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Abstract

Lyme disease is a tickborne multisystem illness caused by the spirochete Borrelia burgdorferi.The clinical manifestations of illness are divided into three stages (Table 1). Stage I is predominantly characterized by erythema chronicum migrans (EM), a skin rash that classically begins as a single macule that expands to an annular lesion, frequently with subsequent secondary annular lesions. The occurrence of EM is often associated with minor constitutional symptoms. Stage II is characterized by neurologic involvement (particularly meningoencephalitis) or cardiovascular involvement (endocarditis, endomyocarditis, vasculitis, or fibrinous pericarditis), usually beginning several weeks after the appearance of EM. Stage III is characterized by recurrent migratory arthritis, primarily of the large joints, which occurs several weeks to 2 years after infection. Myositis, fasciitis, and peripheral neuropathies can also be associated with stage III Lyme disease. Patients may develop EM without further sequelae, or they may present with stage II or stage III disease without recalling prior EM or a tick bite. In some instances, Lyme disease can be severely debilitating without appropriate antimicrobial therapy; therefore, accurate diagnosis and treatment are critical to the clinical management and the public health control of this illness.

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References

  1. Afzelius, A., Erythema chronicum migrans, Acta Derm. Venereol. 2: 120–125 (1921).

    Google Scholar 

  2. Anderson, J., Mammalian and avian reservoirs for Borrelia burgdorferi, Ann. N.Y. Acad. Sci. 539: 180–191 (1988).

    Article  PubMed  CAS  Google Scholar 

  3. Anderson, J., Johnson, R., Magnarelli, L., and Hyde, F., Identification of endemic foci of Lyme disease: Isolation of Borrelia burgdorferifrom feral rodents and ticks (Dermacentor variabilis), J. Clin. Microbiol. 22: 36–38 (1985).

    PubMed  CAS  Google Scholar 

  4. Bannwarth, A., Chronische lymphocytare meningitis, entzundliche polyneuritis und “Rheumatismus” . Ein Beitrag zum problem “Allergie und Nervensystem,” Arch. Psychiatr. Nervenkr. 113: 284–376 (1941).

    Article  Google Scholar 

  5. Baranton, G., and Saint-Gibbons, I., Borrelia burgdorferisurvival in human blood samples, Ann. N.Y. Acad. Sci. 539: 444–445 (1988).

    Article  Google Scholar 

  6. Barbour, A., and Garon, C., The genes encoding major surface proteins of Borrelia burgdorferiare located on a plasmidAnn. N.Y. Acad. Sci. 539: 144–153 (1988).

    Article  PubMed  CAS  Google Scholar 

  7. Barbour, A., Heiland, R., and Howe, T., Heterogeneity of major proteins in Lyme disease borreliae: A molecular analysis of North American isolates, J. Infect. Dis. 152: 478–484 (1985).

    Article  PubMed  CAS  Google Scholar 

  8. Beck, G., Habicht, G., Benach, J., and Coleman, J., Chemical and biologic characterization of a lipopolysaccharide extracted from the Lyme disease spirochete (Borrelia burgdorferi), J. Infect. Dis. 152: 108–117 (1985).

    Article  PubMed  CAS  Google Scholar 

  9. Benach, J., and Coleman, J., Clinical and geographical characteristics of Lyme disease in New York, Zentralbl. Bakteriol. Mikrobiol. Hyg. A 263: 477–482 (1986).

    Google Scholar 

  10. Benach, J., Bosler, E., Hanrahan, J., Coleman, J., Habicht, G., Bast, T., Cameron, D., Ziegler, J., Barbour, A., Burgdorfer, W., Edelman, R., and Kaslow, R., Spirochetes isolated from the blood of two patients with Lyme disease, N. Engl. J. Med. 308: 740–742 (1983).

    Article  PubMed  CAS  Google Scholar 

  11. Bendig, J., and Ogilvie, D., Severe encephalopathy associated with Lyme disease, Lancet 1: 681–682 (1987).

    Article  PubMed  CAS  Google Scholar 

  12. Benoit, P., Dournon, E., Destee, A., and Warot, P., Spirochaetes and Lyme disease, Lancet 2: 1223 (1986).

    Article  PubMed  CAS  Google Scholar 

  13. Berger, B., Kaplan, M., Rothenberg, I., and Barbour, A., Isolation and characterization of the Lyme disease spirochete from the skin of patients with erythema chronicum migrans, J. Am. Acad. Dermatol. 13: 444–449 (1985).

