In the last 10 years, Lyme disease has been diagnosed in every state except for Hawaii. However, 96% of all confirmed cases of Lyme were isolated to only 14 states in 2014. Since then, the disease has been widely studied and diagnosed in nearly every state. Here are the top 12 worst states:

12. Maryland
Incidence of Lyme disease: 16.0 (per 100,000 residents)
Maryland is one of several Mid-Atlantic states where Lyme disease is more than twice as common as it is nationwide. There were 16.0 confirmed cases of the disease in 2014 for every 100,000 residents, far more than the national incidence of 7.9 cases per 100,000 people.

11. Minnesota
>Incidence of Lyme disease: 16.4 (per 100,000 residents)
There were 896 confirmed cases of Lyme disease and another 520 likely cases in Minnesota in 2014 alone. Counties at the highest risk of Lyme disease are located in the northern half of the state, and along the border with Wisconsin, a state with a similar Lyme incidence rate.

10. Wisconsin
>Incidence of Lyme disease: 17.2 (per 100,000 residents)
Wisconsin is the worst state in the Midwest for Lyme disease. There were 17.2 confirmed cases of the disease for every 100,000 state residents in 2014, well more than double the nationwide Lyme disease infection rate. Incidence of the disease peaks in summer months — and 2014 was no different in Wisconsin. More than half of all confirmed cases that year were reported in June and July

9. New Jersey
>Incidence of Lyme disease:
29.0 (per 100,000 residents)
There were 2,589 confirmed cases of Lyme disease and another 697 probable cases in New Jersey in 2014. Though only about 5% of New Jersey residents live in rural areas, nearly 95% of people in the Garden State have easy access to areas for physical activity, the largest share of any state in the country.

8. Delaware
>Incidence of Lyme disease: 36.4 (per 100,000 residents)
Lyme disease was more common in Delaware than in any other state during five of the last 10 years. However, the diagnosis rate has fallen recently in the state. There were 36.4 confirme

7. New Hampshire
Incidence of Lyme disease: 46.9 (per 100,000 residents)
There were 622 cases of Lyme disease in New Hampshire in 2014. The incidence of Lyme disease diagnosis can vary year to year depending on a number of conditions, including weather and awareness.

6. Connecticut
Incidence of Lyme disease: 47.8 (per 100,000 residents)
Lyme disease gets its name from Lyme, Connecticut, a small town along the eastern shore of Connecticut River, just north of Long Island Sound. The disease was discovered there in the mid-1970s, when children were being diagnosed with juvenile rheumatoid arthritis at the height of tick season. Today, Lyme disease is far more common in Connecticut than in much of the country, with 47.8 diagnoses for every 100,000 state residents in 2014.

5. Pennsylvania
>Incidence of Lyme disease:
50.6 (per 100,000 residents)
Pennsylvania had the highest number of confirmed cases of Lyme disease in 2014. There were 50.6 cases of the disease for every 100,000 state residents, more than in all but four other states. As was the case in many other states, 2014 marked a 10-year high for Lyme disease in Pennsylvania. In fact, the 2014 infection rate in the Keystone State is nearly double the rate from just five years ago.

4. Rhode Island
>Incidence of Lyme disease: 54.0 (per 100,000 residents)
There were only 3.6 Lyme disease diagnoses for every 100,000 Rhode Island residents in 2005. Since then, the incidence of Lyme disease in the state has shot up, and 2014’s rate was 15 times higher. This was by far the largest increase in the country. Some medical experts attribute the sharp increase to underreporting in years past.

3. Massachusetts
Incidence of Lyme disease: 54.1 (per 100,000 residents)
In the last 10 years, the incidence of Lyme in Massachusetts peaked in 2009, when there were 61 cases for every 100,000 residents. Still, the diagnosis rate of 54.1 incidents per 100,000 people in 2014 is 49% higher than it was 10 years prior.

2. Vermont
>Incidence of Lyme disease: 70.5 (per 100,000 residents)
Lyme disease is more common in Vermont than in any other state in the country other than Maine. While the high incidence of Lyme disease in Vermont is largely attributable to geography, the active, outdoor lifestyles of state residents also increases their risk of exposure. Nearly 81% of adults in the state are regularly physically active, one of the highest shares of any state in the country.

1. Maine
Incidence of Lyme disease: 87.9 (per 100,000 residents)
The Lyme disease incidence rate of 87.9 diagnoses per 100,000 Maine residents is the highest it has been in the state in the last decade. Lyme disease is more than twice as common as it was just five years ago. It is perhaps not surprising that Maine is also the most rural state in the