The Epidemiology of Lyme Disease in the United States 1987-1988

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Abstract
Lyme disease is the leading vectorborne disease in the United States. The 4,572 cases reported in 1988 represent a ninefold increase since 1982, when national surveillance was established, and a doubling of cases over the previous year (2,368 cases were reported in 1987). Lyme disease has spread from its original geographic focus in the northeast to include 43 states, with marked regional differences in incidence rates. New York state alone reported 56% of all the cases in 1988. Six northeastern states (New York, New jersey, Connecticut, Pemisylvania, Rhode Island, and Massachusetts) accounted for 80% of the nation's cases in 1987 and 1988. These states in addition to Wisconsin, Minnesota, and California, collectively account for 95% of cases reported in 1987-1988. A preliminary analysis indicates that cases in the Pacific states, primarily California, occur over a broader range of months and represent a different age distribution than cases in other regions. Differences in tick vector species, their rates of infection, and ecology may be reflected in regional differences in risk and epidemiologic patterns of Lyme disease.

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