Lyme disease epidemiology and demographics: Difference between revisions
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{{Lyme disease}} | {{Lyme disease}} | ||
{{CMG}} {{AE}} {{IMD}} | {{CMG}} {{AE}} {{Anmol}}{{IMD}} | ||
==Overview== | ==Overview== | ||
Lyme disease is the most | [[Lyme disease]] is the most commonly reported vector-borne illness in the United States. In 2015, it was the sixth most common Nationally Notifiable disease. The number of people diagnosed with [[Lyme disease]] each year in the United States is around 30,000. This disease is concentrated heavily in the northeast and upper mid-west. | ||
==Epidemiology and Demographics== | ==Epidemiology and Demographics== | ||
===Incidence=== | ===Incidence=== | ||
*Lyme disease is the most common [[tick-borne disease]] in North America and Europe, and one of the fastest-growing [[infectious diseases]] in the United States. | *Lyme disease is the most common [[tick-borne disease]] in North America and Europe, and one of the fastest-growing [[infectious diseases]] in the United States. | ||
* | * The number of people diagnosed with [[Lyme disease]] each year in the United States is around 30,000.<ref name="urlLyme disease data tables | Lyme Disease | CDC">{{cite web |url=https://www.cdc.gov/lyme/stats/tables.html |title=Lyme disease data tables | Lyme Disease | CDC |format= |work= |accessdate=}}</ref> | ||
*In the | * In the United states, the [[incidence]] of [[Lyme disease]] is 8.9 per 100,000 persons; as per data collected by [[Center for Disease Control]] ([[CDC]]). <ref name="urlLyme disease data tables | Lyme Disease | CDC" /> | ||
*Although Lyme disease has now been reported in | *In the fourteen states where [[Lyme disease]] is most common , the average was 40.4 cases for every 100,000 persons for the year 2015.<ref name="urlLyme disease data tables | Lyme Disease | CDC" /><ref name="urlData and Statistics | Lyme Disease | CDC">{{cite web |url=https://www.cdc.gov/lyme/stats/index.html |title=Data and Statistics | Lyme Disease | CDC |format= |work= |accessdate=}}</ref> | ||
*Although [[Lyme disease]] has now been reported in majority of states in the U.S, about 95% of all reported cases are confined to just five geographic areas including New England, Mid-Atlantic, East-North Central, South Atlantic, and West North-Central.<ref name="urlData and Statistics | Lyme Disease | CDC" /> | |||
[[Image:Reported cases of lyme disease in usa from 2001-2015.gif|center|750px|frame|Reported cases of Lyme disease in the United Stated from 2001 to 2015]] | [[Image:Reported cases of lyme disease in usa from 2001-2015.gif|center|750px|frame|Reported cases of Lyme disease in the United Stated from 2001 to 2015]] | ||
=== Seasonal Variation === | |||
*[[Prevalence]] of [[infection]] in adult [[ticks]] are more then nymph stage by [[pathogens]] [[infectious]] to humans.<ref name="SchwartzFish1997">{{cite journal|last1=Schwartz|first1=Ira|last2=Fish|first2=Durland|last3=Daniels|first3=Thomas J.|title=Prevalence of the Rickettsial Agent of Human Granulocytic Ehrlichiosis in Ticks from a Hyperendemic Focus of Lyme Disease|journal=New England Journal of Medicine|volume=337|issue=1|year=1997|pages=49–50|issn=0028-4793|doi=10.1056/NEJM199707033370111}}</ref> But the majority of [[infections]] are caused by [[ticks]] in the nymph stage during late spring and summer.<ref name="pmid10206627">{{cite journal| author=Falco RC, McKenna DF, Daniels TJ, Nadelman RB, Nowakowski J, Fish D et al.| title=Temporal relation between Ixodes scapularis abundance and risk for Lyme disease associated with erythema migrans. | journal=Am J Epidemiol | year= 1999 | volume= 149 | issue= 8 | pages= 771-6 | pmid=10206627 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=10206627 }}</ref> | |||
