Lyme disease is present throughout France, but its distribution is uneven.
In 2019, approximately 30% of the French population reported having been bitten by a tick at some point in their lives, and about 21% reported having never heard of Lyme disease.
In this context, Santé publique France’s mission focuses on two main areas: surveillance and prevention.

Epidemiological Surveillance of Lyme Disease

Santé publique France coordinates the surveillance of Lyme borreliosis across the country. In this context, the agency relies on several partners, notably the Sentinelles Network (Inserm/Sorbonne University), the National Reference Center for Borrelia, and data from the Health Information System (PMSI - SNDS).

Annual surveillance is based on:

• Data from the Sentinelles Network, which has been monitoring Lyme borreliosis since 2009. For this surveillance, a case of Lyme borreliosis is defined by the presence of erythema migrans (clinical diagnosis) or a neurological, joint, or skin manifestation suggestive of Lyme borreliosis in a patient with a positive serology. The criteria were defined in accordance with the case definition of Eucalb (European Union Concerted Action on Lyme Borreliosis; Stanek et al; Clin Microbiol Infect 2011;17:69-79).

• Analysis of hospital data from the Medical Information Systems Program (PMSI), which records all hospital stays and the diagnoses associated with those stays. A case definition was established by a multidisciplinary group, and an algorithm that accounts for the diversity of the disease’s clinical manifestations is used to calculate the number of people hospitalized for Lyme borreliosis.

The combination of these two systems, which are stable over time, allows for a description of the epidemiology of the different forms of the disease and for tracking trends.

This ongoing surveillance is supplemented by ad hoc studies on the incidence and seroprevalence of Lyme borreliosis.
Between 2000 and 2015, regional incidence studies of Lyme borreliosis were conducted by five Interregional Epidemiology Units (CIRE) of Santé publique France. Seven seroprevalence studies were also conducted between 1989 and 2020, five of which were carried out by the Mutualité sociale agricole (MSA).

Finally, the CNR for Borrelia, established in 2002, complements the surveillance of Lyme borreliosis in France. Since 2012, this has been the Bacteriology Laboratory of the Strasbourg University Hospitals/Faculty of Medicine of Strasbourg.
The CNR contributes to epidemiological surveillance of humans, the vector (Ixodes ricinus), and the reservoir (wildlife). Its missions also include contributing to the development and evaluation of diagnostic methods for borrelioses, as well as methods for identifying and analyzing Borrelia diversity.

Prevention measures against Lyme disease

Santé publique France’s prevention efforts have been based on the “National Plan to Combat Lyme Disease and Tick-Borne Diseases” and continue to this day.

Although Lyme borreliosis is the most common tick-borne infectious disease in France, a significant proportion of the population (21%) had never heard of it, and only 41% of the population reported feeling well-informed about Lyme disease in 2019.

Starting in 2016, Santé publique France launched educational prevention initiatives targeting two audiences—the general public and healthcare professionals—aimed at raising awareness about the disease (transmission routes, symptoms, treatment) and existing prevention methods, which involve individual measures.

Santé publique France:

• Provides healthcare professionals and the general public with informational brochures (including one for children)

• Offers a public awareness poster to be displayed at the entrances to forests or woodlands

• Has produced an audio press kit on Lyme disease. Consisting of 10 informational segments, each 1 minute and 30 seconds long, this kit helps people better understand the disease as well as the preventive measures they can take to protect themselves. This audio kit can also be shared via a website or in a reception area.

These various resources can be found in the “Tools” tab.