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Lyme borreliosis is caused by infection with spirochetes of the Borrelia Burgdorferi sensu lato complex, which are transmitted by Ixodes ticks. Estimates put the annual number of Lyme cases at 85,000 in Europe and 300,000 in the United States, making it the most prevalent vector-borne disease in the Northern Hemisphere. Lyme is endemic to areas in North America, Europe, and Asia, but research suggests that due to a combination of demographic, social, and environmental factors, the disease’s prevalence and distribution is growing. Lyme cases have been reported in Africa, Mexico, and Australia despite these regions being primarily considered non-endemic, resulting in controversy over the existence of the disease in such areas. Given that travel to or residence in an endemic area, or lack thereof, determines whether or not Lyme borreliosis will be considered in the diagnosis of patients with clinical manifestations consistent with the disease, an accurate understanding of where Lyme can be acquired is vital. In this study, I compiled reports of suspected Lyme cases in non-endemic areas and evaluated their implications by considering the strength of the laboratory evidence presented, patients’ travel histories and clinical symptoms, and the potential for the existence of the causative agent and vectors of Lyme borreliosis. I have summarized the details of published reports of Lyme in Mexico and Africa in tables, and provided an updated table of cases in Australia. Based on the results of my literature search and analysis, there is evidence that Lyme borreliosis occurs in northeastern Mexico and northern Africa, contradicting the stances of multiple public health organizations and many reviewers in the field. Clinicians should be aware of this possibility, and investigate clinical manifestations of the disease accordingly.
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Thomas, Elizabeth Miranda, "An Analysis of the Existing Evidence for Lyme Borreliosis in Australia, Mexico, and Africa" (2020). Senior Projects Spring 2020. 97.
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