*This is the reason for an increase in [[incidence]] of [[Lyme disease]] during the months of May to August. | |||
[[image:Seasonal variation of lyme disease.jpg|center|500px|thumb|Confirmed [[Lyme disease]] cases by month of disease onset–United States, 2001-2015]] | |||
===Widespread disease and endemic regions=== | ===Widespread disease and endemic regions=== | ||
*The number of reported cases of [[Disease|the disease]] have been increasing, as are endemic regions in North America. | *The number of reported cases of [[Disease|the disease]] have been increasing, as are [[Endemic (epidemiology)|endemic]] regions in North America. | ||
*''B. burgdorferi'' sensu lato has been maintained in enzootic cycles in California as well as other regions throughout North America, Europe and North Africa. Indeed, the [[DNA]] of ''[[Borrelia]]'' has been detected in lizards, indicating that they can be infected.<ref>{{cite journal |author=Swanson KI, Norris DE |title=Detection of Borrelia burgdorferi DNA in lizards from Southern Maryland |journal=Vector Borne Zoonotic Dis. |volume=7 |issue=1 |pages=42-9 |year=2007 |pmid=17417956 |doi=10.1089/vbz.2006.0548}}</ref> | *''[[Borrelia burgdorferi|B. burgdorferi]]'' sensu lato has been maintained in enzootic cycles in California as well as other regions throughout North America, Europe and North Africa. Indeed, the [[DNA]] of ''[[Borrelia]]'' has been detected in lizards, indicating that they can be [[Infection (disambiguation)|infected]].<ref>{{cite journal |author=Swanson KI, Norris DE |title=Detection of Borrelia burgdorferi DNA in lizards from Southern Maryland |journal=Vector Borne Zoonotic Dis. |volume=7 |issue=1 |pages=42-9 |year=2007 |pmid=17417956 |doi=10.1089/vbz.2006.0548}}</ref> | ||
*In Europe, cases of ''B. burgdorferi'' sensu lato [[infected]] [[Tick|ticks]] are found predominantly in Norway, Netherlands, Germany, France, Italy, Slovenia and Poland, but have been isolated in almost every country on the continent. Lyme disease statistics for Europe can be found at [http://www.eurosurveillance.org/ew/2006/060622.asp Eurosurveillance website]. | *In Europe, cases of ''[[Borrelia burgdorferi|B. burgdorferi]]'' sensu lato [[infected]] [[Tick|ticks]] are found predominantly in Norway, Netherlands, Germany, France, Italy, Slovenia and Poland, but have been isolated in almost every country on the continent. [[Lyme disease]] statistics for Europe can be found at [http://www.eurosurveillance.org/ew/2006/060622.asp Eurosurveillance website]. | ||
*''B. burgdorferi'' sensu lato infested ticks are being found more frequently in Japan, as well as in northwest China and far eastern Russia.<ref>{{cite journal |author=Li M, Masuzawa T, Takada N, ''et al'' |title=Lyme disease Borrelia species in northeastern China resemble those isolated from far eastern Russia and Japan |journal=Appl. Environ. Microbiol. |volume=64 |issue=7 |pages=2705-9 |year=1998 |pmid=9647853 |url=http://aem.asm.org/cgi/content/full/64/7/2705?view=long&pmid=9647853}}</ref><ref>{{cite journal |author=Masuzawa T |title=Terrestrial distribution of the Lyme borreliosis agent Borrelia burgdorferi sensu lato in East Asia |journal=Jpn. J. Infect. Dis. |volume=57 |issue=6 |pages=229-35 |year=2004 |pmid=15623946 |url = http://www.nih.go.jp/JJID/57/229.html}}</ref> ''[[Borrelia]]'' has been isolated in Mongolia as well.<ref>{{cite journal |author=Walder G, Lkhamsuren E, Shagdar A, ''et al'' |title=Serological evidence for tick-borne encephalitis, borreliosis, and human granulocytic anaplasmosis in Mongolia |journal=Int. J. Med. Microbiol. |volume=296 Suppl 40 |issue= |pages=69-75 |year=2006 |pmid=16524782 |doi=10.1016/j.ijmm.2006.01.031}}</ref> | *''[[Borrelia burgdorferi|B. burgdorferi]]'' sensu lato infested [[Tick|ticks]] are being found more frequently in Japan, as well as in northwest China and far eastern Russia.