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Study Shows: Lyme Not Propelled by Climate Change

Lyme Not Propelled by Climate Change

Recently, a plethora of books and articles have come out on how climate change is driving Lyme disease, and in fact, a recent article by The Center for Public Integrity, flat out accuses Maine’s governor, who happens to be a climate skeptic, of tying health officials’ hands and personally impeding valuable tick borne illness research:  https://madisonarealymesupportgroup.com/2018/08/09/why-the-cpis-article-on-how-a-climate-skeptic-is-holding-up-tick-borne-illness-research-is-dead-wrong/.

It has become clear to many that there is a Pied Piper pushing a climate change agenda.

Standing in opposition to the flutist’s tune, a recent study shows that warm winters are lethal to I. scapularis (black-legged) ticks.  In fact, overwinter survival dropped to 33% when the snow melted.  This has been substantiated by other researchers as well.  Scott & Scott, 2018, ticks and climate change, JVSM

The short of it is that snow cover is vital for tick survival as it serves as a buffer for when ticks find themselves exposed.  Typically ticks will seek out and hide in snow or leaf litter when conditions become harsh.  Without this buffer they are exposed and fewer survive.

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“Tick Guy” Tom Mather shows how ticks survive 3 degrees in 24 hours with snow cover.

The flutists insist that global warming, climate change, and pollution are the reasons for the spread of ticks and Lyme disease.  Independent tick researcher John Scott states those hypotheses are unsubstantiated.

Scott offers that yearly bidirectional, songbird migration in spring and fall is behind tick expansion and that the climate change model actually reflects migratory flight not warmer futuristic temperatures.

An Acadian Flycatcher with larval neotropical ticks.  (Courtesy Tim Guida)

One of Scott’s studies found 35% of song-bird transported I. scapularis nymphs to be infected with B burgdorferi (Bb).  Further, these heavily tick infested migrating song-birds can start new foci of ticks on islands and remote mainland areas.

Birds are serving as transport systems for ticks and are spreading them all over the world.

The other crucial but overlooked factor climate change researchers have not been considering is something called photoperiod.

Evidently, ticks have sensory organs that monitor the external environment which includes light.  Light wavelength as well as intensity will make the difference from if and when a nymph will molt and if and when an engorged female will lay eggs.

In a nutshell, light (photoperiod) has much more of an impact on ticks than temperature.

Scott’s in-house tick studies have shown that black-legged ticks require 14 hours of daylight to molt.  If ticks can’t molt, they can’t move on to their next life-cycle.  Photoperiod is innate and can not be altered by the climate.  He states:

“The hypothesis that I. scapularis ticks will expand further north in the Prairie Provinces because of climate change is not only unscientific, but deceiving.”

He demonstrates this by noting that I. scapularis ticks are not established in the Neotropics where the temperature is warmer.  The reason for this is the photoperiod is balanced between night and day.  In other words, the ticks have less light than they need to molt.

The study points out that both ticks and spirochetes are ecoadaptive survivors as demonstrated by the fact borrelial spirochetes have survived for thousands of years https://www.utoronto.ca/news/u-t-researchers-find-ancient-iceman-s-infection-helps-lyme-disease-bone-loss-discovery,  https://madisonarealymesupportgroup.com/2018/02/12/the-persistent-spiral-the-ancient-history-of-lyme-disease-and-tick-borne-infections/, and so have infected ticks:  http://www.sci-news.com/paleontology/blood-engorged-tick-dominican-amber-04757.html  (This one infected with a Babesia species).  This survival demonstrates adaptation to any potential climate shifts.

Another problem with the climate change models is they overlook the fact that deer ticks were established in northwestern Ontario, southern Manitoba and were already in central Canada prior to 1970.  What they predict to happen in the future has already happened in Canada.  Their oversight caused a skewed rate of tick expansion and a miscalculation of northward projected movement.

“For blacklegged ticks, climate change is an apocryphal issue.” -John Scott

The study states that another problem is the over-emphasis on white-footed mice:  https://madisonarealymesupportgroup.com/2016/06/21/first-frankenbugs-now-frankinmice/.  Scott has shown that there are established populations of deer ticks in Manitoba as well as in insular, hyper-endemic Corkscrew Island, yet both are devoid of white-footed mice.  He points out that there are numerous reservoir hosts that must be considered including other mammals, birds, and reptiles.

