3 Personal history She had a remote history of a cesarean section she had no known allergies She lived with her husband and dog and was a homemaker During the 2 months before the onset of illness, she had been living in a wooded area of coastal New England; she took frequent walks to ponds and to the beach, kayaked, and had seen deer skunks, and rabbits Several months before the onset of illness, she had taken a hiking trip in southern California Consumed alcohol in moderation, did not smoke or use illicit drugs, and had no exposure to sick persons A sister had systemic lupus erythematosus, and other family members had hypertension, cataracts, and glaucoma3 Personal history : She had a remote history of a cesarean section she had no known allergies She lived with her husband and dog and was a homemaker. During the 2 months before the onset of illness, she had been living in a wooded area of coastal New England; she took frequent walks to ponds and to the beach, kayaked, and had seen deer, skunks, and rabbits. Several months before the onset of illness, she had taken a hiking trip in southern California Consumed alcohol in moderation, did not smoke or use illicit drugs, and had no exposure to sick persons. A sister had systemic lupus erythematosus, and other family members had hypertension, cataracts, and glaucoma