Lyme disease, caused by infection with Borrelia burgdorferi, is the most frequently reported arthropod-borne disease in the United States. To develop a national map of the distribution of the vectors of B. burgdorferi to humans (Ixodes scapularis Say and Ixodes pacificus Cooley & Kohls ticks), we sent questionnaires to acarologists, health officials, and Lyme disease researchers; surveyed the 1966-1996 MEDLINE data base; and reviewed 1907-1995 National Tick Collection data. Tick collection methods cited included flagging and dragging, deer surveys, small- and medium-sized mammal surveys, CO2 baiting, and receipt of tick submissions. A total of 1,058 unique, county-specific I. scapularis and I. pacificus records was obtained. Tick populations were classified as "reported" (< 6 ticks and 1 life stage identified) or "established" (> or = 6 ticks or > 1 life stage identified). Established populations of I. scapularis were identified in 396 counties in 32 states in the eastern and central United States, whereas established populations of I. pacificus were found in 90 counties in 5 western states. Counties with established populations were most concentrated in the northeastern, upper northcentral, and west-coastal states but were also clustered in southeastern and Gulf-coastal states. A less concentrated distribution was found in the south-central states. Reports were notably missing from all but a few counties in Ohio, West Virginia, western Virginia and North Carolina, Kentucky, and Tennessee. They were absent in the Great Plains and Rocky Mountain regions and from large areas of western states east of the Cascade and Sierra Nevada cordilleras. These data are useful for identifying areas of Lyme disease risk, for targeting Lyme disease prevention strategies, and for monitoring trends in spatial distribution of Lyme disease vector ticks.

West Nile fever is a more severe illness than has previously been documented. Mandatory reporting of West Nile fever cases in addition to West Nile meningoencephalitis cases could allow more accurate and timely recognition of the geographic distribution of West Nile virus infections and could inform public health interventions.