For decades we’ve been told it’s the mice.  Yet a real problem in the West and South are reptiles like skinks and lizards:  https://madisonarealymesupportgroup.com/2017/12/03/biologists-at-sf-state-dig-into-ticks-and-ld/,  https://madisonarealymesupportgroup.com/2018/06/25/the-confounding-geography-of-lyme-disease-in-the-u-s/

Another problem with the climate change insistence is study time vs. deer tick establishment.  The progression of studies used by some researchers follows the order in which they were conducted not the result and progression of climate change, and just because U.S. studies start in the early 80’s does not mean that was when ticks were established.  As noted before, ticks and spirochetes have both been found in fossils, obviously long before the 80’s.  This demonstrates climate adaptability.

“The time-lapse model sharply conflicts with the actual areas designated as Lyme disease foci.  Such models contradict field data, and misrepresent the Lyme disease timeline of tick establishment in Canada.”  – John Scott

Also, climate-change researchers overlooked and did not take into account established populations of I. scapularis found in the late 1960’s in the upper Midwest, as well as at Manitoba in 1991, in their climate change model maps.  Even game hunters remember ticks on the heads and necks of deer in the 1950’s and 1960’s in northwestern Ontario and southern Manitoba.  The faulty climate change maps are devoid of any ticks in those areas – yet experience shows otherwise.  This has been the experience of patients across the globe as well.

The study states that migratory song-birds transport black-legged tick larvae and nymphs hundreds of kilometers during northward migratory flights and are important drivers for wide-spread dispersal not only of ticks but of tick-associated pathogens.  

This is shown by the fact that neotropical songbirds are transporting ticks from Brazil into Canada.  Neotropical Amblyomma ticks do not overwinter in Canada yet they are being transported there.  Birds are also transporting Ixodes spp. ticks as well.  Scott claims if there was any substance to climate warming in propagating ticks the Amblyomma americium (lone star tick) would have become established in the southernmost part of Ontario, but they haven’t.

Thankfully others are studying the bird component as well:  https://madisonarealymesupportgroup.com/2017/08/17/of-birds-and-ticks/https://madisonarealymesupportgroup.com/2016/10/02/the-role-of-birds-in-tickborne-illness/,  https://madisonarealymesupportgroup.com/2018/07/09/infected-ticks-collected-from-birds-in-northern-italy/,  https://madisonarealymesupportgroup.com/2018/08/12/bbsl-infected-ticks-in-canadian-songbirds/,  https://madisonarealymesupportgroup.com/2018/06/08/hemorrhagic-fever-virus-found-on-ticks-on-migratory-birds/.

In sum,

  • certain researchers are predicting a spread of LD due to climate change
  • independent tick research John Scott says these are “spurious and unsubstantiated” contentions
  • birds, not weather, are propagating the spread of ticks and disease
  • transmission depends on whether a tick is infected and whether the tick has vector competence
  • during bad weather ticks adapt by finding cover
  • warmer temperatures actually reduce tick populations
  • temperature and precipitation has no bearing on tick abundance
  • climate change alarmists have used Canadian studies making 1970 their benchmark for models but didn’t take into account established tick populations that had already been in existence for decades, centuries, or even millennia at northern latitudes
  • regarding ticks, climate change is insignificant

Scott JD, Scott CM. Lyme Disease Propelled by Borrelia burgdorferi-infected Blacklegged Ticks, Wild Birds, and Public Awareness – Not Climate Change. J Veter Sci Med 6(1):8 (2018)  Scott & Scott, 2018, ticks and climate change, JVSM

For an interview with Scott:  https://madisonarealymesupportgroup.com/2017/08/14/canadian-tick-expert-climate-change-is-not-behind-lyme-disease/

“The climate change range expansion model is what the authorities have been using to rationalize how they have done nothing for more than thirty years. It’s a huge cover-up scheme that goes back to the 1980’s. The grandiose scheme was a nefarious plot to let doctors off the hook from having to deal with this debilitating disease. I caught onto it very quickly. Most people have been victims of it ever since.  This climate change ‘theory’ is all part of a well-planned scheme. Even the ticks are smarter than the people who’ve concocted this thing.  Climate change has nothing to do with tick movement. Blacklegged ticks are ecoadaptive, and tolerate wide temperature fluctuations…..It’s all a red herring to divert your attention.”- John Scott

And in conclusion, climate change data has not and will not help Lyme/MSIDS patients and/or the doctors who treat them. Time to hunker down and get to work spending money and backing research that relieves human suffering.

