1. Lyme Disease Paul Mead, MD, MPH Division of Vector-borne Diseases Centers for Disease Control and Prevention

3. Common human-biting ticks in the U.S. Transmit Lyme disease

4. Lyme disease transmission cycle Risk of human infection greatest in late spring and summer

5. Signs and symptoms of Lyme disease in humans

7. Other presentations of EM From: Nadelman RB, Wormser GP. Management of tick bites and early Lyme disease, Lyme disease . 1998; Philadelphia: American College of Physicians. 49-75

8. Later stages of Lyme disease Arthritis Facial palsy

9. Lyme disease cases reported to CDC, United States, 1992-2008 Increase in reports due to more complete surveillance, plus expansion in some areas

10. Reported Lyme disease cases, United States, 2008

11. Reported Lyme disease cases, Northeastern United States, 2008

12. Lyme disease incidence by age and sex, United States, 1992-2006

13. Reported Lyme disease cases by onset month, United States, 1992-2006

14. Clinical features of reported Lyme disease cases, United States, 1992-2006 N = 150,829

21. Symptoms after treatment for Lyme disease Long term follow up of 96 patients with culture-confirmed EM in 1991-4 Nowakowski et al. Am J Med 2003; 115:91-96

33. Thank You! The findings and conclusions in this report have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy