Ixodes scapularis : Vector to an Increasing Diversity of Human Pathogens in the Upper Midwest

The black-legged tick, , is now recognized as the deadliest tick vector in the United States. The Upper Midwest, particularly Wisconsin and Minnesota, are endemic to a diversity of tick-transmitted infectious diseases. Although , the agent of Lyme disease, still accounts for the majority of diagnosed infections, is known to transmit other bacterial, viral, and parasitic agents. To provide an overview of the array of pathogenic microorganisms carried by ticks in the Upper Midwest. A literature review was conducted to collect and analyze current information about lifestyle, transmission, microorganisms carried by the arthropod vector, and the diseases that occur as a result of infections with these microorganisms in the Upper Midwest. Diagnosis of co-infection from tick-borne zoonosis in humans has increased over the last 2 decades. Since I scapularis can transmit multiple pathogens, it is clinically important because different diagnostic testing and treatment strategies may need to be implemented for a patient with -borne infection(s). This review has concentrated on -transmitted diseases affecting the Upper Midwest and has explored the ecology of the vector and its role in pathogen transmission.