Freaking OUT...is this a brown recluse bite??

[barkley1]

i just noticed this on DS (3) this a.m...he hasn't complained at all. But he does say it itches. it's oval shaped, with a red center and red ring around the outside. UGHHHH

[squimp]

When I lived in tick country, I was told a red ring around the bite could mean Lyme. I'd probably go to the doctor.

[TwoBees]

Looks a bit like ringworm, a bit like Lyme. I'd call the ped.

[chlobo]

My vote is for lyme. Definitely call the doctor.

[gatorsmom]

Yikes, that looks like a bullseye rash. I vote Lyme too.

A brown recluse bite would have a black center that would get larger as the necrotic tissue increased.

[barkley1]

Doesn't a tick have to be on you for 24-48 hours to transmit Lyme? He has def not had a tick attached to him lately...

[writermama]

Doesn't a tick have to be on you for 24-48 hours to transmit Lyme? He has def not had a tick attached to him lately...

Less is certain about that than generally assumed. It looks like a bullseye from the photo, you should take it seriously even in the absence of a known tick bite.

[chlobo]

Ticks do not have to be attached that long. Definitely call the pediatrician. Quick treatment will help mitigate against long-term problems.

[TwoBees]

Doesn't a tick have to be on you for 24-48 hours to transmit Lyme? He has def not had a tick attached to him lately...

You might not have seen the tick. Also, I don't think the rash always appears at the site of the tick bit. It could have been in his hair, etc.

From Webmd

Early disseminated Lyme disease is the second stage. It may develop several weeks or months after you become infected and can cause:

Skin problems, such as an expanding, circular rash at the site of the bite. More rashes can then develop on other parts of your body as the infection spreads. More serious skin problems from Lyme disease are rare in the United States but can include swelling in the earlobes and near the nipples, and severe thinning of the skin on the hands and feet.

[mom2binsd]

I've had a bad mosquito bite look exactly like that. No words of wisdom from me though.

[barkley1]

I txt a pic to his ped, who said "no tick, no Lyme" and that he hasn't seen a case of Lyme on 42 Yrs. Wwyd?

[ha98ed14]

I txt a pic to his ped, who said "no tick, no Lyme" and that he hasn't seen a case of Lyme on 42 Yrs. Wwyd?

Take him to Urgent care and get a second opinion

[zukeypur]

Brown recluse bites HURT like nothing else.

[Twoboos]

I txt a pic to his ped, who said "no tick, no Lyme" and that he hasn't seen a case of Lyme on 42 Yrs. Wwyd?

I had Lyme and never saw a tick on me. Second opinion time!

[arivecchi]

I txt a pic to his ped, who said "no tick, no Lyme" and that he hasn't seen a case of Lyme on 42 Yrs. Wwyd? I would be annoyed with your ped! How can he rule something out over a text? I would be heading for the hills (or in this case - a second opinion). That is one scary bite!

[o_mom]

I txt a pic to his ped, who said "no tick, no Lyme" and that he hasn't seen a case of Lyme on 42 Yrs. Wwyd?

I would get a new ped.

The ticks that transmit lyme can be as small as a poppy seed. They are easy to miss. Depending on where you live, I would take his 'never seen lyme' as a sign he's never looked for it.

[TwinFoxes]

I would be annoyed with your ped! How can he rule something out over a text? I would be heading for the hills (or in this case - a second opinion). That is one scary bite!

:yeahthat:

[Smillow]

I txt a pic to his ped, who said "no tick, no Lyme" and that he hasn't seen a case of Lyme on 42 Yrs. Wwyd?

Where do you live? It is becoming increasingly more common, so the 42 year comment seems pretty ignorant (of the Dr.)....

[TwoBees]

Take him to Urgent care and get a second opinion

:yeahthat: Espeically after all I've learned from Melbel.

[barkley1]

Where do you live? It is becoming increasingly more common, so the 42 year comment seems pretty ignorant (of the Dr.)....

East TN

[MamaMolly]

I think the peace of mind you get from a second opinion would be worth it.

[mctlaw]

I would be annoyed with your ped! How can he rule something out over a text? I would be heading for the hills (or in this case - a second opinion). That is one scary bite!

:yeahthat:

And I'd be annoyed at the blow-off tone of his response.

