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September 4, 1991, Vol 266, No. 9 >
ARTICLE | September 4, 1991

Lyme Disease: Title and subTitle BreakTracking an Epidemic FREE

David T. Dennis, MD, MPH
[+] Author Affiliations

Reprint requests to Centers for Disease Control, PO Box 2087, Fort Collins, CO 80522-2087 (Dr Dennis).


JAMA. 1991;266(9):1269-1270. doi:10.1001/jama.1991.03470090103042
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References

Lyme disease, a complex and enigmatic spirochetal illness involving the skin, nervous system, heart, and joints, continues to challenge clinicians, scientists, and public health practitioners. In this issue of JAMA, White et al1 use both passive and active surveillance to describe the geographic and temporal spread of Lyme disease in New York State. The results of their investigation are cause for concern. In New York, which has logged more cases of Lyme disease than any other state, the number of reported cases has increased fourfold in the 4-year period from 1986 through 1989 as compared with 1982 through 1985, the number of designated Lyme disease—endemic counties has doubled (from four to eight) in the same period, and evidence is presented that the tick vector, Ixodes dammini, has expanded its geographic range. National surveillance data reveal similar trends. Eleven states reported 497 cases of Lyme disease to the Centers for

REFERENCES

1 +
White DJ, Chang H-G, Benach JL, et al.  The geographic spread and temporal increase of the Lyme disease epidemic. JAMA . 1991;;266:1230-1236.
2 +
Centers for Disease Control.  Lyme disease surveillance—United States, 1989-1990. MMWR . 1991;;40:417-421.
3 +
Berger BW, Kaplan MH, Rothenberg IR, Barbour AG.  Isolation and characterization of the Lyme disease spirochete from the skin of patients with erythema chronicum migrans. J Am Acad Dermatol . 1985;;13:444-449.
4 +
Ramselaar T, Kuiper H, de Jongh B, Spanjaard L. Erythema migrans: diagnostic findings in 37 prospectively followed patients in the Netherlands. In: Program and abstracts of the IV International Conference on Lyme Borreliosis; June 18-21,1990; Stockholm, Sweden. Abstract W/TH-P-50.
5 +
Pachner AR.  Borrelia burgdorferi in the nervous system: the new 'great imitator.' Ann N Y Acad Sci . 1988;;539:56-64.
6 +
Schwartz BS, Goldstein MD, Ribiero JMC, Schulze TL, Shahied SI.  Antibody testing in Lyme disease: a comparison of results in four laboratories. JAMA . 1989;;262:3431-3434.
7 +
Luger S, Krause E.  Serological tests for Lyme disease: interlaboratory variability. Arch Intern Med . 1990;;150:761-763.
8 +
Centers for Disease Control.  Wharton M, Chorba TL, Vogt RL, Morse DL, Buehler JW. Case definitions for public health surveillance. MMWR . 1990;;39:19-21. No. (RR-13) .
9 +
Lastavica CC, Wilson ML, Berardi VP, Spielman A, Deblinger RD.  Rapid emergence of a focal epidemic of Lyme disease in coastal Massachusetts. N Engl J Med . 1989;;320:133-137.
10 +
Cartter JL, Mshar P, Hadler JL.  The epidemiology of Lyme disease in Connecticut. Conn Med . 1989;;53:320-323.
11 +
Schulze TL, Shisler JK, Bosler EM, Lakat MF, Parkin WE.  Evolution of a focus of Lyme disease.  In: Stanek G, Flamm H, Barbour AG, Burgdorfer W, eds. Lyme Borreliosis: Proceedings of the Second International Symposium on Lyme Disease and Related Disorders, Vienna 1985 . New York, NY: Springer-Verlag Inc; 1987;:65-71.
12 +
Anderson FJ, Duray PH, Magnarelli LA.  Borrelia burgdorferi and Ixodes dammini prevalent in the greater Philadelphia area. J Infect Dis . 1990;;161:811-812.
13 +
Bouseman JK, Kitron UD, Kilpatrick CE, Siegel JP, Todd KS.  The status of Ixodes dammini and Lyme disease in Illinois. J Med Entomol . 1990;;27:556-560.
14 +
Maupin GO, Fish D, Zultowsky J, Campos EG, Piesman J.  Landscape ecology of Lyme disease in a residential area of Westchester County, New York. Am J Epidemiol . 1991;;133:1105-1113.
15 +
Piesman J, Mather TN, Sinsky RJ, Spielman A.  Duration of tick attachment and Borrelia burgdorferi transmission. J Clin Microbiol . 1987;;25:557-558.
16 +
Costello CM, Steere AC, Pinkerton RF, Feder HM Jr.  A prospective study of tick bites in an endemic area for Lyme disease. J Infect Dis . 1989;;159:136-139.