Cyclosporiasis Update For Wisconsin

https://www.cdc.gov/parasites/cyclosporiasis/outbreaks/2018/a-062018/index.html

Multistate Outbreak of Cyclosporiasis Linked to Del Monte Fresh Produce Vegetable Trays

CDC and federal, state, and local public health partners are investigating an increase in reported cases of Cyclospora infection.

https://www.cdc.gov/parasites/cyclosporiasis/  Cyclosporiasis is an intestinal illness caused by the microscopic parasite Cyclospora cayetanensis.  People can become infected with Cyclospora by consuming food or water contaminated with the parasite.

https://www.cdc.gov/parasites/cyclosporiasis/disease.html  Symptoms of cyclosporiasis begin an average of 7 days (range, 2 days to ≥2 weeks) after ingestion of sporulated oocysts (the infective form of the parasite).

Symptoms of cyclosporiasis may include the following:

  • Watery diarrhea (most common)
  • Loss of appetite
  • Weight loss
  • Cramping
  • Bloating
  • Increased gas
  • Nausea
  • Fatigue
  • Other symptoms that may occur but are less common include the following:
  • VomitingLow-grade fever

LAST UPDATED JULY 19, 2018 7:30 PM EDT

On June 15, 2018, Del Monte Fresh Produce recalled 6 oz., 12 oz., and 28 oz. vegetable trays containing fresh broccoli, cauliflower, celery sticks, carrots, and dill dip. Recalled products were sold in clear, plastic clamshell containers.

Recalled products were distributed to the following stores: Kwik Trip, Kwik Star, Demond’s, Sentry, Potash, Meehan’s, Country Market, FoodMax Supermarket, and Peapod.

Recalled products have a “Best If Enjoyed By” date of June 17, 2018.
The recalled 6 oz. Del Monte Fresh Produce vegetable tray has a UPC code of 7 1752472715 2 found on the package label.

  • The recalled 12 oz. Del Monte Fresh Produce vegetable tray has a UPC code of 7 1752472518 9 found on the package label.
  • The recalled 28 oz. Del Monte Fresh Produce small vegetable tray has a UPC code of 7 1752478604 3 found on the package label.

Do not eat or sell recalled vegetable trays. Throw them away.
CDC, public health and regulatory officials in several states, and the U.S. Food and Drug Administration are investigating a multistate outbreak of Cyclospora infections.

As of July 19, 2018 (1pm EDT), CDC has been notified of 237 laboratory-confirmed cases of cyclosporiasis in persons who reportedly consumed pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip. The reports have come from four states.

Seven (7) of these people have been hospitalized, and no deaths have been reported.

Epidemiologic evidence indicates that pre-packaged Del Monte Fresh Produce vegetable trays containing broccoli, cauliflower, carrots, and dill dip are the likely source of these infections.

The investigation is ongoing. CDC will provide updates when more information is available.

 

FREE Online – Making Herbal Medicine Series

http://thegrownetwork.pages.ontraport.net/mhmk-registration-aff?oprid=52634

Go to the Link to register for a Free 4-Part Video Training Series on how to make 95% of your common health care needs safely at home.

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Marjory has been featured by National Geographic as an expert in sustainable living, she has hosted Mother Earth News “Online Homesteading Summit”, she was honored in Reuters “Food Sustainability Media Award”, and is a creator of several books and videos with over 500,000 copies in use by gardeners, herbalists, survivalists, missionary organizations, and universities in more than 35 countries around the world.

 

Tweets of 7th TBD Working Group Meeting

https://www.lymedisease.org/7th-tbdwg-tweets/

Please go to link to read Tweets

 

HHS Not to Be Trusted With Lyme

https://www.change.org/p/1120418/u/23024031?utm_medium=email&utm_source=petition_update&utm_campaign=380451&sfmc_tk

Lawsuit initiated by Robert F. Kennedy, Jr. against Health and Human Services (HHS)

Carl Tuttle
Hudson, NH
JUL 18, 2018 — Please see the following email addressed to representatives Smith and Peterson who are proposing additional Lyme disease legislation. (Cc: Tick Borne Disease Working Group)

This is not meant to be disrespectful in any way but is an eye opener for the HHS track record.

