In these 10 states — Nebraska, Kansas, Minnesota, Iowa, Missouri, Wisconsin, Illinois, Michigan, Indiana, and Ohio — 137 out of every 100,000 emergency department visits in April were related to tick bites. That’s just shy of the one-month incident rate record the region saw last May, of 153 per 100,000, and well above the 56 per 100,000 it sees on average in April.