<ref>{{cite journal |author=Li M, Masuzawa T, Takada N, ''et al'' |title=Lyme disease Borrelia species in northeastern China resemble those isolated from far eastern Russia and Japan |journal=Appl. Environ. Microbiol. |volume=64 |issue=7 |pages=2705-9 |year=1998 |pmid=9647853 |url=http://aem.asm.org/cgi/content/full/64/7/2705?view=long&pmid=9647853}}</ref><ref>{{cite journal |author=Masuzawa T |title=Terrestrial distribution of the Lyme borreliosis agent Borrelia burgdorferi sensu lato in East Asia |journal=Jpn. J. Infect. Dis. |volume=57 |issue=6 |pages=229-35 |year=2004 |pmid=15623946 |url = http://www.nih.go.jp/JJID/57/229.html}}</ref> ''[[Borrelia]]'' has been isolated in Mongolia as well.<ref>{{cite journal |author=Walder G, Lkhamsuren E, Shagdar A, ''et al'' |title=Serological evidence for tick-borne encephalitis, borreliosis, and human granulocytic anaplasmosis in Mongolia |journal=Int. J. Med. Microbiol. |volume=296 Suppl 40 |issue= |pages=69-75 |year=2006 |pmid=16524782 |doi=10.1016/j.ijmm.2006.01.031}}</ref> | ||
*In South America tick-borne disease recognition and occurrence is rising. | *In South America [[tick-borne disease]] recognition and occurrence is rising. | ||
*Ticks carrying ''B. burgdorferi'' sensu lato, as well as canine and human [[tick-borne disease]], have been reported widely in Brazil, but the subspecies of ''Borrelia'' has not yet been defined.<ref>{{cite journal |author=Mantovani E, Costa IP, Gauditano G, Bonoldi VL, Higuchi ML, Yoshinari NH |title=Description of Lyme disease-like syndrome in Brazil. Is it a new tick borne disease or Lyme disease variation? |journal=Braz. J. Med. Biol. Res. |volume=40 |issue=4 |pages=443-56 |year=2007 |pmid=17401487 }}</ref> The first reported case of Lyme disease in Brazil was made in 1993 in Sao Paulo.<ref>{{cite journal |author=Yoshinari NH, Oyafuso LK, Monteiro FG, ''et al'' |title=Lyme disease. Report of a case observed in Brazil |language=Portuguese |journal=Revista do Hospital das Clínicas |volume=48 |issue=4 |pages=170-4 |year=1993 |pmid=8284588 }}</ref> *''B. burgdorferi'' sensu stricto antigens in patients have been identified in Colombia and in Bolivia. | *[[Tick|Ticks]] carrying ''[[Borrelia burgdorferi|B. burgdorferi]]'' sensu lato, as well as canine and human [[tick-borne disease]], have been reported widely in Brazil, but the subspecies of ''Borrelia'' has not yet been defined.<ref>{{cite journal |author=Mantovani E, Costa IP, Gauditano G, Bonoldi VL, Higuchi ML, Yoshinari NH |title=Description of Lyme disease-like syndrome in Brazil. Is it a new tick borne disease or Lyme disease variation? |journal=Braz. J. Med. Biol. Res. |volume=40 |issue=4 |pages=443-56 |year=2007 |pmid=17401487 }}</ref> The first reported case of [[Lyme disease]] in Brazil was made in 1993 in Sao Paulo.<ref>{{cite journal |author=Yoshinari NH, Oyafuso LK, Monteiro FG, ''et al'' |title=Lyme disease. Report of a case observed in Brazil |language=Portuguese |journal=Revista do Hospital das Clínicas |volume=48 |issue=4 |pages=170-4 |year=1993 |pmid=8284588 }}</ref> | ||