Legislation over thirty years has not resolved the Lyme crisis here in the United States as there is tight control over Lyme disease policy refusing to recognize that Lyme disease can cause horrific disability and death. Until Lyme is upgraded to a life-altering/life-threatening infection like AIDS we will see continued health and disability claim rejections stemming from the racketeering scheme associating Lyme to the “aches and pains of daily living.”

Anyone wishing to contact the Lyme Disease Working Group can send an email to:

tickbornedisease@hhs.gov

——— Original Message ———-
From: Carl Tuttle
To: tickbornedisease@hhs.gov, chris.smith@mail.house.gov, collin.peterson@mail.house.gov
Cc: mark.dayton@state.mn.us, daniel.tillson@mail.house.gov, kvf1@comcast.net, iturko@umd.edu, allen.l.richards.civ@mail.mil, richard.wolitski@hhs.gov, scott.cooper@cms.hhs.gov, khoney@stanford.edu, ddutko@hanszenlaporte.com, kalachakra108@aol.com, adam.durand@mail.house.gov, info@smith4nj.com, marisa.kovacs@mail.house.gov, ddiallo@sisterlove.org, tamir.elnabarawy@mail.house.gov, matt.hadro@mail.house.gov, cbb0@cdc.gov, smithr@mmc.org, dennis.dixon1@nih.hhs.gov, estella.jones@fda.hhs.gov, mary.noonan@mail.house.gov, james.berger@hhs.gov, vanila.singh@hhs.gov, lise.nigrovic@childrens.harvard.edu, sdonta@comcast.net, wendyadams1@gmail.com, ptourad1@jhmi.edu, don.wright@hhs.gov, jaucott2@jhmi.edu, olx1@cdc.gov, kbechto1@jhmi.edu

Date: July 17, 2018 at 3:34 PM
Subject: Lawsuit initiated by Robert F. Kennedy, Jr. against Health and Human Services (HHS)

July 17, 2018
The Honorable Chris Smith and Collin Peterson
United States House of Representatives
2373 Rayburn House Office Building
Washington, D.C. 20515
Dear Representatives Smith and Peterson,

I would like to call attention to a recent lawsuit initiated by Robert F. Kennedy, Jr. against Health and Human Services (HHS) regarding their refusal to respond to a Freedom of Information Act request.

In 1986 President Ronald Regan passed the Vaccine Injury Compensation Act known as VICA to protect the vaccine manufacturers from lawsuits as a result of injury or death.

HHS was required to put a task force together to oversee the safety of childhood vaccines and report to congress every two years.

Informed Consent Action Network (ICAN) submitted a FOIA request looking for records relating to the required HHS task force and reporting to congress asking for each two year report.

After a year and a half of no response Robert F. Kennedy, Jr was instrumental in obtaining a court ordered stipulation.

Here is what was revealed from that lawsuit per the following article:
http://bolenreport.com/robert-f-kennedy-jr-and-an-amazing-vaccine-legal-victory/

“The department’s search for records did not locate any records responsive to your request. The Department of Health and Human Services (HHS), Immediate Office of the Secretary (IOS) conducted a thorough search of its document tracking system and the Department also conducted a comprehensive review of all relevant indexes of HHS Secretarial correspondence records maintained at federal record centers that remain in the custody of HHS. These searches did not locate records responsive to your request, or indicate that records responsive to your request and in the custody of HHS are located at federal records center.”

So basically, no one has been performing the vaccine safety testing since 1986. Thirty-two years!
_______________________________________

Congressman Smith and Peterson,

You are looking to pass Lyme disease legislation requiring Health and Human Services to report to Congress:

Excerpt From the following link: https://chrissmith.house.gov/news/documentsingle.aspx?DocumentID=401130

“The legislation also calls for a new national strategy on tick-borne diseases, and requires the HHS Secretary to report to Congress on federal efforts to diagnose and treat Lyme and on how best to foster collaboration between federal tick-borne disease programs.”

Also taken from that link:

“So many patients suffer from the debilitating effects of this disease that persist for years, especially if not detected early, while being told that their illness does not exist,” Rep. Smith, the author of the bill, said.

You have identified the injustice outlined in the SHRADER & ASSOCIATES, LLP racketeering lawsuit in which the Centers for Disease Control has played an integral role as they have aligned themselves with the seven defendants named in this RICO lawsuit.