    Article  PubMed  CAS  Google Scholar 

  14. Binder, E., Doepfmer, R., and Hornstein, O., Experimentelle Übertragung des Erythema chronicum migrans von Mensch zu Mensch, Hautarzt 6: 494–496 (1955).

    PubMed  CAS  Google Scholar 

  15. Bosler, E., and Schulze, T., The prevalence and significance of Borrelia burgdorferiin the urine of feral reservoir hosts, Zentralbl. Bakteriol. Mikrobiol. Hyg. A 263: 40–44 (1986).

    PubMed  CAS  Google Scholar 

  16. Bosler, E., Ormiston, B., Coleman, J., Hanrahan, J., and Benach, J., Prevalence of the Lyme disease spirochete in populations of white-tailed deer and white-footed mice,Yale J. Biol. Med. 57: 651–659 (1984).

    PubMed  CAS  Google Scholar 

  17. Bosler, E., Cohen, D., Schulze, T., Olsen, C., Bernard, W., and Lissman, B., Host responses to Borrelia burgdorferiin dogs and horses, Ann. N.Y. Acad. Sci. 539: 221–234 (1988).

    Article  PubMed  CAS  Google Scholar 

  18. Burgdorfer, W., Barbour, A., Hayes, S., Benach, J., Grunwaldt, E., and Davis, J., Lyme disease-A tickborne spirochetosis? Science 216: 1319–1320 (1982).

    Article  Google Scholar 

  19. Burgdorfer, W., Lane, R., Barbour, A., Gresbink, J., and Anderson, J., The Western black-legged tick, Ixodes pacificus: A vector of Borrelia burgdorferi, Am. J. Trop. Med. Hyg. 34: 925–930 (1985).

    PubMed  CAS  Google Scholar 

  20. Burgdorfer, W., Hayes, S., and Benach, J., Development of Borrelia burgdorferiin ixodid tick vectors, Ann. N. Y. Acad. Sci. 539: 172–179 (1988).

    Article  PubMed  CAS  Google Scholar 

  21. Burgess, E., Borrelia burgdorferiinfection in Wisconsin horses and cows, Ann. N.Y. Acad. Sci. 539: 235–243 (1988).

    Article  PubMed  CAS  Google Scholar 

  22. Burgess, E., Amundson, T., Davis, J., Kaslow, R., and Edelman, R., Experimental inoculation of Peromyscus spp. with Borrelia burgdorferi: Evidence of contact transmission, Am. J. Trop. Med. Hyg. 35: 355–359 (1986).

    PubMed  CAS  Google Scholar 

  23. Centers for Disease Control, Update: Lyme disease-United States, Morbid. Mortal. Weekly Rep. 33: 268–270 (1984).

    Google Scholar 

  24. Centers for Disease Control, Lyme Disease-Connecticut, Morbid. Mortal. Weekly Rep. 37: 1–3 (1988).

    Google Scholar 

  25. Chengxu, A., Yuxin, W., Yongquo, Z., Shaoshan, W., Quicheng, Q., Zhixue, S., Deyou, L., Donguan, C., Ziaodung, L., and Jienhua, Z., Clinical manifestations and epidemiological characteristics of Lyme disease in Hailin County, Heilongjiang Province, China, Ann. N.Y. Acad. Sci. 539: 302–313 (1988).

    Article  Google Scholar 

  26. Ciesielski, C., Markowitz, L., Horsley, R., Hightower, A., Russel, H., and Broome, C., The geographic distribution of Lyme disease in the United States, Ann. N.Y. Acad. Sci. 539: 283–288 (1988).

    Article  PubMed  CAS  Google Scholar 

  27. Cohen, D., Bosler, E., Bernard, W., Meirs, D., Eisner, R., and Schulze, T., Epidemiologic studies of Lyme disease in horses and their public health significance, Ann. N.Y. Acad. Sci. 539: 244–257 (1988).

    Article  PubMed  CAS  Google Scholar 

  28. Craft, J., Grodzicki, R., and Steere, A., Antibody response in Lyme disease: Evaluation of diagnostic tests, J. Infect. Dis. 149: 789–795 (1984).

    Article  PubMed  CAS  Google Scholar 

  29. Craft, J., Grodzicki, R., Shrestha, M., Fischer, D., Garcia-Blanco, M., and Steere, A., The antibody response in Lyme disease, Yale J. Biol. Med. 57: 561–565 (1984).

