Clinical manifestations and descriptive epidemiology of Lyme disease in New Jersey, 1978 to 1982

Clinical manifestations and epidemiologic characteristics of 117 cases (31 children and 86 adults) of Lyme disease in New Jersey from 1978 to 1982 are summarized. The male-female sex ratio was 1.9:1. An endemic focus in Monmouth County has been recognized. Erythema chronicum migrans was present in 93% of cases and was the only clinical manifestation in 25% of patients. Nonspecific febrile syndrome, in addition to erythema chronicum migrans, was present in 45% of cases; 26% had arthritis. The proportion of cases with arthritis in 1982 (7/56) was less than for 1978 to 1981 (24/61) probably because of better recognition of milder cases by physicians and earlier antibiotic treatment, which may have reduced late complications. Meningitis (10%) and cranial nerve palsies (8%) were the most frequent neurological manifestations. As medical personnel and the public become more aware of the disease, Lyme disease is being recognized with increased frequency in central and southern New Jersey.