Publications

prevalence of lyme disease infection in oklahoma.	even though lyme disease probably existed in oklahoma prior to 1975 when the disease was first reported in connecticut and even though ecological conditions favor a high prevalence, an unexpectedly low rate was evidenced in both a serological survey and the number of cases reported to the oklahoma state department of health. lyme disease does not appear to pose a significant public health threat in oklahoma at the present time; however, the the presence of all the necessary factors for transmiss ...	1992	1404480
persistence of serum antibodies to borrelia burgdorferi in patients treated for lyme disease.	to determine if antibodies to borrelia burgdorferi persist after antibiotic treatment, we recalled 32 patients with lyme disease from a primary care practice a mean of 16 months after treatment and analyzed initial and follow-up serum samples by elisa and immunoblot assays. of the eight patients whose initial serum specimens were positive for igm antibody by elisa, three had positive titers of igm antibody at follow-up; of the 23 patients whose initial serum specimens were positive for igg antib ...	1992	1445977
human babesiosis in new york state: an epidemiological description of 136 cases.	epidemiological data on 136 cases of human babesiosis reported from laboratories and clinicians in the state of new york from 1982 to 1991 were reviewed. all but two patients, who had traveled to nantucket island in massachusetts, acquired disease in suffolk county, long island. the highest average age-group-specific annual incidence rates occurred among men > or = 80 years of age (7.72 per 100,000) and among women 70-79 years of age (3.61 per 100,000). seven patients (5%) had previously undergo ...	1992	1457632
third-year evaluation of host-targeted permethrin for the control of ixodes dammini (acari: ixodidae) in southeastern connecticut.	the impact of commercially available permethrin-treated cotton balls targeted at ixodes dammini spielman, clifford, piesman & corwin on white-footed mice, peromyscus leucopus, was evaluated for a third year at five residential sites in south-central connecticut. each site had been treated twice each year from 1989 through 1991 with sufficient product to treat 0.4 ha of mouse habitat, and results were compared with five untreated sites. there were no significant differences in the number of host- ...	1992	1495085
relationship between development of antibodies to borrelia burgdorferi in dogs and the subsequent development of limb/joint borreliosis.	the relationship between antibody production and the subsequent development of limb/joint disorders of borreliosis was examined in dogs from south central connecticut. dogs without signs of illness, determined by physical examination, were selected from dogs being tested for dirofilaria immitis. an elisa was used to detect antibodies to borrelia burgdorferi in 234 apparently healthy dogs during 1988. these dogs were monitored for 20 months after initial analyses to determine the prevalence of li ...	1992	1548169
dna analysis of borrelia burgdorferi nch-1, the first northcentral u.s. human lyme disease isolate.	the dna of the first northcentral united states human lyme disease isolate, borrellia burgdorferi nch-1, was characterized and compared with the dnas of nine other b. burgdorferi isolates. strain nch-1 was isolated in august 1989 from a human skin biopsy specimen. dna was analyzed by pulsed-field gel electrophoresis and restriction endonuclease analysis. contour-clamped homogeneous electric field pulsed-field gel electrophoresis of in situ-lysed cells was performed to compare the plasmid profile ...	1992	1551988
babesiosis: an underdiagnosed disease of children.	babesiosis is a malaria-like illness caused by the intraerythrocytic parasite babesia microti and is transmitted by the same tick that transmits borrelia burgdorferi, the causative agent of lyme disease. babesiosis is well recognized in adult residents of southern new england and new york but has been described in only five children. to determine whether children are infected with b microti less often than are adults, a prospective serosurvey was carried out on block island, ri, where babesiosis ...	1992	1594345
antibodies to borrelia burgdorferi in rodents in the eastern and southern united states.	serologic studies were conducted to determine whether white-footed mice (peromyscus leucopus) and cotton mice (peromyscus gossypinus) contained serum antibodies to borrelia burgdorferi, the causative agent of lyme borreliosis. enzyme-linked immunosorbent assays detected antibodies to this spirochete in 35.7 and 27.3% of 56 p. leucopus and 535 p. gossypinus serum samples, respectively, collected in connecticut, north carolina, south carolina, georgia, florida, alabama, and mississippi. antibody t ...	1992	1624561
lyme disease knowledge, attitudes, and behaviors--connecticut, 1992.	lyme disease (ld), caused by infection with the spirochete borrelia burgdorferi, is the most commonly reported tick-borne illness in the united states (1). because no vaccine is available and effective measures to control tick populations are experimental, education is the most important approach to preventing ld. ld was identified in connecticut in 1975 (2); in 1991, connecticut had the highest rate of ld in the united states (36 per 100,000 population), and cases were reported in residents fro ...	1992	1630426
babesia microti, human babesiosis, and borrelia burgdorferi in connecticut.	babesia microti was isolated from a white-footed mouse (peromyscus leucopus) that was captured in southeastern connecticut in 1988, when the first human case of babesiosis acquired in connecticut was recognized. to date, 13 cases of babesiosis have been reported in connecticut, the largest number of human cases reported on the mainland united states. two of nine patients quiried remembered a prior tick bite. since babesia parasites are known to be vectored only by ticks, we surmise that 12 of th ...	1991	1757548
antibodies to borrelia burgdorferi in deer and raccoons.	an enzyme-linked immunosorbent assay (elisa) was developed to detect serum antibodies to borrelia burgdorferi, the causative agent of lyme borreliosis, in deer (odocoileus virginianus) and raccoons (procyon lotor). blood samples were collected from these mammals in connecticut, maryland, north carolina, georgia and florida. seropositivity for deer was highest in connecticut (56% of 353 sera) and maryland (51% of 35 sera). raccoons in connecticut, maryland, north carolina, and florida also had an ...	1991	1758022
