Cases of Lyme Disease in the United States: Locations Correlated with Distribution of Ixodes dammini

Abstract
Lyme disease, defined by erythema chronicum migrans and sometimes followed by neurologic, cardiac or joint involvement, affects 512 patients in the USA. The disease apparently occurs in 3 distinct foci, along the northeastern coast, in Wisconsin, and in California and Oregon; this distribution correlates closely with that of I. dammini in the 1st 2 areas and with I. pacificus in the last. The implicated tick, saved by 6 patients in the Northeast, was identified as nymphal I. dammini. Residence in or travel to endemic areas and history of tick bite may be important clues to diagnosis.

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