Lyme Disease and Related Tick-Borne Infections - Risk Factors

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Highlights	Diseases with Similar Symptoms	Babesiosis
Introduction	Diagnosis	Resources
Symptoms	Treatment	References
Risk Factors	Prevention
Complications	Human Granulocytic Anaplasmosis (HGA)

In such areas, between 1 - 3% of people who live there become infected at some time. New York has had the highest number of total cases to date, followed by Connecticut, which actually has the highest number of infected patients per total population. Pennsylvania and New Jersey have the next highest infection rates.

Worldwide Locations. Pockets of Lyme disease exist around the world. The disease is common in Europe, particularly in forested areas of middle Europe and Scandinavia. The Borrelia family is also responsible for tick infections in Europe, but different subspecies (B. garinii and B. afzelii) may be more common there and cause slightly different symptoms. The infection has also been reported in Russia, China, and Japan.

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High-Risk Landscapes

One analysis suggested the risk for Lyme disease exposure is highest in wet, green areas, and lower in areas with lawns or low vegetation. Hiking and camping in the Northeastern woods carries a significant risk for tick bites and Lyme disease.

The disease is not limited to rural settings. It is becoming increasingly common in suburban areas. Beaches are also home to ticks.

Time of Year

The time of year of highest risk depends on the geographical region.

Northeast and North Central U.S. In the northeastern and north central U.S., most cases of Lyme disease are reported from May through August, with July being the peak month.

Exceptions may occur in years of warm winters and wet springs, which can bring the deer tick nymphs out about 2 weeks earlier. This same climate also creates the wet, green environment that increases the prevalence of ticks.

Noncoastal Western States. In the noncoastal western U.S., the disease most often occurs between January and May.

West Coast. The risk is higher on the west coast between November and April.

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Review Date: 01/18/2007
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital

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