Epidemiology of Lyme disease in Pennsylvania 2006–2014 using electronic health records

Publication date: Available online 26 October 2018Source: Ticks and Tick-borne DiseasesAuthor(s): Katherine A. Moon, Jonathan Pollak, Annemarie G. Hirsch, John N. Aucott, Cara Nordberg, Christopher D. Heaney, Brian S. SchwartzAbstractLyme disease is the most common vector-borne disease in the United States. Electronic health record (EHR)-based research on Lyme disease is limited. We used Geisinger EHR data from 479,344 primary care patients in 38 Pennsylvania counties in 2006–2014 to compare EHR-based Lyme disease incidence rates to surveillance incidence rates, evaluate individual and community risk factors for incident Lyme disease, and to characterize the proportion of cases with diagnoses consistent with post-treatment Lyme disease syndrome in the EHR (PTLDSEHR). We primarily identified Lyme disease cases using diagnosis codes, serologic testing order codes, and medication orders but also completed subgroup analyses among those with positive serology and those with both diagnosis code and antibiotic treatment. We compared annual incidence rates from the EHR to surveillance by age, sex, and county. In case-control analyses, we compared cases to randomly selected controls frequency-matched on year, age, and sex. We identified 9,657 cases of Lyme disease, including 1,791 cases with positive serology and 4,992 cases with both diagnosis code and antibiotic treatment. Annual incidence rates in the EHR were 4.25 to 7.43 times higher than surveillance. In adjusted analyses, whi...
Source: Ticks and Tick borne Diseases - Category: Zoology Source Type: research