Introduction

The Washington State Department of Health, the University of Washington Division of Infectious Diseases and the University of Washington School of Public Health and Community Medicine have produced this monograph to provide Washington State physicians with a clinical update of Lyme disease and a summary of current knowledge about the disease in Washington State. The information in this educational monograph was derived from the references listed on pages 17 and 18, and from Washington State Department of Health surveillance data.

It is important for health care providers in Washington to be aware of Lyme disease for several reasons. Lyme disease is the most common vector-borne disease in the United States. Although the disease is not known to be common in Washington State, patients exhibiting symptoms similar to those of Lyme disease are frequent visitors to physicians' offices. Current serologic tests for Lyme disease are of limited utility for diagnosing Lyme disease. Lyme disease is, therefore, primarily a clinical diagnosis, which can be challenging due to the protean manifestations of the disease. There is a great deal of public concern about the disease and health care providers are frequently asked about it. Lyme disease is reportable in Washington State.

After reading this monograph, provider should understand: The transmission and clinical manifestations of Lyme disease. The complexities of diagnosing Lyme disease, particularly given the unreliability of currently available diagnostic tests. The treatment and prevention of Lyme disease. The distribution of tick vectors and human cases of Lyme disease in Washington State.