Epidemiology and Diagnosis of Lyme Disease in the United States.

Lyme disease, also referred to as Lyme borreliosis (LB), is an infection caused by tick-borne spirochetes in the Borrelia burgdorferi sensu lato (s.l) complex and is the most common vector-borne disease in the United States. Nonspecific clinical manifestations, pathogen persistence, immune system evasion, species-dependent tropism, and inherent limitations of current diagnostic assays, have all contributed to the diagnostic challenges associated with LB. This review presents a succinct summary of LB epidemiology, current recommended testing strategies, available technologies, and the future directions of LB diagnostics in the United States.