Article: Sorting out the manifestations of Lyme disease.(Recertification Refresher)

Lyme disease is the most common arthropodborne infection in the United States, (1) with approximately 16,000 cases reported each year. (2) Most have occurred in the northeastern states ranging from Maryland to Massachusetts and in Wisconsin, Minnesota, California, and Oregon.

The disease is caused by the spirochete Borrelia burgdorferi, which is transmitted by ticks. In the eastern and midwestern United States, the bacterium is transmitted to humans by Ixodes scapularis, a deer tick; in the western states, the responsible vector is Ixodes pacificus, a deer and cattle tick.

Transmission of the spirochete to the tick occurs during the tick's blood meals. ...

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