Lyme disease is the most common vector-borne infection in the United States. In 1997, there were 12,801 cases reported in the United States. It is transmitted by ticks from the genus Ixodes. The Ixodes tick goes through a 2-year life cycle that is composed of three stages: larva, nymph, and adult. Tick larvae acquire the spirochete via a blood meal from an infected host. Both the nymph and female adult infect humans.
A tick must be attached for at least 24 h to transmit the spirochete. Tick engorgement and attachment for 72 h are predictors of subsequent human infection. Ixodes ticks in the northeastern and midwestern United States belong to the Ixodes dammini (scapularis) species, in the western United States to Ixodes pacificus, in Europe to Ixodes ricinus, and in Asia to Ixodes persulcatus. Rodents and small mammals are the natural hosts of the larval and nymphal stages.
Lyme disease was first documented in the United States in 1975. The organism that causes Lyme disease is transmitted by the bite of a tick. Lyme disease is named for the town in Connecticut where some of the first cases in the U.S. occurred. Lyme disease cases have since been documented in about 43 states, with over 15,000 cases reported annually between 1998 and 2004. Over 153,000 cases have been reported in the U.S. between 1993 and 2002. During 2002, 23,763 Lyme disease cases were reported, making this the peak year. Several cases of Lyme disease have been reported in Florida