[elliput]

A brown recluse bite would have a black center that would get larger as the necrotic tissue increased.
:yeahthat: DH was bit by a brown recluse just last week. It definitely does not look like your picture.

Get a second opinion. I'm a bit leery of the "no tick, no lyme" statement.

[Fairy]

I'm a worrier by nature, so I'd be taking him to the ped for a real look.

[SkyrMommy]

I think the peace of mind you get from a second opinion would be worth it.

:yeahthat: And as PPs have said, ticks can be so, so small and go unoticed.

[JElaineB]

I would get a new ped.

The ticks that transmit lyme can be as small as a poppy seed. They are easy to miss. Depending on where you live, I would take his 'never seen lyme' as a sign he's never looked for it.

:yeahthat: Look up some of Melbel's threads on Lyme. I think those will convice you to take him to a different ped to check for Lyme. Your current ped would obviously blow it off.

ETA: It's also possible it could be ringworm. Either way you should see someone who will evaluate it based on what it might be, not preconcieved notions.

[ChristinaLucia]

New ped. Lyme is nothing to play with and you need a doctor who is open to that possibility. Those darn ticks are SO SO SO hard to spot. We used to live in a Lyme infested area and know lots of people who had it and I don't remember 1 person remember the tick!

[Smillow]

East TN

Yeah, definitely get a second opinion. Here in central VA, practically every family I know has had a Lyme's experience. It is rampant. I would expect the same in your area.

[lfp2n]

My friends son just had a brown recluse bite and it didnt look like that at all.

[MSWR0319]

I just had that exact rash on my back two weeks ago. I was told it was Lyme. I, too, had never seen the tick. The dr told me she's never seen a case, but didn't hesitate to diagnose by just the rash and that the tick was as small as a freckle so i probably just missed him. They gave me antibiotics and told me to come back in a few months to redo blood work. I'm trying to find a lyme dr to make sure its treated properly. I'd get him to a new dr ASAP. I didn't realize how bad I felt until day 5 of the meds kicking in. I just thought I was tired. I also just read a short article in Parenting magazine that said the risk of Lyme is high this year due to a decrease in mice, which the ticks feed on. Let us know the outcome.

[pb&j]

I txt a pic to his ped, who said "no tick, no Lyme" and that he hasn't seen a case of Lyme on 42 Yrs. Wwyd?

Take him to a different doc. Bullseye rash (if that's what this is) is considered diagnostic for Lyme, even in the absence of bite. I would definitely have someone else check him out. Any doc who has never seen Lyme in E. TN has missed a lot of cases, IMO.

DS had a deer tick bite this week and it is pure chance that we saw the tick. It was SO tiny. At first I didn't even think it was a tick - and we spend time outside in woods/grass daily and are on high alert for them (we're in Central VA - lots of Lyme around here). I could very easily see how the tick could feed for 24+ hours and drop off, totally unnoticed. Also, the rash doesn't have to be at the site of the original bite, so the tick could have been hiding behind an ear or in his hair at the time of the bite.

[daisysmom]

Yikes, that looks like a bullseye rash. I vote Lyme too.

A brown recluse bite would have a black center that would get larger as the necrotic tissue increased.

I got bitten by a brown recluse spider almost 10 years ago. Never felt the bite(presumably this happend to a trip down to the river near us with the dogs one morning), but had a really sore calf for the rest of the day and figured I must have strained it running. By that night, I had a fever and went to bed thinking I had a bug. By 5 in the morning, I woke up not being able to stand on my leg and with a groin lymph node the size of a golfball. Went to the ER at 9 am and was admitted, got sepsis with red stripes all the way up my leg. Only later the second day, I think, was when the black patch started to develop on my ankle. At its biggest, it was 5 inches wide of dead skin.

If there is a question about a brown recluse bite, get thee to the doctor.

[daisysmom]

Yeah, definitely get a second opinion. Here in central VA, practically every family I know has had a Lyme's experience. It is rampant. I would expect the same in your area.

I am in central VA too - I didn't know about the increase in Lyme - that worries me because my DD has so much thick hair and we are often down at the river. Thanks for the heads up, I am going to be more vigilent on this. I had a cousin get Lyme 10 years ago and he really had a tough time.

[wellyes]

I'd fire that ped.
I'm sorry. Hopefully it's something innocuous.

[barkley1]

Ok I'm taking him to the dermatologist tomorrow. There are no MDs that can see him until end of Sept but I was able to get an appt w a nurse practitioner. I hope she's knowledgeable!

