Tick-borne illnesses are on the increase in the United States and disease cases have doubled between 2004 and 2016, according to a new report released by the Centers for Disease Control and Prevention.

Further, the report found that disease cases from infected mosquitoes, ticks and fleas have tripled in 13 years and since 2004, nine vector-borne diseases were discovered or introduced for the first time from the United States and its territories.

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According to the CDC report, 48,000 tick-borne diseases were reported in 2016 and Lyme disease accounted for 82 percent of all tick-borne diseases between 2004 and 2016. In 2004, 22,000 tick-borne diseases were reported. In its report, the CDC said the nation needs to be better prepared to face this public health threat.

“Zika, West Nile, Lyme, and chikungunya—a growing list of diseases caused by the bite of an infected mosquito, tick, or flea—have confronted the U.S. in recent years, making a lot of people sick.

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And we don’t know what will threaten Americans next,” CDC Director Robert R. Redfield said in a news release. “Our Nation’s first lines of defense are state and local health departments and vector control organizations, and we must continue to enhance our investment in their ability to fight against these diseases.”

In Michigan, between 2004 and 2016, there were 1,493 tick-borne disease cases, according to CDC data. Michigan was in the third 20 percent of states for tick-borne diseases. Michigan had slightly more cases than Ohio, but less than Indiana. Tick-borne diseases occur throughout the country but predominate in the eastern parts of the country and along the Pacific Coast.

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