Longitudinal Assessment of the Clinical and Epidemiological Features of Lyme Disease in a Defined Population

• Published in: The Journal of infectious diseases Vol. 154; no. 2; pp. 295 - 300
• Main Authors: Steere, Allen C., Taylor, Elise, Wilson, Mark L., Levine, Jay F., Spielman, Andrew
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 01.08.1986; University of Chicago Press
• Subjects: Adolescent; Adult; Age Factors; Antibodies; Antibodies, Bacterial - analysis; Arthritis; Arthritis, Infectious - etiology; Asymptomatic infections; Bacterial diseases; Biological and medical sciences; Blood; Borrelia - immunology; Borrelia burgdorferi; Child; Child, Preschool; Diseases; Erythema - etiology; Female; Human bacterial diseases; Humans; Immunoglobulin G - analysis; Immunoglobulin M - analysis; Infant; Infections; Infectious diseases; Joint diseases; Longitudinal Studies; Lyme disease; Lyme Disease - complications; Lyme Disease - epidemiology; Lyme Disease - immunology; Male; Massachusetts; Medical sciences; Middle Aged; Miscellaneous; Myocarditis - etiology; Origical Articles; Peninsulas; Risk; Symptoms; Massachusetts; USA, Massachusetts; Infection; Bacteriosis; Lyme arthritis; Spirachaetosis
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1093/infdis/154.2.295

From 1979 to 1983, Lyme disease was studied longitudinally in the 162 long-term residents of Great Island, Massachusetts. In retrospect, the index case occurred in 1962, and the peak years of disease transmission (about three new cases per 100 residents per year) were the late 1970s. Thereafter, during the period of active surveillance, attack rates declined by half. Altogether, 26 (16%) of the 162 residents developed symptoms of the disease. Most of those affected had erythema chronicum rnigrans, and when untreated, they subsequently developed arthritis or, in one instance, myocarditis. A minority of individuals, mostly children, had arthritis alone. Of 121 asymptomatic residents who gave blood samples, 10 adults (8%) had high titers of IgG antibodies to the Lyme disease spirochete; these titers sometimes persisted for years. From 1981 to 1983, the estimated ratio of apparentto- inapparent infecton was 1:1. The high frequency of Lyme disease on Great Island underscores the need for surveillance and control programs.