Lyme Disease, 2018: DCN - Minnesota Dept. of Health

Lyme Disease, 2018

Lyme disease is caused by Borrelia burgdorferi, a spirochete transmitted to humans by bites from Ixodes scapularis, the blacklegged tick. Recently, a new species, B. mayonii, has also been identified as a cause of human disease, and 9 cases have been reported in Minnesota residents since 2013, 1 in 2018. In Minnesota, the same tick vector also transmits the agents of babesiosis, human anaplasmosis, one form of human ehrlichiosis, and a strain of Powassan virus.

In 2018, 950 confirmed Lyme disease cases (17 cases per 100,000 population) were reported. In addition, 591 probable cases (physician-diagnosed cases that did not meet clinical evidence criteria for a confirmed case but that had laboratory evidence of infection) were reported. Despite some yearly fluctuations, the number of reported cases of Lyme disease has been increasing, as evidenced by the median number of cases from 2009 through 2017 (median, 1,203; range, 896 to 1,431) compared to the median from 2000 to 2008 (median, 913; range, 463 to 1,239) (Figure 1).

Five hundred eighty-eight (62%) confirmed cases were male, and the median case age was 44 years (range, 1 to 91). Physician-diagnosed erythema migrans (EM) was present in 601 (63%) cases. Three hundred eighty-nine (41%) cases had one or more late manifestations of Lyme disease (including 282 with a history of objective joint swelling, 84 with cranial neuritis including Bell’s Palsy, 4 with lymphocytic meningitis, 20 with acute onset of 2nd or 3rd degree atrioventricular conduction defects, and 9 with radiculoneuropathy) and confirmation by Western immunoblot (positive IgM ≤30 days post-onset or positive IgG). Of the 876 cases with known onset dates, onset of symptoms peaked from June through August, with 69% of EM cases experiencing symptom onset in June or July. This timing corresponds with peak activity of nymphal I. scapularis ticks in mid- May through mid-July. The majority of cases either resided in or traveled to endemic counties in north-central, east-central, or southeast Minnesota, or Wisconsin.

I scapularis-borne disease cases

Updated Monday, 16-Sep-2019 11:18:23 CDT