Background

Lyme disease (LD) is an infectious disease that is emerging in eastern and central Canada associated with the spread of the tick vector Ixodes scapularis. National surveillance shows that children are an at-risk age group.

Objectives

To study the epidemiology of LD in Canadian children using the Canadian Paediatric Surveillance Program (CPSP) to better understand exposure history, clinical manifestations, diagnosis and treatment of paediatric LD cases in Canada.

Methods

A structured questionnaire was completed by paediatricians for each LD case reported as part of the Canadian Paediatric Surveillance Program from 2014 to 2017.

Results

There were 95 cases that met inclusion criteria as confirmed or probable cases. The median age was 7 years; 38 % were 5–9 years and 35 % were 10−15 years of age. Most cases were acquired in known Canadian endemic locations; 5 were acquired during travel to the US. Most cases were reported from Nova Scotia and Ontario (46 % and 38 % respectively). The most common clinical presentation was arthritis (59 % of all cases), which is a manifestation of the late disseminated stage of LD. Late disseminated disease presented through the year, whereas early LD (Erythema migrans) and early disseminated LD presented during the summer and fall. Antibiotic choice and duration of therapy generally followed accepted guidelines.

Conclusion

This study of the clinical spectrum of LD in Canadian children underlines the need for preventive measures to protect children in Canada from emerging LD, and the need for health care provider awareness.

中文翻译：

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儿童莱姆病：来自加拿大儿科监测计划的数据。

背景

莱姆病（LD）是一种传染病，在加拿大东部和中部逐渐出现，与壁虱媒介x肩I（Ixodes scapularis）的传播有关。国家监测显示，儿童属于高危年龄段。

目标

使用加拿大儿科监护计划（CPSP）研究加拿大儿童LD的流行病学，以更好地了解加拿大儿童LD病例的接触史，临床表现，诊断和治疗。

方法

儿科医生针对2014年至2017年加拿大儿科监护计划中报告的每例LD病例完成了一份结构化问卷。

结果

有95个满足纳入标准的确诊或可能病例。中位年龄为7岁；5-9岁为38％，10-15岁为35％。大多数病例是在加拿大已知的地方流行的。5件是在赴美旅行期间获得的。大多数病例来自新斯科舍省和安大略省（分别为46％和38％）。最常见的临床表现是关节炎（占所有病例的59％），这是LD传播后期的表现。一年中出现晚期传播性疾病，而夏季和秋季则出现早期LD（红斑红斑病）和早期传播性LD。抗生素的选择和治疗时间通常遵循公认的准则。

结论

这项对加拿大儿童LD的临床研究表明，需要采取预防措施来保护加拿大儿童免受新兴LD的侵害，以及对医疗服务提供者的意识的需求。