*In Northern Africa ''B. burgdorferi'' sensu lato has been identified in Morocco, Algeria, Egypt and Tunisia.<ref>{{cite journal |author=Bouattour A, Ghorbel A, Chabchoub A, Postic D |title=Lyme borreliosis situation in North Africa |language=French |journal=Archives de l'Institut Pasteur de Tunis |volume=81 |issue=1-4 |pages=13-20 |year=2004 |pmid=16929760 }}</ref><ref>{{cite journal |author=Dsouli N, Younsi-Kabachii H, Postic D, ''et al'' |title=Reservoir role of lizard Psammodromus algirus in transmission cycle of Borrelia burgdorferi sensu lato (Spirochaetaceae) in Tunisia |journal=J. Med. Entomol. |volume=43 |issue=4 |pages=737-42 |year=2006 |pmid=16892633 }}</ref><ref>{{cite journal |author=Helmy N |title=Seasonal abundance of Ornithodoros (O.) savignyi and prevalence of infection with Borrelia spirochetes in Egypt |journal=Journal of the Egyptian Society of Parasitology |volume=30 |issue=2 |pages=607-19 |year=2000 |pmid=10946521}}</ref> | *''[[Borrelia burgdorferi|B. burgdorferi]]'' sensu stricto antigens in patients have been identified in Colombia and in Bolivia. | ||
*In Western and sub-Saharan Africa, tick-borne [[relapsing fever]] was first identified by the British physicians Joseph Dutton and John Todd in 1905. | *In Northern Africa, ''[[Borrelia burgdorferi|B. burgdorferi]]'' sensu lato has been identified in Morocco, Algeria, Egypt and Tunisia.<ref>{{cite journal |author=Bouattour A, Ghorbel A, Chabchoub A, Postic D |title=Lyme borreliosis situation in North Africa |language=French |journal=Archives de l'Institut Pasteur de Tunis |volume=81 |issue=1-4 |pages=13-20 |year=2004 |pmid=16929760 }}</ref><ref>{{cite journal |author=Dsouli N, Younsi-Kabachii H, Postic D, ''et al'' |title=Reservoir role of lizard Psammodromus algirus in transmission cycle of Borrelia burgdorferi sensu lato (Spirochaetaceae) in Tunisia |journal=J. Med. Entomol. |volume=43 |issue=4 |pages=737-42 |year=2006 |pmid=16892633 }}</ref><ref>{{cite journal |author=Helmy N |title=Seasonal abundance of Ornithodoros (O.) savignyi and prevalence of infection with Borrelia spirochetes in Egypt |journal=Journal of the Egyptian Society of Parasitology |volume=30 |issue=2 |pages=607-19 |year=2000 |pmid=10946521}}</ref> | ||
*In Western and sub-Saharan Africa, tick-borne [[relapsing fever]] was first identified by the British physicians Joseph Dutton and John Todd in 1905. ''[[Borrelia]]'' in the manifestation of [[Lyme disease]] in this region is presently unknown but evidence indicates that Lyme disease may occur in humans in sub-Saharan Africa. The abundance of hosts and [[tick]] [[Vector|vectors]] would favor the establishment of [[Lyme]] [[infection]] in Africa.<ref>{{cite journal |author=Fivaz BH, Petney TN |title=Lyme disease--a new disease in southern Africa? |journal=Journal of the South African Veterinary Association |volume=60 |issue=3 |pages=155-8 |year=1989 |pmid=2699499}}</ref> In East Africa, two cases of [[Lyme disease]] have been reported in Kenya.<ref>{{cite journal |author=Jowi JO, Gathua SN |title=Lyme disease: report of two cases |journal=East African medical journal |volume=82 |issue=5 |pages=267-9 |year=2005 |pmid=16119758}}</ref> | |||
*In Australia there is no definitive evidence for the existence of ''B. burgdorferi'' or for any other [[Tick-borne disease|tick-borne]] [[Spirochaete|spirochete]] that may be responsible for a local syndrome being reported as Lyme disease.<ref>{{cite journal |author=Piesman J, Stone BF |title=Vector competence of the Australian paralysis tick, Ixodes holocyclus, for the Lyme disease spirochete Borrelia burgdorferi |journal=Int. J. Parasitol. |volume=21 |issue=1 |pages=109-11 |year=1991 |pmid=2040556}}</ref> | *In Australia there is no definitive evidence for the existence of ''[[Borrelia burgdorferi|B. burgdorferi]]'' or for any other [[Tick-borne disease|tick-borne]] [[Spirochaete|spirochete]] that may be responsible for a local syndrome being reported as [[Lyme disease]].<ref>{{cite journal |author=Piesman J, Stone BF |title=Vector competence of the Australian paralysis tick, Ixodes holocyclus, for the Lyme disease spirochete Borrelia burgdorferi |journal=Int. J. Parasitol. |volume=21 |issue=1 |pages=109-11 |year=1991 |pmid=2040556}}</ref> Cases of neuroborreliosis have been documented in Australia but are often ascribed to travel to other continents. The existence of [[Lyme disease]] in Australia is controversial. | ||
