Despite increasing awareness of the disease and increasing attention in the media there are no published data suggesting an increase in LB prevalence in Europe. However, recent unpublished studies in Sweden indicate that in some areas a real increase in cases may have occurred over the last few years, apparently related to greater abundance of ticks. Media reports have coloured European public perceptions of LB by suggesting that the infection is difficult to diagnose and treat and has a high morbidity, but this applies only to a tiny minority of cases.
Diagnosis is primarily clinical and takes into account the risk of tick bite.
Supporting evidence is provided by laboratory investigation, usually antibody tests . LB clinical presentations range from asymptomatic infection to significant illness, usually affecting the skin, nervous and musculoskeletal systems and rarely the heart. Very few deaths associated LB have been reported in the medical literature. The most feared complication of LB, chronic neuroborreliosis, is very rare in Europe. The different manifestations of LB do not show an even geographical distribution.