In the ten states where Lyme disease is most common, the average was 31.6 cases for every 100,000 persons for the year 2005.Although Lyme disease has been reported in all states about 99% of all reported cases are confined to just five geographic areas (New England, Mid-Atlantic, East-North Central, South Atlantic, and West North-Central). New 2011 CDC Lyme case definition guidelines are used to determine confirmed CDC surveillance cases.Effective January 2008, the CDC gives equal weight to laboratory evidence from 1 a positive culture for B. burgdorferi; 2) two-tier testing (ELISA screening and Western blot confirming); or 3) single-tier IgG (old infection) Western blot. Previously, the CDC only included laboratory evidence based on (1) and (2) in their surveillance case definition. The case definition now includes the use of Western blot without prior ELISA screen.The number of reported cases of the disease has been increasing, as are endemic regions in North America. For example, B. burgdorferi sensu lato was previously thought to be hindered in its ability to be maintained in an enzootic cycle in California, because it was assumed the large lizard population would dilute the number of people affected by B. burgdorferi in local tick populations; this has since been brought into question, as some evidence has suggested lizards can become infected.Except for one study in Europe, much of the data implicating lizards is based on DNA detection of the spirochete and has not demonstrated that lizards are able to infect ticks feeding upon them.
High-functioning autism (HFA) is an autism classification where a person exhibits no intellectual disability, but may exhibit deficits in communication, emotion recognition and expression, and social interaction. HFA is not included in either the American Psychological Associations DSM-5 or the World Health Organizations ICD-10, neither of which subdivides autism based on intellectual capabilities. Characterization
High-functioning autism is characterized by features similar to those of Asperger syndrome. The defining characteristic recognized by psychologists is a significant delay in the development of early speech and language skills, before the age of three years. The diagnostic criteria of Asperger syndrome exclude a general language delay.Further differences in features of people with high-functioning autism from those with Asperger syndrome include the following:
Lower verbal reasoning ability
Better visual/spatial skills (higher performance IQ)
Less deviating locomotion (e.g. clumsiness)
Problems functioning independently
Curiosity and interest for many different things
Not as good at empathizing with other people
Male to female ratio (4:1) much smallerAs of 2013, Asperger Syndrome and High-functioning autism are no longer terms used by the American Psychological Association, and have instead both been merged into autism spectrum disorder (ASD). As of 2021, the World Health Organization also retired the terms and merged them into autism spectrum disorder. Comorbidities
Individuals with autism spectrum disorders, including high-functioning autism, risk developing symptoms of anxiety.