*Data shows that Northern hemisphere temperate regions are most [[Endemic (epidemiology)|endemic]] for [[Lyme disease|Lyme diseas]]<nowiki/>e.<ref>{{cite journal |author=Grubhoffer L, Golovchenko M, Vancová M, Zacharovová-Slavícková K, Rudenko N, Oliver JH |title=Lyme borreliosis: insights into tick-/host-borrelia relations |journal=Folia Parasitol. |volume=52 |issue=4 |pages=279-94 |year=2005 |pmid=16405291}}</ref><ref>{{cite journal |author=Higgins R |title=Emerging or re-emerging bacterial zoonotic diseases: bartonellosis, leptospirosis, Lyme borreliosis, plague |journal=Rev. - Off. Int. Epizoot. |volume=23 |issue=2 |pages=569-81 |year=2004 |pmid=15702720}}</ref> | |||
*Data shows that Northern hemisphere temperate regions are most endemic for Lyme disease.<ref>{{cite journal |author=Grubhoffer L, Golovchenko M, Vancová M, Zacharovová-Slavícková K, Rudenko N, Oliver JH |title=Lyme borreliosis: insights into tick-/host-borrelia relations |journal=Folia Parasitol. |volume=52 |issue=4 |pages=279-94 |year=2005 |pmid=16405291}}</ref><ref>{{cite journal |author=Higgins R |title=Emerging or re-emerging bacterial zoonotic diseases: bartonellosis, leptospirosis, Lyme borreliosis, plague |journal=Rev. - Off. Int. Epizoot. |volume=23 |issue=2 |pages=569-81 |year=2004 |pmid=15702720}}</ref> | |||
[[Image:Geographical distribution of reported Lyme Disease cases.png|centre|650px|Geographical distribution of Lyme disease.]] | [[Image:Geographical distribution of reported Lyme Disease cases.png|centre|650px|Geographical distribution of Lyme disease.]] | ||
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===Age | ===Age=== | ||
*There's a higher incidence of [[infection]] among children and infants of less than a year to 15 years. | *There's a higher [[incidence]] of [[infection]] among children and infants of less than a year to 15 years. | ||
*Another peak occurs in individuals between the ages of 40 to 55 years. | *Another peak occurs in individuals between the ages of 40 to 55 years. | ||
*On average, there is a higher incidence among males than females. However among ages 70 and higher, females tend to have a higher incidence of infection. | |||
[[Image:Agesex lyme.gif|center| | ===Gender=== | ||
*On average, there is a higher incidence among males than females. | |||
*However among ages 70 and higher, females tend to have a higher incidence of infection. | |||
[[Image:Agesex lyme.gif|center|500px|thumb|Peaks occur in males between the ages of less than one year to 15 and 40 to 55 years. Female patients are at a slightly higher risk than male patients above the age of 70.]] | |||
===Race=== | |||
*[[Lyme disease]] is more prevalent in the white people.<ref name="urlRacial Disparities in Nationally Notifiable Diseases --- United States, 2002">{{cite web |url=https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5401a4.htm |title=Racial Disparities in Nationally Notifiable Diseases --- United States, 2002 |format= |work= |accessdate=}}</ref> | |||
==References== | ==References== |
Revision as of 17:16, 28 July 2017
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anmol Pitliya, M.B.B.S. M.D.[2]Ilan Dock, B.S.
Overview
Lyme disease is the most commonly reported vector-borne illness in the United States. In 2015, it was the sixth most common Nationally Notifiable disease. The number of people diagnosed with Lyme disease each year in the United States is around 30,000. This disease is concentrated heavily in the northeast and upper mid-west.