[Binkandabee]

Glad to hear you're taking him in. Hopefully it's nothing, but that peace of mind will be priceless.

[Melbel]

Wow. Some strong mixed emotions on this thread. First, I am appalled at the doctor's response. Without question, this is appears to be a bullseye rash warranting immediate antibiotic treatment for a minimum of 4 weeks (Doxycycline or Azithromycin for older children, Amoxicillin for younger children is typically prescribed). Disseminated Lyme Disease from untreated or under treated tick bites can be a nightmare. My DS went from an A+, athletic, outgoing and popular child to a child that had to drop all sports, had a steep decline in grades, was mercilessly bullied (verbal and physical) by peers who did not "get" his illness, and ultimately declined to the point he could not walk. He developed over 40 symptoms (many debilitating) all consistent with Lyme, before hospital doctors finally responded to my pleas for Lyme testing. If we had listened to his pediatrician, neurologist and many other specialists, I have no doubt he would be in a wheelchair now. Doctors are woefully misinformed about Lyme, and the consequences can be catastrophic. Please do not be afraid to seek a second opinion and advocate for your child. My DS has now improved tremendously after treating for 7 months on a cocktail of antibiotics and supplements. Trust me, you do not want to deal with chronic, disseminated Lyme.

Secondly, I am so incredibly proud of all of the informed responses here.

As for the poster who replied about a bullseye rash after a mosquito bite, there is a contingency that believes Lyme can also be spread by mosquitos. I have read of at least one case where the rash from a mosquito bite was cultured and tested positive for Lyme.

As mentioned by PPs, Lyme has also been documented with much shorter attachment periods than the standard 24-48 hour guidelines. This is particularly the case when the tick is not removed properly and the stomach contents are expelled into the host. Many people with Lyme Disease do not every realize they were bit by a tick (about 1/2). No tick, no Lyme is just plain wrong.

Here are links that may help:

Top 10 Tips to Avoid Chronic Lyme brochure:
http://www.ilads.org/lyme_disease/Prevent_chronic_lyme.pdf

What every primary physician should know about Lyme:
http://www.ilads.org/lyme_disease/Primary_care_brochure_08_08.pdf

Links to treatment guidelines:
IDSA: http://www.ilads.org/files/ILADS_Guidelines.pdf
Dr. Burrascano (one of the most cited, highly respected Lyme doctors): http://www.lymenet.org/BurrGuide200810.pdf Quote from page 7 - After a tick bite, serologic tests (ELISA. IFA, western blots, etc.) are not expected to become positive until several weeks have passed. Therefore, if EM is present, treatment must begin immediately, and one should not wait for results of Borrelia tests. You should not miss the chance to treat early disease, for this is when the success rate is the highest. Indeed, many knowledgeable clinicians will not even order a Borrelia test in this circumstance.

Here are a couple of my favorite Lyme sites:
http://www.LymeDisease.org/
http://tbdalliance.org/

Here are a couple sites relating to Lyme in children:
http://www.drjoneskids.com/
http://www.lymedisease.org/resources/children.html

There is a well reputed Lyme specialist in Franklin, TN (near Nashville). If you are interested, I can also provide links to find a doctor closer to your home.

[Melbel]

Ok I'm taking him to the dermatologist tomorrow. There are no MDs that can see him until end of Sept but I was able to get an appt w a nurse practitioner. I hope she's knowledgeable!

I am glad to hear you are following up. I would print off the two brochures and the two treatment guidelines.

I recently read about a form that patients (or parents) request the doctor to sign if they refuse Lyme testing or treatment. I have not seen the form myself, but I am curious as to how it is worded and how it would play out.

One more tip - The rashes can disappear quickly. Take more high resolution photos in good lighting.

[Melbel]

Something else to consider - cases of Rocky Mountain Spotted Fever (another tick borne illness) have reportedly soared (over 500% increase) in TN this summer. More often than not, ticks transmit numerous bacteria/infections at once.

http://www.timesfreepress.com/news/2012/may/03/warm-winter-spring-blamed-for-rise-in-blood/

ETA:
http://health.nytimes.com/health/guides/disease/rocky-mountain-spotted-fever/overview.html

[cntrymoon2]

OP, how did the derm appt go?

[BelleoftheBallFlagstaff]

Any news?