You are counting on Health and Human Services to correct this injustice? Seriously?

If we are to resolve the Lyme disease crisis here in the U.S. any agency/individual who has been involved in setting Lyme disease policy has to be removed from that position of authority.

The only way to do this is to initiate a congressional investigation of the CDC, IDSA and American Lyme disease Foundation through subpoena power requiring testimony under oath. It is also time to request the full contents of the 3000 pages of emails from CDC employees Barbara Johnson, Paul Mead and David Dennis. As previously mentioned, 50% of those FOIA documents were redacted. What has the CDC hidden from the public and our legislators?

FOIA request to CDC took five years to fulfill
https://ire.org/blog/transparency-watch/2013/05/20/foia-request-cdc-took-five-years-fulfill/

Why do we continue to dance around this blatantly obvious offense?

Sincerely,

Carl Tuttle
Lyme Endemic Hudson, NH

________________

**Comment**

Kudos to Mr. Tuttle for speaking the obvious.  Why are we trusting the people behind this fiasco?  They’ve already shown their true colors for long enough.

The Cabal must end.

https://madisonarealymesupportgroup.com/2017/01/13/lyme-science-owned-by-good-ol-boys/

https://madisonarealymesupportgroup.com/2016/11/29/spider-attacks-cdc/

https://madisonarealymesupportgroup.com/2018/04/06/cdcs-troubling-lack-of-research-ethics/

https://madisonarealymesupportgroup.com/2017/09/25/speaking-of-fake-science-fifty-seven-million-anti-trust-lawsuit-against-cdc-lyme-tests/

https://madisonarealymesupportgroup.com/2017/12/13/suppression-of-microscopy-for-lyme-diagnostics-professor-laane/

https://madisonarealymesupportgroup.com/2017/10/06/remembering-dr-masters-the-rebel-for-lyme-patients-who-took-on-the-cdc-single-handedly/

https://madisonarealymesupportgroup.com/2018/01/31/when-als-is-lyme-letter-to-tbi-working-group/

https://madisonarealymesupportgroup.com/2018/06/14/corruption-human-rights-violations-against-lyme-doctors-scientists-and-parents-now-on-united-nations-record/

https://madisonarealymesupportgroup.com/2018/06/21/the-corruption-of-evidence-based-medicine-killing-for-profit/

https://madisonarealymesupportgroup.com/2017/01/28/sit-down-science/

https://madisonarealymesupportgroup.com/2017/01/02/fake-science/

First RMSF Death in Wisconsin

https://www.dhs.wisconsin.gov/news/releases/071018.htm

FOR IMMEDIATE RELEASE
July 10, 2018
CONTACT: Jennifer Miller, 608-266-1683
Elizabeth Goodsitt, 608-266-1683
Jo Foellmi, 608-785-5753

DHS Confirms Death of a La Crosse County Resident from Rocky Mountain Spotted Fever

State and local health departments urge residents to take precautions to protect against tick bites

The Wisconsin Department of Health Services and the La Crosse County Health Department today announced the first documented death from Rocky Mountain spotted fever (RMSF) in the state.

RMSF is rarely reported in Wisconsin and most commonly occurs in the central and southeastern regions of the United States. Most tickborne diseases transmitted in Wisconsin are spread by the blacklegged (or deer) tick; RMSF, however, is spread by the bite of the American dog (or wood) tick (Picture Attached). Early symptoms of RMSF can be mild and typically include fever, headache, nausea, vomiting, rash, and stomach pain. If left untreated, however, a RMSF infection can rapidly develop into a serious illness.

dog-tick-closeup-rocky-mountain-spotted-fever

American dog tick, which can transmit RMSF

“We are saddened to learn of this death and encourage Wisconsin residents to take steps to protect themselves and their families from tick bites while enjoying the outdoors,” said Karen McKeown, State Health Officer.

  • Use an insect repellent with at least 20% DEET or another EPA-registered repellent according to the label instructions.
  • Use 0.5% permethrin products on clothing, socks, and shoes according to label instructions.
  • Stay on trails and avoid walking through tall grasses and brush.
  • Wear long sleeves and pants, and tuck pants into socks and shirts into pants to avoid ticks crawling under clothing.
  • Check your entire body for ticks after being outdoors.
  • Take a shower as soon as possible after coming in from outdoors.
  • Place clothes in the dryer on high heat for 10 minutes to kill any ticks on clothing.
  • Use a veterinarian-prescribed tick prevention treatment on pets.