    PubMed  CAS  Google Scholar 

  30. Craft, J., Fischer, D., Shimamoto, G., and Steere, A., Antigens of Borrelia burgdorferirecognized during Lyme disease, J. Clin. Invest. 78: 934–939 (1986).

    Article  PubMed  CAS  Google Scholar 

  31. Dattwyler, R., Thomas, J., Benach, J., and Golightly, M., Cellular immune responses in Lyme disease, Zentralbl. Bakteriol. Mikrobiol. Hyg. A 263: 151 (1986).

    PubMed  CAS  Google Scholar 

  32. Dattwyler, R., Halperin, J., Pass, H., and Luft, B., Ceftriaxone as effective therapy in refractory Lyme disease, J. Infect. Dis. 155: 1322–1325 (1987).

    Article  PubMed  CAS  Google Scholar 

  33. Dattwyler, R., Volkman, D., Halperin, J., Luft, B., Thomas, J., and Golightly M., Seronegative Lyme disease: Specific immune responses in Lyme borreliosis. Characterization of T cell and B cell responses to Borrelia burgdorferi, Ann. N.Y. Acad. Sci. 539: 93–102 (1988).

    Article  PubMed  CAS  Google Scholar 

  34. Dattwyler, R., Volkman, D., Luft, B., Halperin, J., Thomas, J., and Golightly, M., Seronegative Lyme disease: Dissociation of specific T- and B-lymphocyte responses to Borrelia burgdorferi, N. Engl. J. Med. 319: 1441–1446 (1988).

    Article  PubMed  CAS  Google Scholar 

  35. Davis, J., Schell, W., Amundson, T., Godsey, M., Spielman, A., Burgdorfer, W., Barbour, A., Laventure, M., and Kaslow, R., Lyme disease in Wisconsin: Epidemiologic, clinical, serologic, and entomologic findings, Yale J. Biol. Med. 57: 685–696 (1984).

    PubMed  CAS  Google Scholar 

  36. Dekonenko, E., Steere, A., Berardi, V., and Kravchuk, L., Lyme borreliosis in the Soviet Union: A cooperative Us-Ussr report, J. Infect. Dis. 158: 748–753 (1988).

    Article  PubMed  CAS  Google Scholar 

  37. Dupont, H., Hornick, R., Dawkins, A., Heiner, G., Fabrikant, I., Wisseman, C., and Woodward, T., Rocky mountain spotted fever: A comparative study of the active immunity induced by inactivated and viable pathogenic Rickettsia rickettsii, J. Infect. Dis. 128: 340–344 (1973).

    Article  PubMed  CAS  Google Scholar 

  38. Duray, P., and Steere, A., Clinical pathologic correlations of Lyme disease by stage, Ann. N.Y. Acad. Sci. 539: 65–79 (1988).

    Article  PubMed  CAS  Google Scholar 

  39. Falco, R., and Fish, D., Prevalence of Ixodes dammininear the homes of Lyme disease patients in Westchester County, New York, Am. J. Epidemiol. 127: 826–830 (1988).

    PubMed  CAS  Google Scholar 

  40. Falco, R., and Fish, D., Ticks parasitizing humans in a Lyme disease endemic area of southern New York state, Am. J. Epidemiol. 128: 1146–1152 (1988).

    PubMed  CAS  Google Scholar 

  41. Fumarola, D., Munno, I., Marcuccio, C., and Miragliotta, G., Endotoxin-like activity associated with Lyme disease borrelia, Zentralbl. Bakteriol. Mikrobiol. Hyg. A 263: 137–141 (1986).

    Google Scholar 

  42. Garin Bujadoux, C., Paralysie par les tiques, J. Med. Lyon 71c: 765–767 (1922).

    Google Scholar 

  43. Goubau, P., and Biggignum, G., Lyme borreliosis: The new face of an old disease, Acta Clin. Belg. 42: 1–4 (1987).

    PubMed  CAS  Google Scholar 

  44. Greene, R., Walker, R., Nicholson, W., Heidner, H., Levin, J., Burgess, E., Wyand, M., Breitschwerdt, E., and Berkhoff, H., Immunoblot analysis of immunoglobulin G response to the Lyme disease agent (Borrelia burgdorferi)in experimentally and naturally exposed dogs, J. Clin. Microbiol. 26: 648–653 (1988).

    PubMed  CAS  Google Scholar 

  45. Grodzicki R., and Steere, A., Comparison of immunoblotting and indirect enzyme-linked immunosorbent assay using different antigen preparations for diagnosing early Lyme disease, J. Infect. Dis. 157: 790–797 (1988).

