This includes states around the Great Lakes like Wisconsin, Minnesota, northern Illinois, Indiana, Michigan. These areas also have the blacklegged tick, so Lyme, anaplasmosis, and babesiosis are common here (Wisconsin and Minnesota in particular see a lot of these). Anaplasmosis has been on the rise in Minnesota/Wisconsin. There’s a pocket of ehrlichiosis in the Midwest too: Missouri and Arkansas have quite a bit of it, carried by Lone Star ticks. Minnesota and Wisconsin have also reported Powassan virus cases in recent years. RMSF occurs in the Midwest but not as frequently as in the South (though Missouri, Oklahoma, and Arkansas – bordering Midwest/South – are hotspots for RMSF).