<Tr> <Th> Prevention </Th> <Td> Prevention of tick bites (long pants, DEET), doxycycline </Td> </Tr> <Tr> <Th> Medication </Th> <Td> Doxycycline, amoxicillin, cefuroxime </Td> </Tr> <Tr> <Th> Frequency </Th> <Td> 365,000 per year </Td> </Tr> <P> Lyme disease, also known as Lyme borreliosis, is an infectious disease caused by bacteria of the Borrelia type which is spread by ticks . The most common sign of infection is an expanding area of redness on the skin, known as erythema migrans, that begins at the site of a tick bite about a week after it has occurred . The rash is typically neither itchy nor painful . Approximately 25--50% of infected people do not develop a rash . Other early symptoms may include fever, headache and feeling tired . If untreated, symptoms may include loss of the ability to move one or both sides of the face, joint pains, severe headaches with neck stiffness, or heart palpitations, among others . Months to years later, repeated episodes of joint pain and swelling may occur . Occasionally, people develop shooting pains or tingling in their arms and legs . Despite appropriate treatment, about 10 to 20% of people develop joint pains, memory problems, and feel tired for at least six months . </P>

Where does lyme disease occur in the world