Known and unexpected determinants of Lyme disease incidence: Insights from the Czech Republic (2018 - 2024)

Lyme disease (LD) is the most frequently reported vector-borne disease in the Czech Republic (CR). The risk of infection is present throughout the entire country. This study analyzes trends in the number of cases and the incidence of LD in the CR between 2018 and 2024.

The study analyzes data from the Information System of Infectious Diseases, which records notifiable infections in accordance with national legislation, including cases of LD classified under code A69.2 according to the International Classification of Diseases, 10th Revision (ICD-10).

Between 2018 and 2024, a cumulative total of 26,183 LD cases were reported in the CR, with annual incidence ranging from 27.0 to 44.5 per 100,000 population. The female-to-male ratio was 54% versus 46%. The highest incidence was observed in the 45-74 age groups (45-54 years: 40.5/100,000; 55-64 years: 50.3/100,000; 65-74 years: 50.7/100,000). Among pediatric populations, the peak incidence occurred in the 5-9 age group (49.5/100,000). Significant regional differences were observed across the CR, with the highest incidence in the Vysocina Region (100.1/100,000) and the South Bohemian Region (71.1/100,000). The average hospitalization rate was 18.4%. A total of eight deaths attributable to LD were recorded during the study period (2018-2024).

Even during the COVID-19 pandemic, LD maintained interannual variability in its occurrence. In 2021, the lowest incidence in the past 25 years was recorded in the CR. The increase in incidence observed in 2024 indicates a return to pre-pandemic levels.