spotted fever group rickettsiae or borrelia burgdorferi in ixodes cookei (ixodidae) in connecticut.	immatures and females of ixodes cookei, a hard-bodied tick, were collected from woodchucks and other mammals in the northeastern united states and examined for spotted fever group rickettsiae and borrelia burgdorferi. of the 93 nymphs analyzed by a hemolymph test, 4 (4.3%) harbored rickettsiae. six (15%) of 40 females were also infected. all infected ticks were collected from woodchucks in connecticut. indirect fluorescent antibody staining of midgut tissues from 128 nymphs revealed b. burgdorfe ...	1991	1885748
effectiveness of host-targeted permethrin in the control of ixodes dammini (acari: ixodidae)	tubes of commercially available permethrin-treated cotton balls were distributed twice each year in 1989 and 1990 at five sites in a lyme disease endemic area in connecticut. five additional sites were not treated. at each application, 48 tubes, sufficient to treat 0.4 ha, were dispersed at 10-m intervals through woodlands, around ornamental plantings, and along rockwalls. the cotton was collected by white-footed mice (peromyscus leucopus) from the majority of the tubes, which resulted in a decr ...	1991	1941927
geographical and temporal distribution of babesial infection in connecticut.	human babesiosis was first recognized in connecticut in 1989, nearly 15 years after lyme disease, a similarly transmitted spirochetosis, was detected in the state. to determine the seroprevalence for the babesial pathogen and whether it was recently introduced, we used an indirect immunofluorescence assay to test for babesia microti antibody in 1,285 connecticut residents. four groups were studied: i, people seropositive for lyme disease, tested from 1986 to 1989; ii, randomly selected outpatien ...	1991	1993742
lyme disease surveillance--united states, 1989-1990.	surveillance for lyme disease (ld) was initiated by cdc in 1982 (1), and in january 1991, ld became nationally reportable (2). forty-six states reported cases in 1989 and 1990 (figure 1), but the occurrence in nature of the causative bacterium, borrelia burgdorferi, has not been documented in all of these states. from 1982 through 1989, the annual reported number of cases of ld increased 18-fold (from 497 to 8803, respectively) and from 1986 through 1989, nearly doubled each year (figure 2). the ...	1991	2046649
lyme carditis. severe conduction disorder.	lyme disease in most cases occurs in the states of connecticut, wisconsin, oregon, california, missouri and parts of the northeastern coast. showing the exception to the rule, the authors discuss a case in which a patient acquired the disease on the eastern shore of virginia.	1990	2304446
persistence of antibodies to borrelia burgdorferi in dogs of new york and connecticut.	multiple blood samples were obtained from privately owned dogs living in tick-infested areas of new york (westchester county) and connecticut, where lyme disease in human beings has been reported. of the 175 dogs examined, 127 (72.6%) had limb/joint disorder, whereas the remaining 48 dogs were considered healthy. results of analysis of 419 serum samples revealed igm antibody to borrelia burgdorferi in healthy and lame dogs during all seasons. prevalence of seropositivity was significantly (p les ...	1990	2329074
lyme disease. the hidden pandemic.	physicians will recognize lyme disease faster if they maintain a high index of suspicion in a young patient with arthritis accompanied by negative rheumatoid factor and antinuclear antibody in combination with cardiac conduction problems or lymphocytic meningitis. the lyme spirochete (borrelia burgdorferi) has notable sensitivity to tetracycline, penicillin, and erythromycin; therefore, proper and complete treatment of the disease, once it is identified, can be easily achieved. finkel observed t ...	1989	2648375
a connecticut housewife in francis bacon's court: polly murray and lyme disease.		1989	2682690
lyme disease surveillance in the united states, 1983-1986.	during 1983-1986, 5,016 cases of lyme disease were reported to the centers for disease control. cases were acquired in 31 states; however, 86% of the cases were acquired in seven states: massachusetts, rhode island, connecticut, new york, new jersey, wisconsin, and minnesota. for 63% of patients the disease began in summer; 52% recalled a tick bite. erythema chronicum migrans (ecm) occurred in 91% of the patients; arthritis, in 57%; neurologic complications, in 18%; and cardiac manifestations, i ...	2009	2682955
epidemiological and clinical features of 1,149 persons with lyme disease identified by laboratory-based surveillance in connecticut.	laboratory-based surveillance of lyme disease in connecticut during 1984 and 1985 identified 3,098 persons with suspected lyme disease; 1,149 were defined as cases. lyme disease incidence in connecticut towns ranged from none to 1,407 cases per 100,000 population in 1985. a comparison of 1985 data with data from 1977 epidemiologic studies indicated that incidence increased by 129 percent to 453 percent in towns previously known to be endemic for lyme disease and that lyme disease had spread nort ...	2013	2683415
the epidemiology of lyme disease in connecticut.	the overall incidence for lyme disease for connecticut residents in 1988 was 22 per 100,000. the highest rates were among residents of new london (108 per 100,000) and middlesex counties (72 per 100,000), although the greatest increase in incidence between 1985 and 1988 occurred among residents of fairfield county (2 per 100,000 in 1985, 14 per 100,000 in 1988). lyme disease is a statewide problem; in 1988 cases were reported among residents of 104 of connecticut's 169 towns and cities. the dise ...	2009	2758819
national surveillance of lyme disease, 1987-1988.	in 1987 and 1988, 6876 lyme disease cases from 43 states were reported to the centers for disease control. the 4507 cases reported in 1988 was nearly double the case number reported in 1987, and ninefold the number reported in 1982, when a systematic system of national surveillance was established. the average annual incidence of reported lyme disease in the united states in 1987-1988 was 1.4/100,000. new york led the nation in reported cases in 1988 with 57% of the cases reported nationally. ei ...	1989	2758820
reinfection with borrelia burgdorferi.		1989	2758830
lyme disease--connecticut.		1988	3122001
ticks and biting insects infected with the etiologic agent of lyme disease, borrelia burgdorferi.	members of 18 species of ticks, mosquitoes, horse flies, and deer flies were collected in southeastern connecticut and tested by indirect fluorescent-antibody staining methods for borrelia burgdorferi, the etiologic agent of lyme disease. an infection rate of 36.2% (116 tested), recorded for immature ixodes dammini, exceeded positivity values for all other arthropod species. prevalence of infection for hematophagous insects ranged from 2.9% of 105 hybomitra lasiophthalma to 14.3% of seven hybomi ...	1988	3170711
