Lyme disease surveillance summary volume 2, no. 3, April 30, 1991
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    Cases of Lyme disease (LD) reported by States to CDC for 1990 were collated during early April. As in previous years, these data are published provisionally with the expectation that updated reports will continue to arrive over the next few months. The provisional total of 7,995 cases for 1990 is 557 cases (6.5%) less than the final total of 8,552 reported in 1989 (Table 1). In previous years, over 500 late reports have been received after publication of the first provisional figure.

    From 1986 through 1989, nationally reported cases of Lyme disease doubled or nearly doubled each year (Fig. 1). The provisional 1990 data mark a halt in this trend. This may reflect a plateau in case detection, decreased reporting by physicians, or the use of more stringent criteria in defining cases. The new CDC Lyme disease case definition was adopted by the Council of State and Territorial Epidemiologists at its national meeting in April 1990 and became the standard for national reporting in January 1991. Information on the case definition used by each state during 1990 is not yet available.

    The geographic distribution of Lyme disease cases among the 50 states (Fig. 2), and the provisional number of reported cases by federal geographic region (Table 2) show increased reporting from the mid-Atlantic, Pacific, west north-central and east south- central regions. Decreases in reported cases are noted in the northeast, south-Atlantic, west south-central and mountain states. Crude incidence rates by region ranged from a high of 12.9 cases per 100,000 population in the mid-Atlantic states to a low of 0.10/100,000 in the mountain states (Fig. 3).

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