Tick Bites and Lyme Disease in an Endemic Setting

Abstract
SINCE ITS DESIGNATION as a nationally reportable disease in January 1991, Lyme disease (LD) has been by far the most commonly reported vector-borne infectious disease in the United States.1 It is understandably a cause for much concern among physicians and patients in endemic areas. In the absence of erythema migrans, the diagnosis of LD is based on clinical criteria assisted by serologic testing in patients with characteristic clinical manifestations.