new borrelia burgdorferi antigenic variant isolated from ixodes dammini from upstate new york.	a previously undescribed borrelia burgdorferi antigenic variant was isolated from each of four ixodes dammini larvae removed from white-footed mice, peromyscus leucopus, captured in millbrook, n.y. this site is in the northern range of the known distribution of the tick in the northeastern united states. the molecular weights of approximately 32,500 and 35,500 for outer surface a and outer surface b proteins, respectively, were distinctly higher than those for previously characterized isolates f ...	1988	3183008
the geographic distribution of lyme disease in the united states.	in 1982, national surveillance for lyme disease was established by the centers for disease control to monitor trends and determine endemic geographic areas. initially, the endemic areas corresponded to the known distribution of ixodes dammini, a five-state area of the northeastern seaboard (new york, new jersey, connecticut, rhode island, and massachusetts) and wisconsin and minnesota. increasing numbers of cases have been reported outside these areas, however, 86% of the provisional 5731 cases ...	1988	3190099
lyme disease--connecticut.		1988	3233680
leads from the mmwr. lyme disease--connecticut.		1988	3276944
borreliosis in equids in northeastern united states.	during 1982 and 1985, blood samples from 705 equids were examined for antibodies to borrelia burgdorferi. by indirect immunofluorescence staining, igm and total immunoglobulin (igm and igg) antibodies were detected in 37 (5.3%) and 90 (12.8%) serum specimens, respectively. the geometric mean titer for igm antibody (140.4) was highest during july, whereas total immunoglobulin ranged from 94.1 in october to 338 in may. eighty-six equids with total immunoglobulin to b burgdorferi lived in areas of ...	1988	3282461
clinical and serologic studies of canine borreliosis.	during 1984 and 1985, blood samples were obtained from 271 dogs that were suspected of having borreliosis. the dogs lived in areas known to be infested with ticks and had been examined because of limb/joint disorders or for unknown illnesses marked by fever, anorexia, or fatigue. lameness had been the most frequently reported clinical manifestation. analyses of serum specimens, by an indirect fluorescent antibody (ifa) method or by an elisa, detected antibodies to borrelia burgdorferi, the etiol ...	1987	3319989
immunoblot analysis of immunoglobulin g response to the lyme disease agent (borrelia burgdorferi) in experimentally and naturally exposed dogs.	immunoblots were used to study the immunoglobulin g response to borrelia burgdorferi in experimentally and naturally exposed dogs. adsorption studies confirmed that the antibodies were specific for b. burgdorferi. experimentally exposed dogs were asymptomatic. naturally exposed dogs included both asymptomatic animals and animals showing signs compatible with lyme disease. naturally exposed dogs were from four geographic regions of the country. no differences were detected between immunoblot patt ...	1988	3366860
serologic analyses of peromyscus leucopus, a rodent reservoir for borrelia burgdorferi, in northeastern united states.	an enzyme-linked immunosorbent assay (elisa) and indirect fluorescent-antibody test were used to detect antibodies to borrelia burgdorferi, the causative agent of lyme disease, in peromyscus leucopus (white-footed mouse). of the 661 mice captured in connecticut, rhode island, and new york during 1980 and 1983 to 1987, 166 (25.1%) had antibodies to b. burgdorferi by elisa. comparative analyses of 210 serum specimens, collected in areas where lyme disease is endemic, revealed a threefold differenc ...	1988	3384925
spirochetes in ticks and antibodies to borrelia burgdorferi in white-tailed deer from connecticut, new york state, and north carolina.	ticks were screened for spirochetes and serum samples from white-tailed deer (odocoileus virginianus) were assayed for antibodies to borrelia burgdorferi during 1983-1984. using fluorescein isothiocyanate-labeled rabbit antibodies produced to b. burgdorferi, the etiologic agent of lyme disease, spirochetes were detected in ixodes dammini (10.5% of 1,193) and dermacentor albipictus (0.6% of 157) adults from connecticut, i. dammini nymphs (49.1% of 108) and adults (64.7% of 99) from armonk, new yo ...	1986	3520030
culturing borrelia burgdorferi from spleen and kidney tissues of wild-caught white-footed mice, peromyscus leucopus.	borrelia burgdorferi was isolated most frequently from tissue of spleen (n = 13) and kidney (n = 10) and less often from blood (n = 5) of wild-caught peromyscus leucopus. prevalence of infection tended to be highest at sites where lyme disease was most common (e.g., 5 of 6 mice were positive in east haddam, connecticut). spirochetes were not isolated in danbury or new hartford, areas where this malady is rare. however, in fairfield, where the disease is also uncommon, 4 of 9 mice were infected. ...	1986	3577490
comparison of rates of infection by the lyme disease spirochete in selected populations of ixodes dammini and amblyomma americanum (acari: ixodidae).	at a major endemic focus in new jersey, 50% of 290 adult ixodes dammini collected in the fall of 1984 were infected with the lyme disease spirochete (borrelia burgdorferi), which was statistically higher than the rate found in the 202 adult ticks (39.6%) examined during the spring. neither sex nor site of collection within the focus significantly affected the infection rate. the observed infection rates were similar to those reported in endemic areas of new york and connecticut. borrelia burgdor ...	1986	3577494
identification of endemic foci of lyme disease: isolation of borrelia burgdorferi from feral rodents and ticks (dermacentor variabilis).	borrelia burgdorferi, the etiological agent of lyme disease, was isolated from the blood, kidneys, spleens, eyes, or livers of white-footed mice (peromyscus leucopus) (n = 19 of 22) and from the blood, kidneys, or spleens of eastern chipmunks (tamias striatus) (n = 2 of 2) captured at three foci for lyme disease in eastern connecticut. these bacteria were cultured most frequently from spleens (n = 19) and kidneys (n = 15). b. burgdorferi persisted in one mouse for at least 60 days. one spirochet ...	1985	3926816
