After several weeks with no medical answer, mother and daughter watched Discovery Health Channel’s ‘‘Mystery Diagnosis.”

A girl described Lyme disease, a tick-borne multi-inflammatory disease that can affect the central nervous, cardiovascular and muscular-skeletal systems, as a wave of pain that started at the top of her head and rolled through her body.

Amalia said, ‘‘‘Mommy, that’s me,’” Rivera-Oven said last week.

In 2006, Montgomery County tallied the state’s most new reported cases of Lyme disease, said nurse Tina Lacey, director of the county’s disease control program in the department of Health and Human Services.

The disease has reached epidemic and endemic proportions in the county, she said Thursday. It ‘‘has become commonplace and is part of the landscape,” Lacey said.

From 2000-2004, Montgomery County saw 80, 69, 68, 49, and 38 new cases, respectively, Lacey said. New Lyme disease diagnoses in the county shot up to 216 in 2005, she said. In 2006, 228 residents met state criteria for the disease.

More people moving into tick habitats, increased medical community awareness, testing and health department surveillance or ‘‘just more ticks and Lyme disease” could be behind the spike, Lacey said.

A recent epidemiology report from state health department doctors showed the county’s highest incidences of Lyme disease from 1994 to 2005 were reported in the 20854, 20874, 20878, 20882 and 20879 ZIP codes — or Potomac, Germantown, Gaithersburg and Laytonsville.

Brookeville has also been hit hard, said state Del. Karen Montgomery (D-Dist. 14).

‘‘I went up and down the three blocks of our town,” said Montgomery of Brookeville, population 128. ‘‘Almost every household has had some Lyme disease.”

She has had Lyme once, her husband twice, she said, and could ‘‘hardly lift my face out of my breakfast cereal.”

According to the federal Centers for Disease Control, Maryland is among the top five states for overall and new cases.

There have been nearly 12,000 cases of Lyme disease in Maryland since 1980, the CDC reported Sept. 15.

As of last week, a record number of new cases had been reported in the state this year.

Diagnosis questions

Some believe the disease is underdiagnosed.

The Bethesda-based International Lyme and Associated Diseases Society has said CDC’s strict testing criteria excludes thousands of people, many with chronic and late-stage Lyme disease.

‘‘If you take the number and you multiply it by 20 you might get closer,” said Dr. Norton Fishman, who works with Optimal Health Physicians in Rockville. The internist said he treats about a half-dozen Lyme cases a day.

Many diagnosed with late-stage or chronic Lyme do not recall being bitten by a tick and first saw specialists for other illness, Fishman said.

Lyme can be misdiagnosed as ailments from fibromyalgia to neurological problems, he said.

Dr. Peter Eeg of the Poolesville Veterinary Clinic believes the disease has a much higher morbidity rate than people know — based on what he sees in his clinic.

Five years of annual Lyme testing on the clinic’s animal patients show 25 percent to 30 percent test positive for infection, he said.

‘‘We diagnose a case of Lyme disease probably once a day,” Eeg said. ‘‘We see anywhere from 10 to 15 animals a day, so it’s not like we’re seeing hundreds of animals and seeing one.”

He has seen Lyme in horses, dogs and cats but ‘‘would not be surprised if goats, sheep, cows and other production animals” are affected, he said.

‘‘If your animal has been diagnosed with Lyme disease, you should get your whole family tested,” Eeg said, ‘‘because if your pet is infected, Lyme disease is in your environment and you have likely had some exposure.”

Here to stay?

Grace Rivera-Oven wants a fence. Every day, about 30 deer cross the family’s 3-acre property, near a preservation park, she said.

But reducing county deer will not stop Lyme’s spread, according to the Montgomery County Deer Management Work Group’s 2008 annual report released in July.

‘‘In our area, ticks most often pick up the disease by feeding on infected mice and chipmunks, not deer,” the report said.

Deer drop ticks with two-year life spans and one adult female tick can lay 2,000 to 5,000 eggs in a season, Eeg said. White-footed mice are immune Lyme carriers.

‘‘Gaithersburg, Germantown, Clarksburg and all those areas that were farmed and were large agricultural areas and have become suburbanized will still have field mice presence,” Eeg said. ‘‘The mice aren’t eradicated when the bulldozers come, they just move.”