    Article  PubMed  CAS  Google Scholar 

  46. Habicht, G., Beck, G., Benach, J., Coleman, J., and Leichtling, K., Lyme disease spirochetes induce human and murine interleukin-1 production, J. Immunol. 134: 3147–3154 (1985).

    PubMed  CAS  Google Scholar 

  47. Habicht, G., Beck, G., Benach, J., and Coleman, J., Borrelia burgdorferilipopolysaccharide and its role in the pathogenesis of Lyme disease, Zentralbl. Bakteriol. Mikrobiol. Hyg. A 263: 137–141 (1986).

    PubMed  CAS  Google Scholar 

  48. Hanrahan, J., Benach, J., Coleman, J., Bosler, E., Morse, D., Cameron, D., Edelman, R., and Kaslow, R., Incidence and cumulative frequency of endemic Lyme disease in a community, J. Infect. Dis. 150: 489–496 (1984).

    Article  PubMed  CAS  Google Scholar 

  49. Hard, S., Erythema chronicum migrans (Afzelii) associated with mosquito bite, Acta Derm. Venereol. 46: 473–476 (1966).

    PubMed  CAS  Google Scholar 

  50. Hardin, J., Steere, A., and Malawista, S., Immune complexes and the evolution of Lyme arthritis: Dissemination and localization of abnormal Clq binding activity, N. Engl. J. Med. 301: 1358–1363 (1979).

    Article  PubMed  CAS  Google Scholar 

  51. Hardin, J., Steere, A., and Malawista, S., The pathogenesis of arthritis in Lyme disease: Humoral immune responses and the role of intraarticular immune complexes, Yale J. Biol. Med. 57: 589–593 (1984).

    PubMed  CAS  Google Scholar 

  52. Hechemy, K., Harris, H., Duerr, M., Benach, J., and Reimer, C., Immunoglobulin G subclasses specific to Borrelia burgdorferiin patients with Lyme disease, Ann. N.Y. Acad. Sci. 539: 162–169 (1988).

    Article  PubMed  CAS  Google Scholar 

  53. Hedberg, C., Osterholm, M., MacDonald, K., and White, K., An interlaboratory study of antibody to Borrelia burgdorferi, J. Infect. Dis. 154: 1325–1327 (1987).

    Article  Google Scholar 

  54. Hellerstrom, S., Erythema chronicum migrans Afzelii, Acta Derm. Venereol. 11: 315–321 (1930).

    Google Scholar 

  55. Hollströ, E., Successful treatment of erythema migrans Afzelius, Acta Derm. Venereol. 31: 235–243 (1951).

    Google Scholar 

  56. Johnson, R., Schmid, G., Hyde, F., Steigerwalt, G., and Brenner, D., Borrelia burgdorferisp. nov.: Etiologic agent of Lyme disease, Int. J. Syst. Bacteriol. 34: 496–497 (1984).

    Article  Google Scholar 

  57. Johnson, R., Kodner, C., and Russell, M., Active immunization of hamsters against experimental infection with Borrelia burgdorferi, Infect. Immun. 54: 897–898 (1986).

    CAS  Google Scholar 

  58. Johnson, R., Kodner, C., and Russell, M., In vitro and in vivo susceptibility of the Lyme disease spirochete, Borrelia burgdorferi,to four antimicrobial agents, Antimicrob. Agents Chemother. 31: 164–167 (1987).

    Article  PubMed  CAS  Google Scholar 

  59. Johnson, S., Klein, G., Schmid, G., and Feeley, J., Susceptibility of the Lyme disease spirochete to seven antimicrobial agents, Yale J. Biol. Med. 57: 99–103 (1984).

    Google Scholar 

  60. Johnson, S., Klein, G., Schmid, G., Bowen, G., Feeley, J., and Schulze, T., Lyme disease: A selective medium for isolation of the suspected etiologic agent, a spirochete, J. Clin. Microbiol. 19: 81–82 (1984).

    PubMed  CAS  Google Scholar 

  61. Kawabata, M., Baba, S., Iguchi, K., Yamaguti, N., and Russell, H., Lyme disease in Japan and its possible incriminated tick vector, Ixodes persulcatus, J. Infect. Dis. 156: 854 (1987).

    Article  PubMed  CAS  Google Scholar 

  62. Kirsch, M., Ruben, F., Steere, A., Duray, P., Norden, C., and Winkelstein, A., Fatal adult respiratory distress syndrome in a patient with Lyme disease, J. Am. Med. Assoc. 259: 2737–2739 (1988).