Epidemiology and Demographics
Incidence
- Lyme disease is the most common tick-borne disease in North America and Europe, and one of the fastest-growing infectious diseases in the United States.
- The number of people diagnosed with Lyme disease each year in the United States is around 30,000.[1]
- In the United states, the incidence of Lyme disease is 8.9 per 100,000 persons; as per data collected by Center for Disease Control (CDC). [1]
- In the fourteen states where Lyme disease is most common , the average was 40.4 cases for every 100,000 persons for the year 2015.[1][2]
- Although Lyme disease has now been reported in majority of states in the U.S, about 95% of all reported cases are confined to just five geographic areas including New England, Mid-Atlantic, East-North Central, South Atlantic, and West North-Central.[2]
Seasonal Variation
- Prevalence of infection in adult ticks are more then nymph stage by pathogens infectious to humans.[3] But the majority of infections are caused by ticks in the nymph stage during late spring and summer.[4]
- This is the reason for an increase in incidence of Lyme disease during the months of May to August.
Widespread disease and endemic regions
- The number of reported cases of the disease have been increasing, as are endemic regions in North America.
- B. burgdorferi sensu lato has been maintained in enzootic cycles in California as well as other regions throughout North America, Europe and North Africa. Indeed, the DNA of Borrelia has been detected in lizards, indicating that they can be infected.[5]
- In Europe, cases of B. burgdorferi sensu lato infected ticks are found predominantly in Norway, Netherlands, Germany, France, Italy, Slovenia and Poland, but have been isolated in almost every country on the continent. Lyme disease statistics for Europe can be found at Eurosurveillance website.
- B. burgdorferi sensu lato infested ticks are being found more frequently in Japan, as well as in northwest China and far eastern Russia.[6][7] Borrelia has been isolated in Mongolia as well.[8]
- In South America tick-borne disease recognition and occurrence is rising.
- Ticks carrying B. burgdorferi sensu lato, as well as canine and human tick-borne disease, have been reported widely in Brazil, but the subspecies of Borrelia has not yet been defined.[9] The first reported case of Lyme disease in Brazil was made in 1993 in Sao Paulo.[10]
- B. burgdorferi sensu stricto antigens in patients have been identified in Colombia and in Bolivia.
- In Northern Africa, B. burgdorferi sensu lato has been identified in Morocco, Algeria, Egypt and Tunisia.[11][12][13]
- In Western and sub-Saharan Africa, tick-borne relapsing fever was first identified by the British physicians Joseph Dutton and John Todd in 1905. Borrelia in the manifestation of Lyme disease in this region is presently unknown but evidence indicates that Lyme disease may occur in humans in sub-Saharan Africa. The abundance of hosts and tick vectors would favor the establishment of Lyme infection in Africa.[14] In East Africa, two cases of Lyme disease have been reported in Kenya.[15]
- In Australia there is no definitive evidence for the existence of B. burgdorferi or for any other tick-borne spirochete that may be responsible for a local syndrome being reported as Lyme disease.[16] Cases of neuroborreliosis have been documented in Australia but are often ascribed to travel to other continents. The existence of Lyme disease in Australia is controversial.
- Data shows that Northern hemisphere temperate regions are most endemic for Lyme disease.[17][18]
Age
- There's a higher incidence of infection among children and infants of less than a year to 15 years.
- Another peak occurs in individuals between the ages of 40 to 55 years.
Gender
- On average, there is a higher incidence among males than females.
- However among ages 70 and higher, females tend to have a higher incidence of infection.
Race
- Lyme disease is more prevalent in the white people.[19]
References
- ↑ 1.0 1.1 1.2 "Lyme disease data tables | Lyme Disease | CDC".
- ↑ 2.0 2.1 "Data and Statistics | Lyme Disease | CDC".
- ↑ Schwartz, Ira; Fish, Durland; Daniels, Thomas J. (1997). "Prevalence of the Rickettsial Agent of Human Granulocytic Ehrlichiosis in Ticks from a Hyperendemic Focus of Lyme Disease". New England Journal of Medicine. 337 (1): 49–50. doi:10.1056/NEJM199707033370111. ISSN 0028-4793.
