| the global distribution of lyme disease. | erythema chronicum migrans (ecm), the skin lesion characteristic of lyme disease, was first described in sweden in 1909; subsequently, cases of ecm have been reported from at least 19 countries on three continents. in europe cases have occurred within the range of ixodes ricinus ticks, the recognized vector of ecm in europe, although one case outside this range has been ascribed to mosquito bites. in 1970 the first case of ecm acquired in the united states was reported, and in 1977, the full sym ... | 1985 | 3885366 |