An 11-year-old girl has died of Lyme disease, marking what could be the nation's first reported case of a fatality caused by the tick-borne illness, health officials said Wednesday.

The listing of Lyme disease as the cause of death for Mandy Schmidt, of Sayreville, was confirmed Tuesday, said Bernard Mihalko the director of the Middlesex County Health Department.The death also was believed to be the first in the nation caused solely by Lyme disease, said Dr. Terry Schulze, a state Health Department research scientist.

"To my knowledge it's the first time we've had that in New Jersey," Schulze said. "I've heard anecdotally of deaths attributable to Lyme disease from other states, but there's always been some other underlying medical problem that was exacerbated by the Lyme disease."

Tom Skinner, a spokesman for the federal Centers for Disease Control in Atlanta, said Wednesday the agency had never received a report of a death from Lyme disease.

"We have never received a report of a case fatality as a result of Lyme disease. If a case were to go untreated there is a slight possibility it could result in death. But we have never receive a case fatality. It would be the first if that is the case," he said.

Lyme disease is spread to humans by deer ticks infected with the bacteria.

Symptoms include fever, fatigue, headache and stiffness in the neck. Later on in the disease the patient can also suffer swelling and pain in the larger joints, especially the knees.