged widely from < 1% to 55% based on the population studied. In North America, seroprevalence was highest in the mid-Atlantic, Northeast, and Upper Midwest regions of the United States, while in Europe it was highest in Scandinavian/Baltic states and Central Europe. Forestry workers, farmers, and veterinarians were at higher risk of seropositivity and seroprevalence was generally higher in rural, forested areas.
Conclusions: The seroprevalence of B. burgdorferi antibodies varied widely by the country and population studied. The results of this targeted review help to determine at-risk populations for Lyme disease and Ixodes-conducive environments, which can inform disease burden estimates and clinical trial designs for upcoming vaccine candidates.