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Lyme disease

(Borrelia burgdorferi infection)

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Lyme disease was first recognized in the United States in 1975 at Lyme, Connecticut. The infection is caused by a bacterium, Borrelia burgdorferi, transmitted to humans by a tiny tick named Ixodes scapularis (commonly called the blacklegged or deer tick). Lyme disease may cause signs and symptoms affecting the skin, nervous system, heart, or joints of an infected person.

Lyme disease mostly occurs in the northeast, mid-west, and the west coast of the United States. In Wisconsin, the highest number of cases is seen in the western region, but in recent years, cases have increased in the central region and eastern region. It is the highest reported tickborne disease in Wisconsin, with more than 23,000 cases reported between 1980 and 2010.

Lyme disease symptoms may appear from 3 days to 30 days after a bite of an infected tick. The illness often, but not always, begins as a roughly circular reddish rash (called erythema migrans or EM rash) around or near the site of the tick bite. The rash is different from an allergic reaction to an insect bite in that it expands in size over a period of days or weeks, and may have a bull's eye appearance. During the EM rash stage, other symptoms such as fever, headache, fatigue, stiff neck, muscle or joint pain and swelling may be present and may last for several weeks. If left untreated, complications such as meningitis, facial palsy, heart abnormalities, and arthritis may occur within a few weeks to months after the initial onset of symptoms. Lyme disease is treated very effectively with oral antibiotics, which can be given intravenously in severe cases.

Tickborne diseases home

General information

• Lyme disease fact sheet (PDF, 28 KB)  Hmong (PDF, 21 KB)  Spanish (PDF, 17 KB)  

• Prevention and control of tickborne diseases  

• Lyme disease FAQ - CDC 

Data and statistics

Lyme disease has been a reportable disease in Wisconsin since 1980, and became nationally notifiable in 1990. 

• Lyme disease data by year  

Information for health professionals

• This is a Wisconsin Disease Surveillance Category II disease: 
  Report to the patient's local public health department electronically, through the Wisconsin Electronic Disease Surveillance System (WEDSS), by mail or fax using an Acute and Communicable Disease Case Report F44151 (PDF, 167 KB) or by other means within 72 hours upon recognition of a case. DHS Communicable Disease Reporting

• Wisconsin case reporting & public health follow-up guidelines: Lyme disease EpiNet (PDF, 35 KB) 

• Wisconsin Lyme disease Case Report form (fillable) (PDF, 533 KB)  

• Wisconsin Lyme disease Case Classification Algorithm  (PDF, 76 KB)  

• Lyme disease for health care professionals - CDC  

• Lyme disease treatment information - CDC

  Training resources

  • Lyme disease reporting and surveillance update: 3/19/2013 (Webcast, help)

    • Lyme disease 3/19/2013 update presentation slides (PDF, 1732 KB)

  • Tickborne illness in Wisconsin - Lyme disease 2010 (PDF, 2 MB)  

  Laboratory guidance

  • Diagnosis of Lyme disease can be difficult and complicated since many of the signs and symptoms of Lyme disease can be very similar to other viral and bacterial infections, rheumatoid arthritis, and other neurological diseases. Because Lyme disease is endemic in Wisconsin and antibodies to the bacteria Borrelia burgdorferi may not be produced in the early stage of illness, Lyme disease diagnosis can be made in an ill patient who developed the typical EM rash characteristics without laboratory testing. For patients ill with other compatible clinical sign and symptoms and without EM rash present, the results of blood tests to detect the presence of antibodies to the bacteria can be used for diagnosis of Lyme infections. Due to the possibility of false-positive, false-negative, and cross-reactivity in commercial tests, a two-step testing process including the enzyme-linked immunosorbent (ELISA) screening assay and the Western immunoblot (WB) confirmatory assay is recommended by the Centers for Disease Control and Prevention (CDC) for the diagnosis of Lyme disease. For the surveillance of Lyme disease, a two-stage testing process is required to meet the case definition criteria.  

• Lyme Disease Diagnosis - CDC  

• Two-step Laboratory Testing Process - CDC  

Educational material available from the Department of Health Services:

Electronically order forms: Follow the instructions at the top of the page and email the form F-80025A (can be used to order multiple forms/publications) to FM-DPH-PPH@dhfs.state.wi.us
Questions concerning ordering of forms can be addressed to Chris Caputo, 608-267-9054

Additional resources

• Learn about Lyme Disease - CDC 
• Lyme Disease Toolkit - CDC
• National Lyme Disease Statistics - CDC

• IDSA Lyme Disease Treatment Guidelines (PDF, 596 KB) 

• Lyme Disease on Medline Plus (NIH) 
• Lyme Disease - MN Department of Health 
• Blacklegged Ticks - MN Department of Health 
• Deer Tick Images - Iowa State University 
• University of WI Madison Bacteriology Online Textbook 

Contacts

Diep Hoang Johnson, Vectorborne Disease Epidemiologist
Wisconsin Division of Public Health 
Bureau of Communicable Diseases and Emergency Response
(Phone 608-267-0249)  (Fax 608-261-4976)

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Last Revised: May 01, 2013