I am working in locum in Wisconsin and note that the EHR frequently lists a "problem" (not diagnosis) of Lyme disease. The majority of such patients have poorly documented disease manifestations with non-confirmatory serologies upon repeat or Western Blot. The majority are "diagnosed" and empirically treated in the ER or urgent care setting by a primary care doc based on non-specific complaints (when I started practice in 1978 such patients were labeled "chronic brucellosis", now they are labeled "chronic Lyme disease). Hence I am slow to accept any "reports" regarding the incidence of Lyme disease. More likely its the incidence of mis-dagnosis of Lyme disease. A + PPD does not equate to active TB (only exposure), and +serolgy for Lyme does not equate to active disease, only expoure to B. Bergdorfi.