- ↑ Falco RC, McKenna DF, Daniels TJ, Nadelman RB, Nowakowski J, Fish D; et al. (1999). "Temporal relation between Ixodes scapularis abundance and risk for Lyme disease associated with erythema migrans". Am J Epidemiol. 149 (8): 771–6. PMID 10206627.
- ↑ Swanson KI, Norris DE (2007). "Detection of Borrelia burgdorferi DNA in lizards from Southern Maryland". Vector Borne Zoonotic Dis. 7 (1): 42–9. doi:10.1089/vbz.2006.0548. PMID 17417956.
- ↑ Li M, Masuzawa T, Takada N; et al. (1998). "Lyme disease Borrelia species in northeastern China resemble those isolated from far eastern Russia and Japan". Appl. Environ. Microbiol. 64 (7): 2705–9. PMID 9647853.
- ↑ Masuzawa T (2004). "Terrestrial distribution of the Lyme borreliosis agent Borrelia burgdorferi sensu lato in East Asia". Jpn. J. Infect. Dis. 57 (6): 229–35. PMID 15623946.
- ↑ Walder G, Lkhamsuren E, Shagdar A; et al. (2006). "Serological evidence for tick-borne encephalitis, borreliosis, and human granulocytic anaplasmosis in Mongolia". Int. J. Med. Microbiol. 296 Suppl 40: 69–75. doi:10.1016/j.ijmm.2006.01.031. PMID 16524782.
- ↑ Mantovani E, Costa IP, Gauditano G, Bonoldi VL, Higuchi ML, Yoshinari NH (2007). "Description of Lyme disease-like syndrome in Brazil. Is it a new tick borne disease or Lyme disease variation?". Braz. J. Med. Biol. Res. 40 (4): 443–56. PMID 17401487.
- ↑ Yoshinari NH, Oyafuso LK, Monteiro FG; et al. (1993). "Lyme disease. Report of a case observed in Brazil". Revista do Hospital das Clínicas (in Portuguese). 48 (4): 170–4. PMID 8284588.
- ↑ Bouattour A, Ghorbel A, Chabchoub A, Postic D (2004). "Lyme borreliosis situation in North Africa". Archives de l'Institut Pasteur de Tunis (in French). 81 (1–4): 13–20. PMID 16929760.
- ↑ Dsouli N, Younsi-Kabachii H, Postic D; et al. (2006). "Reservoir role of lizard Psammodromus algirus in transmission cycle of Borrelia burgdorferi sensu lato (Spirochaetaceae) in Tunisia". J. Med. Entomol. 43 (4): 737–42. PMID 16892633.
- ↑ Helmy N (2000). "Seasonal abundance of Ornithodoros (O.) savignyi and prevalence of infection with Borrelia spirochetes in Egypt". Journal of the Egyptian Society of Parasitology. 30 (2): 607–19. PMID 10946521.
- ↑ Fivaz BH, Petney TN (1989). "Lyme disease--a new disease in southern Africa?". Journal of the South African Veterinary Association. 60 (3): 155–8. PMID 2699499.
- ↑ Jowi JO, Gathua SN (2005). "Lyme disease: report of two cases". East African medical journal. 82 (5): 267–9. PMID 16119758.
- ↑ Piesman J, Stone BF (1991). "Vector competence of the Australian paralysis tick, Ixodes holocyclus, for the Lyme disease spirochete Borrelia burgdorferi". Int. J. Parasitol. 21 (1): 109–11. PMID 2040556.
- ↑ Grubhoffer L, Golovchenko M, Vancová M, Zacharovová-Slavícková K, Rudenko N, Oliver JH (2005). "Lyme borreliosis: insights into tick-/host-borrelia relations". Folia Parasitol. 52 (4): 279–94. PMID 16405291.
- ↑ Higgins R (2004). "Emerging or re-emerging bacterial zoonotic diseases: bartonellosis, leptospirosis, Lyme borreliosis, plague". Rev. - Off. Int. Epizoot. 23 (2): 569–81. PMID 15702720.
- ↑ "Racial Disparities in Nationally Notifiable Diseases --- United States, 2002".