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September 15, 2023
 The Lake County Health Department has seen an increase in Lyme disease (LD) in Lake County, Illlinois. As of July 31, 2023, there are 38 cases reported which is higher than the average 30 cases that occur annually (Figure). Anaplasmosis and babesiosis have also been reported this year.
The Lake County Health Department, Ecological Services program, found that roughly 30–40% of deer ticks test positive for Borrelia burgdorferi in this region. Tick surveillance also identified deer ticks carrying Borrelia miyamotoi, Anaplasma phagocytophilum, and Babesia microti.
Figure. Number of Lyme Disease Cases, by Year, Lake County, 2012–2022.
 Please remember Lyme disease in your differential. Clinical assessment considerations for LD include:
- Signs/symptoms of Lyme Disease (e.g., a skin rash called erythema migrans, articular, neurological, or cardiac involvement)
- Likelihood of exposure to an infected black-legged tick (Ixodes scapularis),
- Other diseases in differential diagnosis list, and
- Results of lab tests.
The LD test is a two-step process and identifies Borrelia burgdorferi antibodies (IgM and IgG) which may take a few weeks to be detected after infection.
- First, order the LD enzyme immunoassay (EIA) test or other FDA-cleared test.
- If the result is equivocal or positive, this test is reflexed to either the Western Blot assay OR a second FDA-cleared EIA test can be ordered either sequentially or simultaneously using the same blood sample.
The diagnosis of LD is made when BOTH tests are positive (or equivocal). These tests may be performed at a commercial reference laboratory. For more information, review this brief four-minute video from the CDC.
Treatment involves antibiotic therapy from 10 to 28 days depending on early or late presenting symptoms.Here are some quick, one-page guides:
For more information, check out CDC’s Lyme Disease webpage for healthcare providers. CDC’s training modules are CME-eligible.
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