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August 2, 1995

Lyme Disease in Unwary Physicians: A Curbside Cluster

Author Affiliations

Alfred I. duPont Institute Wilmington, Del

JAMA. 1995;274(5):383-384. doi:10.1001/jama.1995.03530050031024

To the Editor.  —Environmental exposure to Ixodes ticks and subsequent infection with Borrelia burgdorferi has been associated with certain outdoor occupations.1-3 For physicians, infectious occupational hazards include human immunodeficiency virus and hepatitis B encountered in the clinical setting; certain arthropod-borne diseases (typhus, malaria, yellow fever) have been acquired by physicians in field hospitals. However, an increased risk of Lyme disease has not been previously described.Five cases of Lyme disease occurred over 1 year among physicians at a children's hospital in an endemic area. All had erythema migrans, two had neurologic involvement, and each presented to the infectious diseases service as "curbside" consultations (Table). This series stimulated us to consider the possibility that physicians might be uniquely vulnerable to Lyme disease. Whether five cases among 83 employed physicians and 55 pediatric residents represents a true clustering is unknown (there may also have been additional cases of which we are

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