[MSWR0319]

Any news?

:yeahthat:

I've been thinking about you.

[trales]

We never saw a tick on DH, he never even got the rash, but went through almost a year of treatment b/c the lyme was so bad.

Another friend found the same rash on her daughter, no tick, our pedi treated right away.

In a risk assessment of antibiotics vs. the potential of Lyme disease, the risk of the antibiotics is negligable. Lyme is so serious and so under diagnosed, and so horrible for the patient and family. We lived through hell with DH. It was also his Dr's first case of Lyme ever, when the vet practice across the street diagnosed it almost everyday. His doc, who we don't seen anymore was choosing not to see a major epidemic in our town.

[Melbel]

We never saw a tick on DH, he never even got the rash, but went through almost a year of treatment b/c the lyme was so bad.

Another friend found the same rash on her daughter, no tick, our pedi treated right away.

In a risk assessment of antibiotics vs. the potential of Lyme disease, the risk of the antibiotics is negligable. Lyme is so serious and so under diagnosed, and so horrible for the patient and family. We lived through hell with DH. It was also his Dr's first case of Lyme ever, when the vet practice across the street diagnosed it almost everyday. His doc, who we don't seen anymore was choosing not to see a major epidemic in our town.

:yeahthat: x 1,000,000. Dogs get tested here annually (regardless if the owner sees a tick), yet many doctors refuse to even test for Lyme even when there are glaringly clear symptoms. My poor DS deteriorated for 10 months to the point he could not walk most days because his team of doctors did not think his symptoms could possibly be Lyme. Our story is repeated thousands of times (it is the rule, not the exception it seems). There is a Lyme epidemic (some say pandemic) yet doctors keep repeating the mantra about how "rare" Lyme is and use outdated, inaccurate and misguided notions. Our pets are walking along side there human friends, so it makes no sense why there are two glaringly different standards. This is an area you simply cannot trust most mainstream doctors. :(

I have read several stories this week about individuals who were untreated or under treated following a tick bite. The infection can lie dormant and/or undetected for many years until your immune system is weakened (i.e. another illness, growth spurts, hormonal changes, pregnancy, another tick bite potentially with co-infections, etc.) at which time the infection explodes and the individual suffers severe symptoms. Just because you do not experience symptoms right away does not mean that you are in the clear. I think that some people's immune systems are better than others at keeping an infection in check.


ETA: There is actually a hearing going on right now addressing the Lyme epidemic. The Bipartisan Lyme and Tick-Borne Disease Prevention, Education, and Research Act (S. 1381), would increase awareness about Lyme disease and provide more resources to study the illness.

"Without exaggeration, Lyme disease has reached a scope of epidemic proportions that needs to be addressed much more seriously in Connecticut and around the country," Blumenthal said. "A national and federal approach to support scientific advances in diagnosis and detection as well as treatment is certainly crucial."

Read more: http://www.newstimes.com/local/article/Hearing-on-Lyme-disease-treatment-3826016.php#ixzz253VHrfro

[squimp]

According to CDC maps there aren't many Lyme cases in East Tenn. No idea how correct this is, but just because it's rare doesn't mean it's impossible. I know we have few cases in OR but I know several people who contracted it here.
http://www.cdc.gov/lyme/stats/maps/interactiveMaps.html

I grew up near Knoxville, and recall hearing a lot about RMSF as a kid. It does seem to be more prevalent according to CDC.
http://www.cdc.gov/rmsf/stats/#geography

[Melbel]

According to CDC maps there aren't many Lyme cases in East Tenn. No idea how correct this is, but just because it's rare doesn't mean it's impossible. I know we have few cases in OR but I know several people who contracted it here.
http://www.cdc.gov/lyme/stats/maps/interactiveMaps.html

I grew up near Knoxville, and recall hearing a lot about RMSF as a kid. It does seem to be more prevalent according to CDC.
http://www.cdc.gov/rmsf/stats/#geography

The numbers are vastly lower than the actual numbers. These very misleading numbers gave us, and our doctors, a false sense of security with respect to Lyme Disease. The numbers are expected to spike this year due to a perfect storm of ecological factors leading to a large increase in the number of ticks. Researchers are finding that the percentages of ticks testing positive for Lyme have also spiked significantly (25% in Texas, a traditionally non-endemic area; 67% of black legged ticks in Ohio; 25-40% in Michigan; 20% of black legged deer ticks in North Carolina; 55% in Pennsylvania are a few examples). About 20 percent of the 5,332 ticks collected in the Eastern half of the country were infected with the bacterium that causes Lyme disease. http://www.npr.org/blogs/health/2012/02/01/146211699/tick-tally-reveals-lyme-disease-risk

According to CDC epidemiologists, the reported cases are underestimated 6- to 12-fold in due to inherent flaws in its passive reporting system. Consequently, the actual number of new Lyme cases in 2009 could be as high as 461,616 (compared to 38,468 reported cases actually reported in 2009).