borreliosis in dogs from southern connecticut.	blood samples were obtained from dogs in tick-infested regions of southern connecticut to assess canine exposure to borrelia burgdorferi, the etiologic agent of lyme disease in human beings. an indirect fluorescent antibody test detected immunoglobulin (ig)m antibodies at titers of 1:64 to 1:512 in 22 of 84 serum samples previously shown to be positive with a polyvalent rabbit anti-dog total ig conjugate. analyses of paired serum samples from 20 seropositive dogs revealed temporal differences in ...	1985	3997647
arthritis caused by borrelia burgdorferi in dogs.	from october 1982 to may 1984, we studied 34 dogs from the lyme, conn area that had a history of tick exposure and lameness associated with pain, warmth, and/or swelling in one or more joints. large numbers of polymorphonuclear leukocytes were seen in giemsa-stained smears of synovial fluid from 9 dogs, and spirochetes (borrelia burgdorferi) were found in 1 sample by darkfield microscopy and immunoperoxidase techniques. the geometric mean antibody titer to b burgdorferi in the 34 dogs was 1:2,70 ...	1985	3997648
facial paralysis in lyme disease.	lyme disease is a multisystemic illness caused by a tick-borne spirochete. once considered unique to the connecticut coastline, thousands of cases are now documented throughout the united states, northern europe, and australia. unilateral and bilateral facial paralysis may occur in up to 11% of patients with lyme disease. this paper reviews the clinical course, distinguishing features, and outcome of 124 such palsies in 101 patients seen between 1975 and 1984. the 99.2% spontaneous recovery rate ...	1985	4058212
geographic distribution of humans, raccoons, and white-footed mice with antibodies to lyme disease spirochetes in connecticut.	an indirect immunofluorescence test was used during 1982-1983 to identify antibodies to lyme disease spirochetes in humans, white-footed mice, and raccoons. serologic tests detected igm or total ig antibodies in serum samples from 67 persons. onset of illness, as marked by erythema chronicum migrans (ecm), occurred mainly during july and august. the majority of the persons with lyme disease lived in south central and southeastern connecticut. analyses also verified prior spirochetal infections i ...	1984	6516459
avian and mammalian hosts for spirochete-infected ticks and insects in a lyme disease focus in connecticut.	spirochetes and their vectors and reservoirs were studied in a lyme disease focus in east haddam, connecticut, from mid-may through september 1983. ixodes dammini subadults were comparable in number on white-footed mice (peromyscus leucopus) (means = 2.9 +/- 3.6 sd) to those on 27 different species of birds (means = 2.3 +/- 4.2 sd) representing 11 families within the order passeriformes. less commonly found ticks on birds (means less than or equal to 0.1) were immature ixodes dentatus and haemap ...	1984	6516460
lyme disease in northern california.	lyme disease is a recently described clinical entity with cutaneous, neurologic, articular and cardiac manifestations. since the original description of the disease in 1977, more than 500 cases have been reported. although the vast majority of patients have been from the area near lyme, connecticut, we have seen four patients from northern california with various aspects of lyme disease. this diagnosis should be considered in patients who have traveled to tick regions and who have a distinctive ...	1983	6636745
parasitism by ixodes dammini (acari: ixodidae) and antibodies to spirochetes in mammals at lyme disease foci in connecticut, usa.		1984	6694176
antibodies to spirochetes in white-tailed deer and prevalence of infected ticks from foci of lyme disease in connecticut.	white-tailed deer (odocoileus virginianus) were examined for the tick, ixodes dammini, and sera were analyzed for antibodies to spirochetes during 1982. of the 323 animals inspected in four areas endemic for lyme disease, 188 (58%) had adult ticks; parasitism ranged from 43% at haddam to 82% at east lyme. direct and indirect fluorescent antibody tests detected spirochetes in 18 of 133 (14%) ticks. indirect immunofluorescence tests revealed antibodies at titers of 1:64-1:4,096 to this bacterium i ...	1984	6716556
occurrence of erythema chronicum migrans and lyme disease among children in two noncontiguous connecticut counties.	in may-november 1977 erythema chronicum migrans of lyme arthritis occurred in at least 12 children in new london county, connecticut, east of the original 3-town epidemic focus. the attack rate (0.15 cases per 1,000 persons under 18) was considerably lower than within the focus itself but similar to the rate in towns west of the focus. no cases were identified in litchfield county in northwest connecticut. observed rates of lyme disease varied markedly within connecticut in 1977.	1981	7326064
ticks (acari: ixodidae) infesting wild birds (aves) and white-footed mice in lyme, ct.	birds were captured and recaptured (20.8% of 5,297) with japanese mist nets, and white-footed mice, peromyscus leucopus (rafinesque), were caught and recaught (69.1% of 355) with sherman box traps during the late spring, summer, and early fall from july 1989 through october 1991 to study tick-host relationships in lyme, ct. ixodes scapularis say, a vector of lyme disease spirochetes, borrelia burgdorferi sensu stricto johnson, schmid, hye, steigerwalt & brenner, infested 803 birds (15.2%) in 36 ...	1995	7650706
borrelia burgdorferi in an urban environment: white-tailed deer with infected ticks and antibodies.	ticks and blood samples were collected from white-tailed deer (odocoileus virginianus) in forests located in an insular, urban area of bridgeport, conn., and in rural south central connecticut during 1992 and 1993. immature and adult ixodes scapularis ticks were tested for borrelia burgdorferi, the etiologic agent of lyme borreliosis, by indirect fluorescent-antibody staining methods. deer sera were analyzed for antibodies to this bacterium by an enzyme-linked immunosorbent assay. infected ticks ...	1995	7751354
prospective assessment of lyme disease in a school-aged population in connecticut.	to determine the incidence and cumulative frequency of lyme disease in a school-aged population in an area in which lyme disease is endemic, serum specimens were obtained before and after the 1990-1992 tick seasons from 410 middle and high school students in southeastern connecticut. sera were tested for serologic evidence of infection with borrelia burgdorferi, and students were questioned about physician-confirmed episodes of clinical lyme disease. at enrollment, 29 (7%) students had a history ...	1995	7751720
childhood neurologic disorders and lyme disease during pregnancy.	to determine the prevalence of clinically significant nervous system disease attributable to transplacental transmission of borrelia burgdorferi, we surveyed neurologists in areas of the united states in which lyme disease is endemic (i.e., massachusetts, rhode island, connecticut, new york, new jersey, wisconsin, and minnesota). overall, 162 of the 176 (92%) pediatric neurologists contacted responded to the survey with a range of 90-100% in the different geographic areas. one pediatric neurolog ...	1994	7986291