    Article  CAS  Google Scholar 

  63. Kramer, N., Rickert, R., Brodkin, R., and Rosenstein, E., Septal panniculitis as a manifestation of Lyme disease, Am. J. Med. 81: 149–157 (1986).

    Article  PubMed  CAS  Google Scholar 

  64. Levine, J., Wilson, M., and Spielman, A., Mice as reservoirs of the Lyme disease spirochete, Am. J. Trop. Med. Hyg. 34: 355–360 (1985).

    PubMed  CAS  Google Scholar 

  65. Lipschütz, B., Über eine seltene Erythemform (Erythema chronicum migrans), Arch. Dermatol. Syphilol. 118: 349–356 (1913).

    Google Scholar 

  66. Luft, B., Volkman, D., Halperin, J., and Dattwyler, R., New chemotherapeutic approaches in the treatment of Lyme borreliosis, Ann. N.Y. Acad. Sci. 539: 352–361 (1988).

    Article  PubMed  CAS  Google Scholar 

  67. Magnarelli, L., and Anderson, J., Ticks and biting insects infected with the etiologic agent of Lyme disease, Borrelia burgdorferi, J. Clin. Microbiol. 26: 1482–1486 (1988).

    PubMed  CAS  Google Scholar 

  68. Magnarelli, L., Anderson, J., Burgdorfer, W., and Chappell, W., Parasitism by Ixodes dammini(Acari: Ixodidae)and antibodies to spirochetes in mammals at Lyme disease foci in Connecticut, USA, J. Med. Entomol. 21: 52–57 (1984).

    PubMed  CAS  Google Scholar 

  69. Magnarelli, L., Anderson, J., Kaufman, A., Lieberman, L., and Whitney, G., Borreliosis in dogs from southern Connecticut, J. Am. Vet. Med. Assoc. 186: 955–959 (1985).

    PubMed  CAS  Google Scholar 

  70. Magnarelli, L., Anderson, J., and Barbour, A., The etiologic agent of Lyme disease in deer flies, horse flies, and mosquitoes, J. Infect. Dis. 154: 355–358 (1986).

    Article  PubMed  CAS  Google Scholar 

  71. Magnarelli, L., Anderson, J., and Johnson, R., Crossreactivity in serological tests for Lyme disease and other spirochetal infections, J. Infect. Dis. 156: 183–188 (1987).

    Article  PubMed  CAS  Google Scholar 

  72. Marcus, L., Patterson, M., Gilfillan, R., and Urband, P., Antibodies to Borrelia burgdorferiin New England horses: Serologic survey, Am. J. Vet. Res. 46: 2570–2571 (1985).

    PubMed  CAS  Google Scholar 

  73. Marcus, L., Steere, A., Duray, P., Anderson, A., and Mahoney, E., Fatal pancarditis in a patient with coexistent Lyme disease and babesiosis. Demonstration of spirochetes in the myocardium, Ann. Intern. Med. 103: 374–376 (1985).

    PubMed  CAS  Google Scholar 

  74. Markowitz, L., Steere, A., Benach, J., Slade, J., and Broome, C., Lyme disease during pregnancy, J. Am. Med. Assoc. 255: 3394–3396 (1986).

    Article  CAS  Google Scholar 

  75. Mather, T., Ribeiro, J., and Spielman, A., Lyme disease and babesiosis: Acaricide focussed on potentially infected ticks, Am. J. Trop. Med. Hyg. 36: 609–614 (1987).

    PubMed  CAS  Google Scholar 

  76. Mertz, L., Wobig, G., Duffy, J., and Katzmann, J., Ticks, spirochetes and new diagnostic tests for Lyme disease, Mayo Clin. Proc. 60: 402–406 (1985).

    Article  PubMed  CAS  Google Scholar 

  77. Neubert, U., Munchhoff, P., Volker, B., Reimers, C., and Pfluger, K., Borrelia burgdorferiinfections in Bavarian forest workers: A follow-up study, Ann. N.Y. Acad. Sci. 539: 476–479 (1988).

    Article  Google Scholar 

  78. Osterholm, M., Forfang, J., White, K., and Kuritsky, J., Lyme disease in Minnesota: Epidemiologic and serologic findings, Yale J. Biol. Med. 57: 677–683 (1984).

    PubMed  CAS  Google Scholar 

  79. Pachner, A., and Steere, A., The triad of neurologic manifestations of Lyme disease: Meningitis, cranial neuritis, and radiculoneuritis, Neurology 35: 47–53 (1985).

