Lyme Disease

A cluster of 51 children and adults in the town all began experiencing uncommon arthritic symptoms and the cases were reported to the state health department. A quarter of the cases were preceded by a skin lesion. The patients tended to live near the woods.

It's an infectious disease caused by Borrelia burgdorferi bacteria. It's spread through the bite of two species of infected ticks, the Western blacklegged ticks on the West Coast, and Blacklegged ticks found throughout the eastern US. The ticks can transmit the disease at both the nymph and adult stage. It's not known to be transmitted from one person to another via kissing or sex.

Infected blacklegged ticks must typically be attached to a person for more than 24 hours—and often closer to 36—to transmit Lyme. That period is enough time for the bacteria that causes Lyme to migrate from the tick's gut into the person's bloodstream while it's latched on through its bite. (There are rare documented cases of transmission under 24 hours.) Rapid removal of the tick is key to disease prevention.

Minimizing your risk of Lyme and other tickborne diseases hinges on quickly removing ticks. To do so, place tweezers on the animal as close to the skin as possible and then pull directly upwards to try to avoid leaving bits of the tick's body behind. If possible, try to take a photo of the tick to share with your doctor to better identify potential disease risks (since certain tick species can carry specific diseases). Next, dispose of the tick without crushing it in your fingers—flushing it down the toilet, or placing it in alcohol or a sealed bag—and then thoroughly wash the bite area and your hands.

Tick saliva has a variety of built-in assets that enable them to go undetected and continue feeding on their prey: They use saliva to form a hard seal around themselves to keep them in place while they feed for a few days, a numbing agent so you don't feel the bite, and even natural anticoagulants to keep blood from clotting.

The searchable database at the bottom of this webpage allows users to check the reported incidence of Lyme disease in US counties and Canadian health regions. In 2022, for example, Baltimore County in Maryland had a rate of about 34 probable and confirmed cases per 100,000 people. Arlington, County in Virginia was less than half of that for the same time period.

The US states with the highest rate of Lyme disease—meaning cases per 100,000 people—were Rhode Island, Vermont, and Maine, in 2023. Rhode Island had 260 cases per 100,000 people, based on cases reported to the US Centers for Disease Control and Prevention. (Some users may encounter a paywall.)

New York, Pennsylvania, and Massachusetts had the highest total number of Lyme disease cases in 2023. New York had more than 22,000 cases that year. Maine had one of the highest Lyme incidence rates of disease that year—213 per 100,000 people—but only 2,942 cases overall.

As of early 2026, there was no vaccine for Lyme disease available. One candidate vaccine, VLA15, was in later-stage clinical trials. Another designed to provide seasonal protection was licensed to a pharmaceutical company in 2025, and was planned for human clinical trials.

Wild white-footed mice are the main carriers of Lyme. A research team is hoping to genetically engineer mice, using CRISPR, to make the animals immune to Lyme. They're proposing a field trial where they would insert a gene with an antibody to Lyme infection to break the disease transmission cycle on a private island and then try it in Nantucket if that goes well. Simply killing the mice isn't an option because it would upend food webs. Unlike traditional vaccines, this "heritable immunization" would pass from one generation of mice to the next.