the risk of acquiring lyme disease or babesiosis from a blood transfusion.	to determine the risk of acquiring lyme disease or babesiosis from blood transfusion, serum was collected before and 6 weeks after patients received multiple transfusions during cardiothoracic surgery and antibodies to borrelia burgdorferi and babesia microti were measured. of 155 subjects, 149 received 601 total units of packed red blood cells (prbc) and 48 received 371 total units of platelets. no patient developed clinical or serologic evidence of lyme disease; 1 (who received 5 units of prbc ...	1994	8014507
detection of borrelia burgdorferi in urine of peromyscus leucopus by inhibition enzyme-linked immunosorbent assay.	an inhibition enzyme-linked immunosorbent assay was developed to detect borrelia burgdorferi, the etiologic agent of lyme borreliosis, in urine from white-footed mice (peromyscus leucopus). of the 87 urine specimens tested from 87 mice collected in widely separated tick-infested sites in connecticut, 57 (65.5%) contained detectable concentrations of spirochetal antigens. forty-seven (62.7%) of 75 serum samples analyzed contained antibodies to b. burgdorferi. in culture work with tissues from bla ...	1994	8195393
geographic distribution of white-tailed deer with ticks and antibodies to borrelia burgdorferi in connecticut.	ticks and blood specimens were collected from white-tailed deer (odocoileus virginianus) in connecticut and analyzed to identify foci for lyme borreliosis. males and females of ixodes scapularis, the chief vector of borrelia burgdorferi, were collected from deer in five of eight counties during 1989-1991. analysis by indirect fluorescent antibody (ifa) staining of midgut tissues showed that prevalence of infection was highest (9.5% of 367 ticks) in south central and southeastern connecticut. inf ...	1993	8256460
reduced abundance of ixodes scapularis (acari: ixodidae) with exclusion of deer by electric fencing.	to assess the effect of deer exclusion on populations of ixodes scapularis say (formerly i. dammini spielman, clifford, piesman & corwin) in the northeastern united states, host-seeking ticks and ticks on white-footed mice, peromyscus leucopus (rafinesque), were monitored inside and outside a wooded, residential deer exclosure (approximately 3.5 ha) in lyme, ct, in 1991 and 1992. another deer exclosure was added in lyme (approximately 7.4 ha) during 1992. additional sample sites at other residen ...	1993	8271257
public awareness of lyme disease in obstetric, pediatric, and student settings in northwestern connecticut.	the purpose of this study has been to survey the attitudes and understandings of lyme disease by pregnant women, mothers, and ninth-grade students in northwestern connecticut. a sample of 100 obstetrical patients from two private obstetric offices, 100 mothers from four private pediatric offices, and 200 students from four secondary schools was asked to complete a 15 question survey about lyme disease. in all groups, the responses indicated some misconceptions or a lack of knowledge about the ma ...	1993	8275686
spatial and temporal patterns of ixodes scapularis (acari: ixodidae) in southeastern connecticut.	the spatial distribution and abundance of host-seeking ixodes scapularis say (formerly i. dammini) were studied in 10 residential sites in woodlands during 1989-1991. in total, 7,385 larval, 2,202 nymphal, 164 female, and 248 male i. scapularis were collected in old lyme, lyme, east haddam, and chester, ct. the majority of host-seeking i. scapularis larvae (84.2%) and nymphs (73.5%) were collected within the woodland plots, whereas a large proportion of the adults were recovered from lawn (36.4% ...	1993	8360900
early lyme disease: a flu-like illness without erythema migrans.	the existence of a form of early lyme disease characterized by a flu-like illness without erythema migrans is controversial. to confirm the existence and define the clinical characteristics of the flu-like illness without erythema migrans of localized lyme disease, the authors studied patients from a lyme disease endemic area of connecticut who visited their primary care physicians with an undefined flu-like illness. patients kept a diary of their symptoms. acute and convalescent sera were obtai ...	1993	8424027
physician reporting of lyme disease--connecticut, 1991-1992.	although disease reporting by physicians is an essential component of public health surveillance, the extent of physician participation in reporting specific diseases is not routinely assessed. as part of an evaluation of lyme disease (ld) surveillance, the connecticut department of health services (cdhs) conducted a study to determine the number and specialty of connecticut physicians who reported ld cases in 1991 and/or 1992. this report summarizes the results of this study.	1993	8483441
from the centers for disease control and prevention. physician reporting of lyme disease--connecticut, 1991-1992.		1993	8492391
coexistence of antibodies to tick-borne pathogens of babesiosis, ehrlichiosis, and lyme borreliosis in human sera.	serum specimens from persons with or without lyme borreliosis were analyzed by indirect fluorescent antibody staining methods for total immunoglobulins to babesia microti, ehrlichia chaffeensis (arkansas strain), and ehrlichia equi (mrk strain). there was serologic evidence of human exposure to multiple tick-borne agents in 15 (6.6%) of 227 serum samples obtained in connecticut and minnesota. of these, 10 serum samples were from connecticut patients who had erythema migrans and antibodies to bor ...	1995	8576376
analyses of mammalian sera in enzyme-linked immunosorbent assays with different strains of borrelia burgdorferi sensu lato.	blood samples were collected from cottontail rabbits (sylvilagus floridanus), raccoons (procyon lotor), white-footed mice (peromyscus leucopus), and white-tailed deer (odocoileus virginianus) between 1977 and 1991 in southern connecticut and new york state (usa) and were tested for antibodies against eight strains of borrelia burgdorferi sensu lato in enzyme-linked immunosorbent assays. among these spirochetes were six strains of b. burgdorferi sensu stricto, one strain of b. garinii (=ip90) and ...	1995	8583632
concurrent lyme disease and babesiosis. evidence for increased severity and duration of illness.	to determine whether patients coinfected with lyme disease and babesiosis in sites where both diseases are zoonotic experience a greater number of symptoms for a longer period of time than those with either infection alone.	1996	8637139
