The Centers for Disease Control and Prevention identifies Butler, Clarion, Armstrong, Jefferson, Indiana, Elk, Clearfield and Cameron counties as high incidence areas with an average of 100 new cases for every 100,000 residents from 2010 to 2014.

Butler County was identified several years ago as one of more than a half-dozen counties in the region with a high incidence of Lyme disease and other tick-borne diseases.

That data, reported by the U.S. Centers for Disease Control and Prevention in 2013 and included in the 2015 “Lyme disease in Pennsylvania” report from a state Lyme disease task force, appears to still be accurate.

“We see a lot of Lyme disease. We see true Lyme disease. Some are not true Lyme disease,” said Uzma Shahzad, one of three physicians in Butler Memorial Hospital's infectious disease department. “We see quite a lot of patients with a Lyme disease diagnosis.”

This is despite the fact that very few tick bites result in transmission of the disease.

“The chance of contracting Lyme disease from a tick bite is 1 percent. The risk of transmission is low,” Shahzad said.

The task force study that resulted in the 2015 report was led by the Pennsylvania Department of Health and mandated by Act 83 of 2014.

The CDC data identifies Butler, Clarion, Armstrong, Jefferson, Indiana, Elk, Clearfield and Cameron counties as high incidence areas with an average of 100 new cases for every 100,000 residents from 2010 to 2014.

Information the CDC reported in 2017 reveals Pennsylvania had the third-highest incidence of Lyme disease in the country with 9,250 confirmed cases and 2,650 probable cases. Thirteen Northeastern states, from Virginia to Maine, as well as Michigan and Wisconsin were high incidence states.

Shahzad said there are several reasons the county is in the “endemic belt” for tick-borne disease, but issues with reporting cases of Lyme disease likely contribute to the high numbers.

“We have to look at the bigger picture. Deforestation forces deer into contact with people. We are doing it to ourselves — building houses deep in the woods,” she said.

Black legged or deer ticks carry the bacteria that cau

ses Lyme disease. They can be found on deer, mice, birds and many other animals.Diagnosing and reporting a true case of Lyme disease can be difficult. The task force report says there is no test to quickly and accurately diagnose the disease.A bite from an infected tick sometimes, but not always, produces a bullseye-shaped rash around the bite. Lyme disease symptoms mirror symptoms of other diseases, Shahzad said.“If I do a Lyme test, it reflects what happened eight weeks ago. It doesn't say what happened immediately,” she said.If blood test results show symptoms of Lyme disease, the case could get reported as Lyme disease even if the test is inconclusive, she said.“A lot of things are going on in the data reporting,” Shahzad said.The best way to diagnose a patient is to perform an examination and listen to his or her history to learn more, including whether they have spent time outdoors without wearing protective clothing or using insecticide, she said.Antibiotics are used to treat patients with Lyme disease.“In Pennsylvania, we do have one of the highest case counts in the U.S.A.,” said Nate Wardle of the department of health. “The black legged tick can be found in every county of Pennsylvania, and so Lyme disease can be found in every county of Pennsylvania.”To prevent a tick bite, the department recommends people cover exposed skin with light colored clothes and use insect bite repellents containing DEET, Wardle said.He said people should check themselves, their children and pets for ticks after coming in from outside.People should take showers to remove ticks, put clothes in a dryer for a few minutes to kill ticks and place anti-tick collars on pets, he said.Joyce Sakamoto, an assistant research professor at Penn State's entomology department, said the black legged tick (Ixodes scapularis) has been found in the state for more than 100 years, but has become the dominant species starting in the 1990s.The groundhog or woodchuck tick (Ixodes cookei) was the dominant species until the 1960s, when it was replaced by the American dog tick (Dermacentor variabilis), she said.She said researchers don't know why one species becomes dominant over others.