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Virtually all recurrences occurred 1 year or more apart. In 20 of the 22 paired episodes of erythema migrans , during June through August the recurrence was observed, paralleling the experience of nymphal I. Scapularis ticks, the vector responsible for more than 90 percent of cases of Lyme disease in the usa. 33 It is unlikely a relapsed infection would have such a seasonal distribution when there exists a delay of 1 1 year or even more between episodes of erythema migrans. In a earlier article describing patients with erythema migrans who acquired a relapse after ineffective therapy with cephalexin, relapses were observed within times to weeks.3 In the 22 paired episodes, 12 different ospC genotypes caused infection, including 8 different genotypes at the initial bout of erythema migrans, and 11 different ospC genotypes at the next episode .