human granulocytic ehrlichiosis in connecticut: report of a fatal case.	we report a case of granulocytic ehrlichiosis in a 71-year-old man who presented with an acute febrile illness and subsequently developed multisystem organ dysfunction and sudden severe anemia with thrombocytopenia requiring intensive care, mechanical ventilation, hemodialysis, and transfusions. the diagnosis was suspected on the fifth hospital day after a peripheral blood smear was examined; intracytoplasmic inclusion bodies were present in granulocytes only. results of serological tests of acu ...	1995	8645839
lyme disease in children in southeastern connecticut. pediatric lyme disease study group.	although the incidence of lyme disease is highest in children, there are few prospective data on the clinical manifestations and outcomes in children.	1996	8857006
presence of ixodiphagus hookeri (hymenoptera: encyrtidae) in two connecticut populations of ixodes scapularis (acari: ixodidae).	two connecticut populations of the black-legged tick, ixodes scapularis (say), the vector of lyme disease spirochetes, borrelia bugrdorferi sensu stricto johnson, schmid, hyde, steigerwalt & brenner, in the northeastern united states, are parasitized by the encyrtid wasp ixodiphagus hookeri (howard), formerly hunterellus hookeri. the wasp was first detected in ticks from a forested site in bridgeport in 1992. i. hookeri was reared from 18.6% of 148 host-seeking i. scapularis nymphs. in 1993 and ...	1996	8906928
a case of concurrent presentation of human ehrlichiosis and lyme disease in connecticut.	this is a case of a long-term connecticut resident who presented with both human granulocytic ehrlichiosis and lyme disease. the etiologic agents and the probability of coinfection are discussed.	1996	8908776
lyme disease in perspective.		1996	9136546
antibodies to multiple tick-borne pathogens of babesiosis, ehrlichiosis, and lyme borreliosis in white-footed mice.	serum samples from peromyscus leucopus (white-footed mouse), collected in connecticut (usa) in 1983, 1985, and during 1990 to 1993, were analyzed by an enzyme-linked immunosorbent assay (elisa) or indirect fluorescent antibody (ifa) staining methods for antibodies to borrelia burgdorferi (strain 2591), babesia microti, ehrlichia chaffeensis (arkansas strain), and ehrlichia equi (mrk strain). of the 294 serum samples tested, 160 (54%) contained immunoglobulins to one or more of these pathogens. t ...	1997	9249691
antibodies to ehrlichia equi in dogs from the northeastern united states.	to determine whether dogs living in tickinfested areas of the northeastern united states had been exposed to ehrlichia equi, an etiologic agent of granulocytic ehrlichiosis.	1997	9364226
predisposing factors for individuals' lyme disease prevention practices: connecticut, maine, and montana.	this study examined factors that predispose individuals to protect against lyme disease.	1997	9431299
residential setting as a risk factor for lyme disease in a hyperendemic region.	the hypothesis that residence in a uniform medium-density residential development is associated with lower incidence of lyme disease is tested with data from a rural, 12-town region of south-central connecticut where the disease is hyperendemic. the residential setting for 424 cases identified by active surveillance from 1993 through 1995 was determined. cases located within the eastern coastal ecologic region, where tick densities are known to be higher than inland and where most of the populat ...	1998	9525534
temporal correlations between tick abundance and prevalence of ticks infected with borrelia burgdorferi and increasing incidence of lyme disease.	the abundance of host-seeking ixodes scapularis nymphs, the principal vector for the lyme disease agent, borrelia burgdorferi, in old lyme, lyme, and east haddam, connecticut, was compared with the incidence of reported human lyme disease in the 12-town area around the connecticut river and the state of connecticut for the period 1989 to 1996. ticks were sampled from lawns and woodlands by dragging flannel over the vegetation and examined for the presence of b. burgdorferi by indirect fluorescen ...	1998	9574684
viable borrelia burgdorferi in the urine of two clinically normal horses.		1998	9576355
human exposure to a granulocytic ehrlichia and other tick-borne agents in connecticut.	indirect fluorescent-antibody (ifa) staining methods with ehrlichia equi (mrk or bds strains) and western blot analyses containing a human granulocytic ehrlichiosis (hge) agent (nch-1 strain) were used to confirm probable human cases of infection in connecticut during 1995 and 1996. also included were other tests for ehrlichia chaffeensis, the agent of human monocytic ehrlichiosis (hme), babesia microti, and borrelia burgdorferi. thirty-three (8.8%) of 375 patients who had fever accompanied by m ...	1998	9738027
a proposal for the reliable culture of borrelia burgdorferi from patients with chronic lyme disease, even from those previously aggressively treated.	since culture of borrelia burgdorferi from patients with chronic lyme disease has been an extraordinarily rare event, clarification of the nature of the illness and proving its etiology as infectious have been difficult. a method for reliably and reproducibly culturing b. burgdorferi from the blood of patients with chronic lyme disease was therefore sought by making a controlled blood culture trial studying 47 patients with chronic lyme disease. all had relapsed after long-term oral and intraven ...	1998	9861561
underreporting of lyme disease by connecticut physicians, 1992.	to determine the magnitude of underreporting of lyme disease, a random sample of connecticut physicians was surveyed in 1993. the magnitude of underreporting was assessed by comparing physician estimates of lyme disease diagnoses with reports of lyme disease sent by physicians to the connecticut lyme disease surveillance system. complete questionnaires were returned by 59 percent (412/698) of those surveyed. of the 224 respondents who indicated that they had made a diagnosis of lyme disease in 1 ...	1996	10186700
infections of granulocytic ehrlichiae and borrelia burgdorferi in white-tailed deer in connecticut.	serum or whole blood samples, obtained from 141 white-tailed deer (odocoileus virginianus) in connecticut (usa) during 1980, 1991, and 1996, were analyzed to detect past or current infections of ehrlichia phagocytophila genogroup organisms and borrelia burgdorferi. when the bds or nch-1 strains of granulocytic ehrlichiae were used separately in indirect fluorescent antibody (ifa) staining methods, antibody positivity rates varied from 25 to 64% in 1991 and 1996, respectively. all 50 sera tested ...	1999	10231753