Figures

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Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

1 +
White DJ, Chang H-G, Benach JL, et al.  The geographic spread and temporal increase of the Lyme disease epidemic. JAMA . 1991;;266:1230-1236.
2 +
Centers for Disease Control.  Lyme disease surveillance—United States, 1989-1990. MMWR . 1991;;40:417-421.
3 +
Berger BW, Kaplan MH, Rothenberg IR, Barbour AG.  Isolation and characterization of the Lyme disease spirochete from the skin of patients with erythema chronicum migrans. J Am Acad Dermatol . 1985;;13:444-449.
4 +
Ramselaar T, Kuiper H, de Jongh B, Spanjaard L. Erythema migrans: diagnostic findings in 37 prospectively followed patients in the Netherlands. In: Program and abstracts of the IV International Conference on Lyme Borreliosis; June 18-21,1990; Stockholm, Sweden. Abstract W/TH-P-50.
5 +
Pachner AR.  Borrelia burgdorferi in the nervous system: the new 'great imitator.' Ann N Y Acad Sci . 1988;;539:56-64.
6 +
Schwartz BS, Goldstein MD, Ribiero JMC, Schulze TL, Shahied SI.  Antibody testing in Lyme disease: a comparison of results in four laboratories. JAMA . 1989;;262:3431-3434.
7 +
Luger S, Krause E.  Serological tests for Lyme disease: interlaboratory variability. Arch Intern Med . 1990;;150:761-763.
8 +
Centers for Disease Control.  Wharton M, Chorba TL, Vogt RL, Morse DL, Buehler JW. Case definitions for public health surveillance. MMWR . 1990;;39:19-21. No. (RR-13) .
9 +
Lastavica CC, Wilson ML, Berardi VP, Spielman A, Deblinger RD.  Rapid emergence of a focal epidemic of Lyme disease in coastal Massachusetts. N Engl J Med . 1989;;320:133-137.
10 +
Cartter JL, Mshar P, Hadler JL.  The epidemiology of Lyme disease in Connecticut. Conn Med . 1989;;53:320-323.
11 +
Schulze TL, Shisler JK, Bosler EM, Lakat MF, Parkin WE.  Evolution of a focus of Lyme disease.  In: Stanek G, Flamm H, Barbour AG, Burgdorfer W, eds. Lyme Borreliosis: Proceedings of the Second International Symposium on Lyme Disease and Related Disorders, Vienna 1985 . New York, NY: Springer-Verlag Inc; 1987;:65-71.
12 +
Anderson FJ, Duray PH, Magnarelli LA.  Borrelia burgdorferi and Ixodes dammini prevalent in the greater Philadelphia area. J Infect Dis . 1990;;161:811-812.
13 +
Bouseman JK, Kitron UD, Kilpatrick CE, Siegel JP, Todd KS.  The status of Ixodes dammini and Lyme disease in Illinois. J Med Entomol . 1990;;27:556-560.
14 +
Maupin GO, Fish D, Zultowsky J, Campos EG, Piesman J.  Landscape ecology of Lyme disease in a residential area of Westchester County, New York. Am J Epidemiol . 1991;;133:1105-1113.
15 +
Piesman J, Mather TN, Sinsky RJ, Spielman A.  Duration of tick attachment and Borrelia burgdorferi transmission. J Clin Microbiol . 1987;;25:557-558.
16 +
Costello CM, Steere AC, Pinkerton RF, Feder HM Jr.  A prospective study of tick bites in an endemic area for Lyme disease. J Infect Dis . 1989;;159:136-139.

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