    Article  PubMed  CAS  Google Scholar 

  80. Pfister, H.-W., Neubert, U., Wilske, B., Preac-Mursic, V., Einhaupl, K., and Borasio, G., Reinfection with Borrelia burgdorferi, Lancet 2: 984–985 (1986).

    Article  CAS  Google Scholar 

  81. Piesman, J., and Sinsky, R., Ability of Ixodes scapularis, Dermacentor variabilis,and Amblyomma americanum(Acari: Ixodidae) to acquire, maintain, and transmit Lyme disease spirochetes (Borrelia burgdorferi), J. Med. Entomol. 25: 336–339 (1988).

    PubMed  CAS  Google Scholar 

  82. Reik, L., Steere, A., Bartenhagen, N., Shope, R., and Malawista, S., Neurologic abnormalities of Lyme disease, Medicine 58: 281–294 (1979).

    Article  PubMed  CAS  Google Scholar 

  83. Reik, L., Burgdorfer, W., and Donaldson, J., Neurologic abnormalities in Lyme disease without erythema chronicum migrans, Am. J. Med. 81: 73–78 (1986).

    Article  PubMed  Google Scholar 

  84. Reznick, J., Braunstein, D., Walsh, R., Smith, C., Wolfson, P., Gierke, L., Gorelkin, L., and Chandler, F., Lyme carditis: Electrophysiologic and histopathologic study, Am. J. Med. 81: 923–927 (1986).

    Article  PubMed  CAS  Google Scholar 

  85. Ribeiro, J., Mather, T., Piesman, J., and Spielman, A., Dissemination and salivary delivery of Lyme disease spirochetes in vector ticks (Acari: Ixodidae), J. Med. Entomol. 24: 201–205 (1987).

    PubMed  CAS  Google Scholar 

  86. Schechter, S., Lyme disease associated with optic neuropathy, Am. J. Med. 81: 143–145 (1986).

    Article  PubMed  CAS  Google Scholar 

  87. Schlesinger, P., Duray, P., Burke, B., Steere, A., and Stillman, M., Maternal-fetal transmission of the Lyme disease spirochete, Borrelia burgdorferi, Ann. Intern. Med. 103: 67–68 (1985).

    PubMed  CAS  Google Scholar 

  88. Schmid, G., The global distribution of Lyme disease, Rev. Infect. Dis. 7: 741–750 (1985).

    Article  Google Scholar 

  89. Schmid, G., Horsley, R., Steere, A., Hanrahan, J., Davis, J., Bowen, S., Osterholm, M., Weisfeld, J., Hightower, A., and Broome, C., Surveillance of Lyme disease in the United States, 1982, J. Infect. Dis. 151: 1144–1148 (1985).

    Article  PubMed  CAS  Google Scholar 

  90. Schulze, T., Bowen, G., Bosler, E., Lakat, M., Ormiston, B., and Shisler, J., Amblyomma americanum: A potential vector of Lyme disease in New Jersey, Science 224: 601–603 (1984).

    Article  PubMed  CAS  Google Scholar 

  91. Schulze, T., Bowen, G., Lakat, M., Parkin, W., and Shisler, J., The role of adult Ixodes dammini(Acari: Ixodidae) in the transmission of Lyme disease in New Jersey, USA, J. Med. Entomol. 22: 88–93 (1985).

    PubMed  CAS  Google Scholar 

  92. Schulze, T., McDevitt, W., Parkin, W., and Shilser, J., Effectiveness of two insecticides in controlling Ixodes dammini(Acari: Ixodidiae) following an outbreak of Lyme disease in New Jersey, J. Med. Entomol. 24: 420–424 (1987).

    PubMed  CAS  Google Scholar 

  93. Schwan, T., and Burgdorfer, W., Antigenic changes of Borrelia burgdorferi asa result of in vitro cultivation, J. Infect. Dis. 156: 852–853 (1987).

    Article  PubMed  CAS  Google Scholar 

  94. Scrimenti, R., Erythema chronicum migrans, Arch. Dermatol. 102: 104–105 (1970).

    Article  PubMed  CAS  Google Scholar 

  95. Shrestha, M., Grodzicki, R., and Steere, A., Diagnosing early Lyme disease, Am. J. Med. 78: 235–240 (1985).

    Article  PubMed  CAS  Google Scholar 

  96. Smith, L., Burgdorfer, W., and Katz, H., Erythema chronicum migrans, Cutis 17(S): 962–964 (1976).

    PubMed  CAS  Google Scholar 

  97. Smith, P., Benach, J., White, D., Stroup, D., and Morse, D., Occupational risk of Lyme disease in endemic areas of New York State, Ann. N.Y. Acad. Sci. 539: 289–301 (1988).