differences are voiced by two lyme camps at a connecticut public hearing on insurance coverage of lyme disease.		2000	10742331
the emergence of another tickborne infection in the 12-town area around lyme, connecticut: human granulocytic ehrlichiosis.	human granulocytic ehrlichiosis (hge) is an emerging tickborne infection, increasingly recognized in areas in which lyme disease is endemic, but there are few data on the incidence of hge. prospective population-based surveillance was conducted in the 12-town area around lyme, connecticut, by means of both active and passive methods, from april through november of 1997, 1998, and 1999. five hundred thirty-seven residents presenting to their primary care provider with an acute febrile illness sug ...	2000	10751139
geographic clustering of an outer surface protein a mutant of borrelia burgdorferi. possible implications of multiple variants for lyme disease persistence.	dna sequences encoding full-length outer surface protein (osp) a were amplified from four joint fluid samples over 4.5 months from a patient with chronic lyme arthritis, with a variant from wild type only found in sample 3. rather than a mutation in vivo, these findings suggested a mixed infection in which borrelia: containing the wild-type and mutant ospa were waxing and waning in the patient's joint. if so, we reasoned that the mutant should be present in the community. we therefore took the n ...	2000	10852986
reactivity of dog sera to whole-cell or recombinant antigens of borrelia burgdorferi by elisa and immunoblot analysis.	enzyme-linked immunosorbent assays (elisas) with separate preparations of 10 purified recombinant antigens of borrelia burgdorferi sensu stricto were used to test sera from 36 dogs not vaccinated with whole cells of this agent and from five dogs vaccinated with whole-cell b. burgdorferi bacteria. all dogs lived in tick-infested areas of connecticut and south-eastern new york state, usa. the non-vaccinated dogs had limb or joint disorder, lameness and fever during the period 1984-1991 and had ant ...	2001	11599738
management of tick bites and early lyme disease: a survey of connecticut physicians.	practice guidelines have been published for the treatment of lyme disease (ld). these guidelines have been challenged as inadequate. two common ld management problems are antibiotic prophylaxis of deer tick bites (deer ticks may carry borrelia burgdorferi, the spirochete that causes ld) and antibiotic treatment of erythema migrans, the pathognomonic rash of ld. a 1-page questionnaire was sent to a 13% (573/4300) sample of connecticut physicians to define how they treat deer tick bites and erythe ...	2001	11731662
comparative reactivity of human sera to recombinant vlse and other borrelia burgdorferi antigens in class-specific enzyme-linked immunosorbent assays for lyme borreliosis.	a comparative study of human sera was conducted to determine which purified preparations of 11 recombinant antigens of borrelia burgdorferi sensu stricto were diagnostically most important in enzyme-linked immunosorbent assays (elisas). to assess sensitivity, 20 serum samples obtained 1-6 weeks after onset of illness from 20 persons who had physician-diagnosed erythema migrans (em) were tested for igm and igg antibodies. in tests for igm antibody, seropositivity of > or = 25% was recorded when e ...	2002	12171295
use of a c6 elisa test to evaluate the efficacy of a whole-cell bacterin for the prevention of naturally transmitted canine borrelia burgdorferi infection.	a commercially available c6 elisa kit was used to detect antibodies induced by natural infection with borrelia burgdorferi in dogs that lived in an area endemic for lyme disease. rates of infection were determined both for nonvaccinated dogs and those that had been vaccinated with a whole-cell b. burgdorferi bacterin (lyme vax, fort dodge animal health) before 6 months of age and were boostered annually. vaccinated dogs had an infection rate of 5% (8 of 163), whereas 64% (25 of 39) of the non-va ...	2002	12584679
prospective study of coinfection in patients with erythema migrans.	the frequency of coinfection with borrelia burgdorferi and either anaplasma phagocytophila or babesia microti among patients with erythema migrans, the initial skin lesion of lyme disease, was assessed in 2 mainland locations in rhode island and connecticut in a 4-year prospective study. of the 93 patients with culture-proven erythema migrans, 2 (2%) patients had coinfection with a. phagocytophila and 2 (2%) had coinfection with b. microti. we concluded that the frequency of coinfection with the ...	2003	12684924
increasing health burden of human babesiosis in endemic sites.	human infection due to babesia microti has been regarded as infrequent and a condition primarily affecting the elderly or immunocompromised. to determine whether risk in endemic sites may be increasing relative to that of borrelia burgdorferi and to define its age-related clinical spectrum, we carried out a 10-year community-based serosurvey and case finding study on block island, rhode island. less intensive observations were conducted in nearby sites. incidence of babesial infection on block i ...	2003	12875292
reduced abundance of ixodes scapularis (acari: ixodidae) and the tick parasitoid ixodiphagus hookeri (hymenoptera: encyrtidae) with reduction of white-tailed deer.	the principal vector for the pathogens of lyme disease, human granulocytic ehrlichiosis, and human babesiosis is the tick ixodes scapularis say. a chalcid wasp, ixodiphagus hookeri, in the family encyrtidae parasitizes populations of the tick on several islands or other geographically isolated sites in new england with high densities of these ticks and white-tailed deer (odocoileus virginianus), the principal host for adult i. scapularis. deer densities were reduced at a forested tract in bridge ...	2003	14596277
lyme disease reporting for navy and marine corps (1997-2000).	reported cases of lyme disease for navy and marine corps personnel during 1997-2000 are presented from data collected in the naval disease reporting system and the defense medical epidemiological database. naval disease reporting system identified 210 case subjects; 60% were men, 49% were family members, and 37% were active duty, and most originated in the second quarter of the calendar year. states reporting the greatest number of reports were connecticut (44%), north carolina (16%), rhode isla ...	2003	14719627
