Table 3 Key indicators used at the national level in countries that monitor Lyme disease (N = 29)

EU COUNTRIES THAT HAVE A POLICY OR SYSTEM (n = 22)

 Belgium [11]

X

X

X

X

 Bulgaria [45]

X

X

X

 Croatia [46]

X

X

X

 Czech Republic [14]

X

X

X

 Denmark [15]

X

 Estonia

Unclear / No national definition found (legislation only specifies ICD-10 code A69.2)[16]

 Finland [17]

X

 France [18]

X

X

X

X

 Germany [20]

X

X

X

In at least 9/16 states

 Hungary [22]

X

X

 Ireland [23]

X

Italy

Unclear / No national definition found

 Latvia [25]

X

Refers to the list of EU case definitions, so LNB

 Lithuania

Unclear / No national definition found (legislation only specifies ICD-10 code A69.2)[26]

 Luxembourg [47]

Unclear if lab tests required

X

 Netherlands [5]

X

X

X

 Poland [48]

X

X

X

 Portugal [30]

X

 Romania [31]

X

X

X

 Slovakia [32, 49]

X

X

X

Cases clearly reported using ICD-10 codes A69.2, G63.0 and M01.2 [49]

 Slovenia [50]

X

X

X

 Spain [34]

X

Some autonomous communities also have a case definition

Subtotal EU

4

6

1

15

9

3

2

0

3

2

OTHER EUROPEAN COUNTRIES (n = 5)

 Iceland [51]

No clinical nor lab information required

 Liechtenstein

X

 Norway [36]

Multiple EMs only

X

X

 Switzerland [37]

X

X

X

 UK [38]

X

Subtotal Europe

4

7

1

16

10

4

3

1

5

2

 Canada [52]

X

X

X

Some provinces record EM without lab

 USA [53]

Confirmed with exposure in high incidence state or with lab and exposure in low incidence state

X

X

TOTAL

4

8

2

18

12

4

3

1

5

2