Lyme Disease: Reporting and Surveillance
Lyme disease is a category II reportable condition in Wisconsin. Health care providers should report to the patient’s local or Tribal health department in one of these ways:
- Electronically, through the Wisconsin Electronic Disease Surveillance System (WEDSS).
- By mail or fax using a Lyme Disease Case Report Form, F-02188 (PDF).
- By calling the Bureau of Communicable Diseases at 608-267-9003.
Complete your report within 72 hours of recognizing a case. To learn more, visit the Wisconsin Department of Health Services (DHS) web page on Disease Reporting.
A new Lyme disease surveillance case definition went into effect in January 2022. For details, refer to the Lyme Disease Case Reporting and Investigation Protocol, P-01735 (PDF).
A video for health departments and their partners on Lyme disease data and resources.
DHS surveillance resources
- New Case Reporting and Investigation Protocol (previously called EpiNet)—Lyme Disease, P-01735 (PDF)
- Non-Lyme Borreliosis Case Reporting and Investigation Protocol (previously called EpiNet)—Borreliosis EpiNet, P-02215 (PDF)
- Lyme disease surveillance case worksheet—Lyme Disease Case Report Form, F-02188 (PDF)
- Video for health departments and their partners on Lyme disease data and resources—Lyme Disease Data and Resources for Health Departments
- Trends in Wisconsin, tick surveillance, and Lyme disease prevention measures.—Surveillance Brief, P-01295 (PDF)
- Preparation and response—Vectorborne Disease Toolkit, P-01109 (PDF)
Provider resources
Clinical practice guidelines of tickborne diseases—Guidelines for the Prevention, Diagnosis and Treatment of Lyme Disease
Information from the CDC (Centers for Disease Control and Prevention):
- Diagnosis, testing, and treatment—Lyme Disease: Health Care Providers
- Two-tiered testing process, diagnosis, and more—Lyme Disease: Diagnosis and Testing
- Recommended antibiotics—Treatment of Lyme Disease
- Dangers of delayed, long-term or alternative treatment—Post-Treatment Lyme Disease Syndrome
The CDC recommends a two-step serologic testing process to support the diagnosis of Lyme disease. This process reduces the risk of false-positive and false-negative results, and antibody cross-reactivity in commercial tests.
Two-step serologic testing includes an enzyme-linked immunosorbent assay (ELISA) or an immunofluorescence assay (IFA) as the first test, followed by a Western immunoblot (WB) as the second test. Another recommended option is the modified two-tiered testing process. This process uses an enzyme immunoassay (EIA) in place of a Western immunoblot for the second test.
For the surveillance of Lyme disease, two-step serologic testing or a molecular test in an appropriate clinical specimen (e.g., synovial fluid for suspected Lyme arthritis) is required to meet the case definition criteria.
Diagnosis of Lyme disease can be difficult and complicated. Many of the signs and symptoms of Lyme disease are similar to other viral and bacterial infections, rheumatoid arthritis, and other neurological diseases.
In Wisconsin, clinicians can diagnose Lyme disease in a patient who develops the typical erythema migrans (EM) rash without lab testing. This is because:
- Lyme disease is widespread in Wisconsin.
- Antibodies to the bacteria Borrelia burgdorferi may not be detectable in the early stage of illness.
If a patient has other compatible clinical symptoms but EM rash isn’t present, clinicians should use the results of blood tests to detect the presence of antibodies to the bacteria to support a diagnosis of Lyme disease. Some patients with Lyme disease may have negative two-step serologic testing in a specimen collected within 30 days after illness onset. Repeat two-step serologic testing at least 30 days after illness onset can help to confirm a Lyme disease diagnosis
Most people treated with oral antibiotics during the early stages of Lyme disease fully recover. Antibiotics commonly used for oral treatment include doxycycline, cefuroxime axetil, or amoxicillin. It’s important to initiate treatment as soon as possible after symptoms start. Delaying treatment can lead to more serious symptoms or long-term health effects.
This table shows the current treatment for early-stage Lyme Disease recommended by the CDC.
| Age Category | Drug | Dosage | Maximum | Duration |
|---|---|---|---|---|
| Adults | Doxycycline | 100 mg, twice per day orally | N/A | 10–14 days |
| Adults | Cefuroxime axetil | 500 mg, twice per day orally | N/A | 14 days |
| Adults | Amoxicillin | 500 mg, three times per day orally | N/A | 14 days |
| Children | Doxycycline | 4.4 mg/kg per day orally, divided into two doses | 100 mg per dose | 10-14 days |
| Children | Amoxicillin | 50mg/kg per day orally, divided into three doses | 500 mg per dose | 14 days |
| Children | Cefuroxime axetil | 30 mg/kg per day orally, divided into three doses | 500 mg per dose | 14 days |
If treatment is delayed, the bacteria can spread to the joints, heart, and nervous system. This can have long-term effects.
Lyme disease can be difficult to treat in later stages. Severe cases may require intravenous antibiotic treatment. Some people may have symptoms that won’t go away or return after proper antibiotic treatment. This condition is called Post-Treatment Lyme Disease Syndrome.
Contact us
Questions about illnesses spread by ticks? Contact us!
Bureau of Communicable Diseases
Phone: 608-267-9003
Fax: 608-261-4976