borrelia burgdorferi infection in a natural population of peromyscus leucopus mice: a longitudinal study in an area where lyme borreliosis is highly endemic.	blood samples from peromyscus leucopus mice captured at an enzootic site in connecticut were examined for antibodies to and dna of borrelia burgdorferi, to characterize the dynamics of infection in this reservoir population. from trappings conducted over the course of 2 transmission seasons, 598 (75%) of 801 serum samples from 514 mice were found to be positive by enzyme immunoassay. seropositivity correlated with date of capture and mouse age, was similar among locations within the site, increa ...	2004	15073690
use of recombinant antigens of borrelia burgdorferi and anaplasma phagocytophilum in enzyme-linked immunosorbent assays to detect antibodies in white-tailed deer.	serum samples obtained from white-tailed deer (odocoileus virginianus) in connecticut (n=218) and south carolina (n=20) (usa) during the period 1992-2002 were analyzed for antibodies to whole-cell or recombinant antigens (i.e., fusion proteins) of borrelia burgdorferi sensu stricto and anaplasma phagocytophilum, etiologic agents of lyme borreliosis and granulocytic ehrlichiosis, respectively. in enzyme-linked immunosorbent assays (elisas) with whole-cell b. burgdorferi, the overall seropositivit ...	2004	15362824
a comparison of serologic tests for the detection of serum antibodies to whole-cell and recombinant borrelia burgdorferi antigens in cattle.	serum samples from healthy dairy and beef cattle, living in tick-infested areas of connecticut, usa, were analyzed by polyvalent enzyme-linked immunosorbent assays (elisa), indirect fluorescent antibody (ifa) staining methods, or western blot procedures to detect antibodies to tick-borne agents. of the 80 sera tested by elisa with whole-cell or 10 separate recombinant antigens (fusion proteins) of borrelia burgdorferi sensu stricto, 57 (71%) were positive to 1 or more antigens, while 36 (45%) re ...	2004	15368740
control of immature ixodes scapularis (acari: ixodidae) on rodent reservoirs of borrelia burgdorferi in a residential community of southeastern connecticut.	a 3-yr community-based study was conducted on residential properties on mason's island, mystic, ct, to determine the efficacy of a rodent-targeted acaricide (fipronil) to control immature ixodes scapularis (say) on peromyscus leucopus. results indicated that modified commercial bait boxes were effective as an acaricide delivery method for reducing nymphal and larval tick infestations on white-footed mice by 68 and 84%, respectively. passive application of fipronil significantly reduced the infec ...	2004	15605643
detection of antibodies to borrelia burgdorferi in naturally infected horses in the usa by enzyme-linked immunosorbent assay using whole-cell and recombinant antigens.	blood samples were collected from 98 horses suspected of having borreliosis or granulocytic ehrlichiosis in connecticut and new york state, usa during 1985, 1995, and 1996. serum antibodies to borrelia burgdorferi were detected by an enzyme-linked immunosorbent assay (elisa), based on whole-cell and recombinant antigens, in 82 (84%) horses. of the 181 sera tested, 59% were positive, using whole-cell antigens, compared to 48% with protein (p)37 and 35% with vlse antigens. an elisa containing eith ...	2005	15924926
occupational disease in connecticut: 2002.	data on chronic work-related conditions were compiled for connecticut for 2002 from physician reports to the occupational disease surveillance system (odss), the workers' compensation (wc) commission, and the bureau of labor statistics (bls)/ connosha survey. physicians reported 2,082 cases of occupational disease in connecticut in 2002, approximately half of the estimate of 4,388 cases using the bls/ connosha methodology. cases in the odss included 921 (44%) reports of musculoskeletal disorders ...	2005	16184858
forest fragmentation predicts local scale heterogeneity of lyme disease risk.	fragmentation of the landscape has been proposed to play an important role in defining local scale heterogeneity in lyme disease risk through influence on mammalian host density and species composition. we tested this observed relationship in a suburban region around lyme, connecticut, where we collected data on the density of the tick vector, ixodes scapularis and prevalence of the lyme bacterium, borrelia burgdorferi at 30 sites. analysis of the landscape pattern of forest patches was performe ...	2005	16187106
strategies for reducing the risk of lyme borreliosis in north america.	the incidence of lyme borreliosis continues to increase in the united states. in 1991, when lyme borreliosis first became a nationally reportable disease to the centers for disease control and prevention (cdc), a total of 9470 cases were reported; in contrast, by 2002 a total of 23,763 cases were reported, >2.5x the total in 1991. area-wide acaricides can be highly effective in killing nymphal ixodes scapularis, with >95% of nymphs killed in studies using cyfluthrin, deltamethrin, or carbaryl. t ...	2006	16524769
epidemic spread of lyme borreliosis, northeastern united states.	we examined the degree of host specialization of different strains of borrelia burgdorferi, the tickborne pathogen that causes lyme borreliosis in the northeastern united states. we first assessed the genetic population structures of b. burgdorferi in ticks obtained from different mammalian host species and in questing ticks sampled in a woodland ecosystem in connecticut. by comparing the patterns found in our study with data from another cross-sectional study, we demonstrate that b. burgdorferi ...	2006	16704808
lyme borreliosis in 2005, 30 years after initial observations in lyme connecticut.	nearly 100 years ago, afzelius described a patient with an expanding skin lesion, called erythema migrans, which is now known to be the initial skin manifestation of lyme borreliosis. approximately 70 years later, in 1976, epidemiologic evaluation of a cluster of children with arthritis in lyme, connecticut led to a complete description of the infection. during the subsequent years, investigators in a number of countries have made remarkable strides in the elucidation of this tick-borne spiroche ...	2006	17160599
antibodies to whole-cell or recombinant antigens of borrelia burgdorferi, anaplasma phagocytophilum, and babesia microti in white-footed mice.	serum samples were obtained from white-footed mice (peromyscus leucopus) in tick-infested areas of connecticut during the period 2001 through 2003 and analyzed for antibodies to borrelia burgdorferi, anaplasma phagocytophilum, and babesia microti. emphasis was placed on the evaluations of highly specific recombinant vlse or protein (p) 44 antigens of b. burgdorferi and a. phagocytophilum, respectively, in a newly developed enzyme-linked immunosorbent assay (elisa) as well as testing sera with wh ...	2006	17255439