Of the illnesses spread by ticks in Wisconsin, Lyme disease is the most common, but ticks can also spread anaplasmosis, ehrlichiosis, and more rarely RMSF and Powassan virus. Many people who contract a tickborne disease do not recall a tick bite, so it’s also important to be aware of the common symptoms of tickborne disease such as fever, rash, headache, body aches, and fatigue.

Most diseases spread by ticks in Wisconsin, including Lyme disease, anaplasmosis, ehrlichiosis, and RMSF, can be effectively treated with antibiotics, making early diagnosis critical. If symptoms develop after a tick bite or after possible tick exposure, see a health care provider.

__________________

**Comment**

Story here:  http://amp.wisn.com/article/wisconsin-woman-dies-from-rocky-mountain-spotted-fever/22108466

Jo Foellimi, a La Crosse County public health nurse, said the woman was bit while camping in western Wisconsin in early May.  The woman was diagnosed with RMSF in mid-June and died days later.  Foellimi said the woman was in her late 50s but declined to identify her.

More on RMSF:  https://madisonarealymesupportgroup.com/2018/06/12/georgia-mom-warns-others-after-son-contracts-rocky-mountain-spotted-fever-after-tick-bite/

https://madisonarealymesupportgroup.com/2015/08/13/severe-case-of-rmsf-had-to-remove-patients-arms-and-legs/

https://madisonarealymesupportgroup.com/2017/06/10/two-deaths-from-rmsf-indiana-has-tbis/

Treatment is doxycycline:  https://www.uptodate.com/contents/treatment-of-rocky-mountain-spotted-fever  Empiric therapy with doxycycline should be started if the diagnosis of Rocky Mountain spotted fever (RMSF) is suspected, even if the symptoms are mild.

Insights From the Geographic Spread of the Lyme Disease Epidemic

https://academic.oup.com/cid/advance-article-abstract/doi/10.1093/cid/ciy510/5039131?redirectedFrom=fulltext

Insights from the Geographic Spread of the Lyme Disease Epidemic

Taylor Eddens, Ph.D Daniel J Kaplan, M.D Alyce J M Anderson, Ph.D Andrew J Nowalk, M.D.,Ph.D Brian T Campfield, M.D
Clinical Infectious Diseases, ciy510, https://doi.org/10.1093/cid/ciy510
Published: 16 June 2018

Reproduced by permission of Oxford University Press on behalf of the Infectious Diseases Society of America. 9c) The Author(s) 2018. All rights reserved. For permissions, e-mail: journals.permissions@oup.com. Please visit: https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciy510/5039131

Abstract
Background
Lyme disease is the most common reportable zoonotic infection in the United States. Recent data suggests spread of the Ixodes tick vector and increasing incidence of Lyme disease in several states, including Pennsylvania. We sought to determine the clinical presentation and healthcare utilization patterns for pediatric Lyme disease in western Pennsylvania.

Methods
The electronic medical records of all patients with an ICD9 diagnosis of Lyme disease between 2003-2013 at Children’s Hospital of Pittsburgh were individually reviewed for cases meeting the 2011 CDC case definition for Lyme disease. 773 patients meeting these criteria were retrospectively analyzed for patient demographics, disease manifestations, and healthcare utilization.

Results
An exponential increase in Lyme disease occurred in the pediatric population of western Pennsylvania. There was a southwestward migration of Lyme cases, with a shift in concentration from rural to non-rural zip codes. Healthcare provider involvement also changed from subspecialists to primary care pediatricians(PCP) and emergency departments(ED). Patients from non-rural zip codes more commonly presented to the ED, while patients from rural zip codes utilized PCPs and EDs similarly.

Conclusions
The current study details the conversion of western Pennsylvania from a Lyme-naïve to a Lyme-epidemic area, highlighting changes in clinical presentation and healthcare utilization as the epidemic evolved. Presenting symptoms and provider-type differed between those from rural and non-rural zip codes. By understanding the temporospatial epidemiology, disease presentation and healthcare utilization of Lyme, the current study may inform future public health initiatives regionally while serving as an archetype for other areas at-risk for Lyme epidemics.