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In 2017, we surveyed forests in the upper Tennessee Valley, Tennessee, USA. We found Ixodes scapularis ticks established in 23 of 26 counties, 4 of which had Borrelia burgdorferi sensu stricto-infected ticks. Public health officials should be vigilant for increasing Lyme disease incidence in this region.
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Hickling et al. (2018) studied this question.
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