    Article  PubMed  CAS  Google Scholar 

  98. Snydman, D., Schenkein, D., Berardi, V., Lastavica, C., and Pariser, K., Borrelia burgdorferi injoint fluid in chronic Lyme arthritis, Ann. Intern. Med. 104: 798–800 (1986).

    PubMed  CAS  Google Scholar 

  99. Spielman, A., Prospects for suppressing transmission of Lyme disease, Ann. N.Y. Acad. Sci. 539: 212–220 (1988).

    Article  PubMed  CAS  Google Scholar 

  100. Stanek, G., Pletschette, M., Flamm, H., Hirschl, A., Aberer, E., Kristoferitsch, W., and Schmutzhard, E., European Lyme borreliosis, Ann. N.Y. Acad. Sci. 539: 274–282 (1988).

    Article  PubMed  CAS  Google Scholar 

  101. Steere, A., and Malawista, S., Cases of Lyme disease in the United States: Locations correlated with distribution of Ixodes dammini, Ann. Intern. Med. 91: 730–733 (1979).

    PubMed  CAS  Google Scholar 

  102. Steere, A., Hardin, J., and Malawista, S., Erythema chronicum migrans and Lyme arthritis: Cryoimmunoglobulins and clinical activity of skin and joints, Science 196: 1121–1122 (1977).

    Article  PubMed  CAS  Google Scholar 

  103. Steere, A., Malawista, S., Hardin, J., Ruddy, S., Askenase, P., and Andiman, W., Erythema chronicum migrans and Lyme arthritis: The enlarging clinical spectrum, Ann. Intern. Med. 86: 685–698 (1977).

    Article  PubMed  CAS  Google Scholar 

  104. Steere, A., Malawista, S., Snydman, D., Shope, R., Andiman, W., Ross, M., and Steele, F., Lyme arthritis: An epidemic of oligoarticular arthritis in children and adults in three Connecticut communities, Arthritis Rheum. 20: 7–17 (1977).

    Article  PubMed  CAS  Google Scholar 

  105. Steere, A., Broderick, T., and Malawista, S., Erythema chronicum migrans and Lyme arthritis: Epidemiologic evidence for a tick vector, Am. J. Epidemiol. 108: 312–321 (1978).

    PubMed  CAS  Google Scholar 

  106. Steere, A., Batsford, W., Weinberg, M., Alexander, J., Berger, H., Wolfson, S., and Malawista, S., Lyme carditis: Cardiac abnormalities of Lyme disease, Ann. Intern. Med. 93: 8–16 (1980).

    PubMed  CAS  Google Scholar 

  107. Steere, A., Malawista, S., Newman, J., Spieler, P., and Bartenhagen, N., Antibiotic therapy in Lyme disease, Ann. Intern. Med. 93: 1–8 (1980).

    PubMed  CAS  Google Scholar 

  108. Steere, A., Bartenhagen, N., Craft, J., Hutchinson, G., Newman, J., Rahn, D., Sigal, L., Spieler, P., Stenn, K., and Malawista, S., The early clinical manifestations of Lyme disease, Ann. Intern. Med. 99: 76–82 (1983).

    PubMed  CAS  Google Scholar 

  109. Steere, A., Grodzicki, R., Kornblatt, A., Craft, J., Barbour, A., Burgdorfer, W., Schmid, G., Johnson, E., and Malawista, S., The spirochetal etiology of Lyme disease, N. Engl. J. Med. 308: 733–740 (1983).

    Article  PubMed  CAS  Google Scholar 

  110. Steere, A., Hutchinson, G., Rahn, D., Sigal, L., Craft, J., Desanna, E., and Malawista, S., Treatment of the early manifestations of Lyme disease, Ann. Intern. Med. 99: 22–26 (1983).

    PubMed  CAS  Google Scholar 

  111. Steere, A., Pachner, A., and Malawista, S., Neurologic abnormalities of Lyme disease: Successful treatment with high-dose intravenous penicillin, Ann. Intern. Med. 99: 767–772 (1983).

    PubMed  CAS  Google Scholar 

  112. Steere, A., Grodzicki, R., Craft, J., Shrestha, M., Kornblatt, A., and Malawista, S., Recovery of Lyme disease spirochetes from patients, Yale J. Biol. Med. 57 : 557–560 (1984).

