In the United States, Lyme disease is the most common arthropod-borne infection. The majority of cases are reported from the Northeast, the Midwest, and California, which are areas with established foci ofBorrelia burgdorferi. Advances in the understanding of the epidemiology ofIxodesticks, the established vector for transmission of Lyme disease, provided strategies to reduce tick populations and the risk of acquiring disease. Genotypic diversity of subspecies ofB. burgdorferihas been associated with differences in disease expression. New methods for detection ofB. burgdorferihave expanded understanding of the pathogenesis of Lyme disease and provided clues into the mechanisms responsible for persistent symptoms. A safe vaccine for the prevention of Lyme disease in humans has been developed, and clinical vaccine efficacy trials are currently under way.
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