During 1973 and 1974, we looked for cases of Colorado tick fever throughout Colorado; 228 cases were identified. Although 90% of the patients reported exposure to ticks before illness, only 52% were aware of an actual tick bite. Typical symptoms of fever, myalgia, and headache were common, but gastrointestinal symptoms were also prominent in 20% of the patients. Twenty percent were hospitalized; no deaths or permanent sequelae were noted. Persistent viremia (greater than or equal to 4 weeks) was found in about half of the cases; this finding was not associated with the occurrence of prolonged symptoms (greater than or equal to 3 weeks), which were also reported in half of the cases. One patient became reinfected with the virus. Increasing tourism in endemic areas and the frequent occurrence of prolonged or biphasic illnesses provide the potential for patients with Colorado tick fever to seek medical care anywhere in the United States.
Amblyomma americanum is a likely secondary vector of Lyme disease in New Jersey. Ticks of this species were removed from the site of the characteristic skin lesion known as erythema chronicum migrans on two patients with the disease, and the Lyme disease spirochete was isolated from nymphs and adults of this species. That A. americanum is a potential vector is supported by its similarities to Ixodes dammini, the known tick vector, in seasonal distribution and host utilization. The extensive range of A. americanum may have great implications for potential Lyme disease transmission outside known endemic areas.
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