    PubMed  CAS  Google Scholar 

  113. Steere, A., Malawista, S., Bartenhagen, N., Spieler, P., Rahn, D., Hutchinson, G., Green, J., Snydman, D., and Taylor, E., The clinical spectrum and treatment of Lyme disease, Yale J. Biol. Med. 57: 453–461 (1984).

    Google Scholar 

  114. Steere, A., Duray, P., Kauffmann, D., and Wormser, G., Unilateral blindness caused by infection with the Lyme disease spirochete, Borrelia burgdorferi, Ann. Intern. Med. 103: 382–384 (1985).

    PubMed  CAS  Google Scholar 

  115. Steere, A., Green, J., Schoen, R., Taylor, E., Hutchinson, G., Rahn, D., and Malawista, S., Successful parenteral penicillin therapy of established Lyme arthritis, N. Engl. J. Med. 312: 869–874 (1985).

    Article  PubMed  CAS  Google Scholar 

  116. Steere, A., Taylor, E., Wilson, M., Levine, J., and Spielman, A., Longitudinal assessment of the clinical and epidemiological features of Lyme disease in a community, J. Infect. Dis. 154: 295–300 (1986).

    Article  PubMed  CAS  Google Scholar 

  117. Telford, S., Mather, T., Moore, S., Wilson, M., and Spielman, A., Incompetence of deer as reservoirs of the Lyme disease spirochete, Am. J. Trop. Med. Hyg. 39: 105–109 (1988).

    PubMed  Google Scholar 

  118. Weber, K., Schierz, G., Wilske, B., and Preac-Mursic, V., European erythema migrans disease and related disorders, Yale J. Biol. Med. 57: 463–471 (1984).

    PubMed  CAS  Google Scholar 

  119. Weder, B., Wiedersheim, P., Matter, L., Steck, A., and Otto, F., Chronic progressive neurological involvement in Borrelia burgdorferiinfection, J. Neurol. 234: 40–43 (1987).

    Article  PubMed  CAS  Google Scholar 

  120. Williams, C., Curran, A., Lee, A., and Sousa, V., Lyme disease: Epidemiologic characteristics of an outbreak in Westchester County, Ny, Am. J. Public Health 76: 62–65 (1986).

    Article  PubMed  CAS  Google Scholar 

  121. Wilske, B., Schierz, G., Preac-Mursic, V., Von Busch, K., Kuhbeck, R., Pfister, H., and Einhaupl, K., Intrathecal production of specific antibodies against Borrelia burgdorferiin patients with lymphocytic meningoradiculitis (Bannworth’s syndrome), J. Infect. Dis. 153: 304–314 (1986).

    Article  PubMed  CAS  Google Scholar 

  122. Wilske, B., Preac-Mursic, V., Schierz, G., Kuhbeck, R., Barbour, A., and Kramer, M., Antigenic variability of Borrelia burgdorferi, Ann. N. Y. Acad. Sci. 539: 126–143 (1988).

    Article  PubMed  CAS  Google Scholar 

  123. Wilson, M., and Spielman, A., Seasonal activity of immature Ixodes dammini(Acari: Ixodidae), J. Med. Entomol. 22: 408–414 (1985).

    PubMed  CAS  Google Scholar 

  124. Wilson, M., Levine, J., and Spielman, A., Effect of deer reduction on abundance of the deer tick (Ixodes dammini), Yale J. Biol. Med. 57: 5697–5705 (1984).

    Google Scholar 

  125. Wilson, M., Telford, S., Presman, J., and Spielman, A., Reduced abundance of immature Ixodes dammini(Acari: Ixodidae) following elimination of deer, J. Med. Entomol. 25: 224–228 (1988).

    PubMed  CAS  Google Scholar 

Suggested Reading

  • Lyme Disease and Related Disorders, Ann. N.Y. Acad. Sci. 539(1988).

    Google Scholar 

  • Proceedings of the First International Symposium on Lyme Disease, Yale J. Biol. Med. 54(4) (1984).

    Google Scholar 

  • Proceedings of the Second International Symposium on Lyme Disease and Related Disorders, Zentralbl. Bakteriol. Mikrobiol. Hyg. A.

    Google Scholar 

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Osterholm, M.T., MacDonald, K.L., Hedberg, C.W. (1991). Lyme Disease. In: Evans, A.S., Brachman, P.S. (eds) Bacterial Infections of Humans. Springer, Boston, MA. https://doi.org/10.1007/978-1-4757-1211-7_19

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