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Epidemiology of Lyme disease

C Benjamin Beard, PhD
Section Editor
Allen C Steere, MD
Deputy Editor
Jennifer Mitty, MD, MPH


Lyme disease is a spirochetal infection, which is transmitted by the bite of infected Ixodes ricinus complex ticks. It is caused primarily by Borrelia burgdorferi in the United States, and primarily Borrelia afzelii, Borrelia burgdorferi, and Borrelia garinii in Europe and Asia. In the northeastern United States, rodents such as the white-footed mouse are the primary reservoir of Borrelia species.

Lyme disease is the most common tick-borne infection in the United States and Europe. Because the ticks that transmit Lyme disease are frequently encountered in backyards and outdoor recreational areas, a high degree of public health awareness of Lyme disease must be maintained wherever the disease is known to occur.

The epidemiology of Lyme disease and the ecology of Ixodes species ticks will be reviewed here. The microbiology of Lyme disease, the evaluation of a tick bite for possible Lyme disease, and the clinical manifestations, diagnosis, treatment, and prevention of Lyme disease are discussed separately. (See "Microbiology of Lyme disease" and "Evaluation of a tick bite for possible Lyme disease" and "Clinical manifestations of Lyme disease in adults" and "Lyme disease: Clinical manifestations in children" and "Diagnosis of Lyme disease" and "Treatment of Lyme disease" and "Prevention of Lyme disease".)

The epidemiology of other tick-borne diseases is reviewed elsewhere. (See "Clinical manifestations and diagnosis of Rocky Mountain spotted fever" and "Human ehrlichiosis and anaplasmosis" and "Southern tick-associated rash illness (STARI)" and "Babesiosis: Microbiology, epidemiology, and pathogenesis" and "Tick paralysis" and "Microbiology, pathogenesis, and epidemiology of relapsing fever".)


Lyme disease was first recognized clinically in 1977 as "Lyme arthritis" during studies of a cluster of children in Connecticut who were thought to have juvenile rheumatoid arthritis [1]. The etiology of Lyme disease was discovered to be a spirochete in the early 1980s [2,3]. The incidence of Lyme disease and the geographic distribution of cases in the United States has increased steadily since then [4-6]. The incidence in some regions of Europe may be increasing as well [7].

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Literature review current through: Nov 2017. | This topic last updated: Aug 18, 2016.
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