From the Guidelines
Nebraska is not considered a high-risk area for Lyme disease, though cases can occasionally occur. Lyme disease is primarily concentrated in the Northeast, Mid-Atlantic, Upper Midwest, and Pacific Northwest regions of the United States [ 1 ]. Nebraska falls outside these endemic regions, with relatively few reported cases compared to states like Connecticut, New York, Pennsylvania, Wisconsin, and Minnesota. The low prevalence in Nebraska is due to ecological factors affecting the blacklegged tick (Ixodes scapularis) population, which is the primary vector for Borrelia burgdorferi, the bacterium causing Lyme disease [ 1 ].
Some key points to consider:
- The risk for Lyme disease differs not only between regions and states and counties within states, but even within counties and townships [ 1 ].
- I. scapularis is the vector in the eastern United States, while I. pacificus transmits B. burgdorferi in the western United States [ 1 ].
- In highly enzootic areas of the United States, approximately 15%-30% of questing I. scapularis nymphs and up to 14% of I. pacificus nymphs are infected with B. burgdorferi [ 1 ].
While Nebraska residents should still practice tick prevention when outdoors, especially in wooded or grassy areas, the risk of contracting Lyme disease within the state is significantly lower than in endemic regions. However, travelers to high-risk areas should be vigilant about tick checks and prevention measures.
From the Research
Lyme Disease Prevalence
- Lyme disease is the most commonly reported tick-borne illness in the United States, with over 90% of US cases occurring in northeastern states from Maine to Virginia, and in Wisconsin, Minnesota, and Michigan 2.
- The disease is also prevalent in northern California and Oregon 2.
- Nebraska is not mentioned as a state with high incidence of Lyme disease in the provided studies.
Geographic Distribution
- The geographic distribution of Lyme disease is determined by the distribution and abundance of vector ticks, ecologic factors influencing tick infection rates, and human behaviors that promote tick bite 3.
- A study found substantial geographic expansion of counties at high risk for Lyme disease in the United States 4.
- Low-incidence states, which may include Nebraska, have different epidemiological characteristics, and misdiagnosis may be common in these areas 5.