Lyme Disease Reporting and Surveillance

Lyme disease is a Category II reportable condition in Wisconsin. Health care providers should report to the patient's local public health department:
  • Electronically, through the Wisconsin Electronic Disease Surveillance System (WEDSS).
  • By mail or fax using a Lyme Disease Case Report Form, F-02188 (PDF)
  • By calling the Bureau of Communicable Diseases at 608-267-9003.

Reporting should be completed within 72 hours upon recognition of a case. For more information, please visit the Department of Health Services (DHS) Disease Reporting page.

As of January 1, 2022, a new Lyme disease surveillance case definition went into effect. Please refer to the Lyme Disease Case Reporting and Investigation Protocol, P-01735, for more details. 

A video for health departments and their partners on Lyme disease data and resources.

 

 Guidance resources

DHS surveillance resources
Provider resources

 Testing

Due to the possibility of false-positive, false-negative, and antibody cross-reactivity in commercial tests, a two-step serologic testing process is recommended by the CDC to support the diagnosis of Lyme disease. Two-step serologic testing includes an enzyme-linked immunosorbent assay (ELISA) or an immunofluorescence assay (IFA) as the first test followed by a Western immunoblot (WB) as the second test, or a modified two-tiered testing process using an enzyme immunoassay (EIA) in place of a Western immunoblot for the second test. For the surveillance of Lyme disease, two-step serologic testing or molecular testing in an appropriate clinical specimen (e.g., synovial fluid for suspected Lyme arthritis) is required to meet the case definition criteria.

 Diagnosis

Diagnosis of Lyme disease can be difficult and complicated. 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 erythema migrans (EM) rash characteristics without laboratory testing. For patients ill with other compatible clinical signs 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.

 Treatment

Most people treated with oral antibiotics during the early stages of Lyme disease recover completely. It is important to get treatment as soon as possible after symptoms start. Antibiotics commonly used for oral treatment include doxycycline, cefuroxime axetil, or amoxicillin. The following table shows the current treatment recommendations from CDC for early stage Lyme disease in adults and children.

Treatment for early Lyme disease

Age Category Drug Dosage Maximum Duration, Days
Adults Doxycycline 100 mg, twice per day orally N/A 10–21
Adults Cefuroxime axetil 500 mg, twice per day orally N/A 14–21
Adults Amoxicillin 500 mg, twice per day orally N/A 14–21
Children Amoxicillin 50 mg/kg per day orally, divided into three doses 500 mg per dose 14–21
Children Doxycycline 4 mg/kg per day orally, divided into two doses 100 mg per dose 10–21
Children Cefuroxime axetil 30 mg/kg per day orally, divided into two doses 500 mg per dose 14–21

If treatment is delayed, the bacteria can spread to the joints, heart, and nervous system and have long-term effects. Lyme disease can be difficult to treat in later stages, and severe cases may require intravenous treatment. Some people may have symptoms that will not go away or return even after appropriate antibiotic treatment, a condition called PTLDS.

Questions about illnesses spread by ticks? Contact us!
Phone: 608-267-9003 | Fax: 608-261-4976

Last Revised: July 6, 2022