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Eugene D. Shapiro,7 Allen C. Steere,9 and Lyme Disease, Department of Medicine, 3Department Thoma J. Rush,' D l W. R n, of Neurology, and 4Department of Medicine, Health Sciences Center, Thomas J. Rush,5 Daniel W. Rahn,10 a sa J. ,' 'Danid W Prang, State University of New York at Stony Brook, and 5private practice, Patricia K. Coyle,3 David H. Persing,1 Briarcliff Manor, New York; 6Division of Vector-Borne Infectious Durland Fish,8 and Benjamin J. Luft4 Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado; Departments of 7Pediatrics and 8Epidemiology and Public Health, Yale University School of Medicine, New Haven, Connecticut; 9Tufts University School of Medicine, New England Medical Center, Boston, Massachusetts; 'OOffice of Medical Management, Medical College of Georgia, Augusta; and "Diagnostics Development, Corixa Corporation, and Infectious Disease Research Institute, Seattle Life Sciences Center, Seattle, Washington