Increase in prevalence of Lyme disease.




Morbidity and Mortality Weekly Report

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Lyme disease is an infection transmitted solely by tick bites. Only two species of ticks, both belonging to the "Ixode" genus, are carriers: deer ticks (Ixodes scapularis), and blacklegged ticks (Ixode pacificus). Ixode ticks are found mainly on deer, although field mice, rabbits, sheep, and cattle may also pick them up. Lyme disease is a challenging illness, both to diagnose and to treat. It is a difficult disease for clinicians to spot. For one thing, Ixode ticks are extremely small, about the size of a pinhead, making them hard to see, especially on areas of the body with hair. What's more, tick bites are virtually painless, so people often have no idea they've been bitten.

The infection usually produces no symptoms at first. In about half the cases, a rash appears at the site of the bite. Called a "bull's eye," this rash is the only visible sign of Lyme disease. Blood tests may not be reliable, since it takes up to four weeks after exposure before antibodies can be found in the blood. After several weeks, a highly sensitive test called "ELISA" can be used to diagnose Lyme disease more accurately. This is followed up with a "Western blot" test for confirmation.

The United States government began recording the occurrence of Lyme disease (LD) in 1982, and it was designated a notable disease in 1991. According to the Morbidity and Mortality Weekly report published by the Center for Disease Control, an 8% increase of LD was seen between 1999 and 2000. A total of 17,730 cases were reported in 2000. Connecticut, Rhode Island, New Jersey, and New York had the highest prevalence of LD. Although the overall number had increased in 2000, 19 states reported a decrease in the occurrence. The highest rate of Lyme disease was seen in children ages 5 to 9 years, and in adults 50 to 59 years of age. Among the patients that reported the month of illness, 57.2% occurred in June and 27.3% occurred in July. Men also were infected more than women. The report stated that the frequency of infection can be reduced by decreasing tick populations, using repellants, and avoiding tick infested areas.1


1. Morbidity and Mortality Weekly Report. CDC. Lyme Disease --- United States, 2000. 2002;51(02);29-31.