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G. Stephen Bowen, MD, MPH; Marie Griffin, MD; Charles Hayne, DO; John Slade, MD; Terry L. Schulze, PhD; William Parkin, DVM, DPH

JAMA. 1984;251(17):2236-2240.

Abstract
Clinical manifestations and epidemiologic characteristics of 117 cases (31 children and 86 adults) of Lyme disease in New Jersey from 1978 to 1982 are summarized. The male-female sex ratio was 1.9:1. An endemic focus in Monmouth County has been recognized. Erythema chronicum migrans was present in 93% of cases and was the only clinical manifestation in 25% of patients. Nonspecific febrile syndrome, in addition to erythema chronicum migrans, was present in 45% of cases; 26% had arthritis. The proportion of cases with arthritis in 1982 (7/56) was less than for 1978 to 1981 (24/61) probably because of better recognition of milder cases by physicians and earlier antibiotic treatment, which may have reduced late complications. Meningitis (10%) and cranial nerve palsies (8%) were the most frequent neurological manifestations. As medical personnel and the public become more aware of the disease, Lyme disease is being recognized with increased frequency in central and southern New Jersey.

(JAMA 1984;251:2236-2240)

Author Affiliations
From the Field Services Division, Epidemiology Program Office, Centers for Disease Control, Atlanta (Drs Bowen and Griffin); the New Jersey State Department of Health, Trenton (Drs Bowen, Griffin, Schulze, and Parkin); the Clinical Services Division, Naval Regional Medical Center, Philadelphia (Dr Hayne); and the Department of Medicine, St Peter's Medical Center, New Brunswick, NJ (Dr Slade).

Footnotes
Reprint requests to Division of Field Services, Epidemiology Program Office, Centers for Disease Control, Atlanta, GA 30333 (Dr Bowen).

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