The large gap between reported and actual cases is caused by a number of factors, including:
1. Inaccurate Lyme tests that miss up to 60% of actual cases
2. Failure of physicians to report cases
3. A labor-intensive process that requires local health officials to contact individual physicians to confirm details of many of the case reports
4. Cases rejected because they don’t fit the conservative surveillance definition of Lyme disease

The Lyme disease surveillance process was changed in 2008, with the goal of reducing the burden of the CDC/CTSE complex mandatory Lyme reporting process on resource-strapped state and local health departments. Unfortunately, the resulting revision, which was held behind closed doors with no provision for public comment, did nothing to address the fundamental flaws in the surveillance criteria—it is still based on an inaccurate blood test, an outdated list of Lyme disease symptoms, and a cumbersome reporting process that places an undue burden on state and local health departments.

Instead, the CDC/CTSE revision added more complexity and less transparency to the reporting system, creating three categories for Lyme cases – confirmed, probable and suspected.

The problem with the “suspected” category of Lyme cases is that it allows state health workers who don’t have time to follow up on valid cases, with positive test results or the classic Lyme bulls eye rash, to place them in a list that the CDC never publishes. In addition, the CDC only reports the confirmed cases to the media, never mentioning the probable and suspected cases, or the fact that CDC epidemiologists say that the actual case count could be 6-12 times higher than the reported cases.

The tragedy of this new process is that physicians (and individuals) make diagnostic decisions based on the CDC case numbers, and when cases in their states are underestimated, more Lyme patients will be misdiagnosed. Congress allocates research funding based on the CDC case numbers, too, and by underestimating these numbers by a factor of up to 12, grants will go to other diseases.

[o_mom]

The problem with the “suspected” category of Lyme cases is that it allows state health workers who don’t have time to follow up on valid cases, with positive test results or the classic Lyme bulls eye rash, to place them in a list that the CDC never publishes. In addition, the CDC only reports the confirmed cases to the media, never mentioning the probable and suspected cases, or the fact that CDC epidemiologists say that the actual case count could be 6-12 times higher than the reported cases.



Not to derail the thread, but do you happen to know if a FOIA request has ever been filed for this data?

[Melbel]

Not to derail the thread, but do you happen to know if a FOIA request has ever been filed for this data?

I have no idea, but that is a great question. FWIW, none of our cases were reported by our doctors because they do not meet the very narrow CDC criteria. Although our son's Western Blot test for Lyme lit up like a Christmas tree (he did not have the right combination of bands that many have criticized) and he has improved tremendously on antibiotics, his case does not count. At our next appointment, I will inquire as to whether or not our cases were reported as "probable".

Another issue resulting in underreporting is that local agencies will not report unless you "know" you contracted the disease in that locality. For the many who do not recall a tick bite and who have travelled, this can be very tricky.

ETA: Apparently, the CDC reports "actual" and "probable" cases if you search for it. http://www.cdc.gov/lyme/stats/chartstables/casesbyyear.html and http://www.cdc.gov/lyme/stats/chartstables/reportedcases_statelocality.html. I could not find online reports of "suspected" cases. The general rule is to add the CDC confirmed + probable numbers and multiply by 10 for a more accurate estimate.

[squimp]

The numbers are vastly lower than the actual numbers. These very misleading numbers gave us, and our doctors, a false sense of security with respect to Lyme Disease. The numbers are expected to spike this year due to a perfect storm of ecological factors leading to a large increase in the number of ticks.

If I lived in the eastern US I would feel very insecure looking at that map! I used to live there and it makes me afraid to go outside. I think it is very smart to continue to push for preventative treatment until they have better testing.

The climate this year is definitely creating a perfect storm for diseases. We're having a big West Nile outbreak this year too. DEET is my friend this year.

