At a series of meetings, involving 27 clinicians from 11 countries, case definitions for the diagnosis of
Lyme borreliosis in Europe were agreed and are presented here, with appropriate serological criteria, as a diagnostic guide. In a separate study questionnaires directed to clinicians were used to collect information on clinical aspects and risk factors of
Lyme borreliosis. Data on the number of
Lyme borreliosis patients seen by physicians indicated a low prevalence of the
disease in western Europe and a relatively high prevalence in eastern Europe. The most commonly encountered symptom was erythema migrans, followed by neurological manifestations. Cardiac problems were rare. Tick bite was strongly associated with
Lyme borreliosis, but the only other significantly associated risk factor was the pastime of gardening.