[MSWR0319]

The numbers are vastly lower than the actual numbers. These very misleading numbers gave us, and our doctors, a false sense of security with respect to Lyme Disease. The numbers are expected to spike this year due to a perfect storm of ecological factors leading to a large increase in the number of ticks. Researchers are finding that the percentages of ticks testing positive for Lyme have also spiked significantly (25% in Texas, a traditionally non-endemic area; 67% of black legged ticks in Ohio; 25-40% in Michigan; 20% of black legged deer ticks in North Carolina;
CDC never publishes. In addition, the CDC only reports the confirmed cases to the media, never mentioning the probable and suspected cases, or the fact that CDC epidemiologists say that the actual case count could be 6-12 times higher than the reported cases.


Melbel, do you have a source for the state percentages? I'd like to show them to my doctor in hopes of getting some more antibiotics until I can find a Lyme doctor.

[Melbel]

Melbel, do you have a source for the state percentages? I'd like to show them to my doctor in hopes of getting some more antibiotics until I can find a Lyme doctor.

I just did a google search and came up with articles as I drafted the reply. I did not always find my original link that I read while drafting my reply earlier, but did come across some BBB threads! In any event, here are some links:

Texas 25%: http://www.researchednutritionals.com/information.cfm?id=275

Ohio 67%: 2010 more than 300 black-legged ticks were captured and tested with 67 percent testing positive for the agent of Lyme disease. http://ourohio.org/home-gardens/keeping-safe/home-and-garden/lyme-disease/
Deer tick surge in OH: http://www.toledoblade.com/local/2012/01/18/Number-of-deer-ticks-surging-across-Ohio.html

Michigan (up to 45 percent of ticks have tested positive for Lyme disease on Western border of Michigan; this is not the link I found earlier, but gets the point across): http://www.michigan.gov/emergingdiseases/0,4579,7-186-25890_26143-95445--,00.html

Pennsylvania (again, not the link I read earlier, but this gets the point across) - "One of our entomologists says that nine out of every 10 black-legged ticks in Pennsylvania is carrying Lyme disease." http://articles.mcall.com/2012-04-02/sports/mc-lyme-disease-prevention-04022012-20120402_1_lyme-disease-black-legged-ticks-adult-ticks

Here are a few stats not in my earlier reply:
http://www.disease-treatment.com/showthread.php?t=72692
(1) Ixodes scapularis ticks in Pennsylvania:

Northwestern PA: 61.6% positive for Lyme disease; 1.9% positive
for Ehrlichiosis
Southeastern PA: 13.1% positive for Lyme disease; 39.8% positive
for Ehrlichiosis
Reported in: Courtney JW; Dryden RL; Montgomery J; et al. Molecular
characterization of Anaplasma phagocytophilum and Borrelia burgdorferi in
Ixodes scapularis ticks from Pennsylvania. Journal of Clinical Microbiology,
41(4):1569-1573. 2003.

(2) Ixodes scapularis ticks in New Jersey:

"Using polymerase chain reaction, we analyzed 529 Ixodes scapularis Say adults
collected from 16 of New Jersey's 21 counties for the presence of Borrelia
burgdorferi, the etiological agent of Lyme disease. Overall, 261 (49.3%) were
positive."
Schulze TL;Jordan RA;Hung RW;Puelle RS;Markowski D;Chomsky MS. Prevalence of
Borrelia burgdorferi in Ixodes scapularis adults in New Jersey, 2000-2001.
J Med Entomol.40(4):555-8. 2003.

(3) Ixodes scapularis ticks in Connecticut:

Woodbridge, CT: 32.9% of nymphal ticks / 52.6% of adult ticks positive
for Lyme disease
Bridgeport, CT: 32.7% of nymphal ticks / 55.0% of adult ticks positive
for Lyme disease
Reported in: Levin ML; des Vignes F; Fish D. Disparity in the natural cycles of
Borrelia burgdorferi and the agent of Human Granulocytic Ehrlichiosis. Emerg
Infect Dis 1999;Vol 5(2)204-8. URL: www.cdc.gov/ ncidod/eid/vol5no2/levin.htm.



ETA: These stats relate to Lyme in deer ticks, not just any type of tick. For example, dog ticks do not carry Lyme. They do however carry other diseases such as Rocky Mountain Spotted Fever.