MONTREAL -- The number of reported cases of Lyme disease continued to rise in Quebec this year, reaching an annual high, according to recent data from the province’s Ministry of Health.

The number of confirmed or probable cases sat at 371 from Jan. 1 to Nov. 5, compared to 304 for 2018.

The worst year so far had been 2017, the ministry finds, with 329 reported cases.

Estrie remains Quebec's most affected region with 139 cases so far -- more than a third of the province's total number. In comparison, the Montérégie had 92 cases, Montreal had 62 and the Outaouais had 19.

Estrie has counted one of the worst regions since 2014, with the only exception being last year.

So far, there have been no reported cases of Lyme disease in Saguenay-Lac-Saint-Jean, on the Côte-Nord, the northern regions of Quebec, as well as Nunavik and James Bay.

Lyme disease can cause skin, neurological, joint, cardiac and vision complications. It is transmitted to humans bitten by an infected tick.

Authorities report that cases of Lyme disease usually occur when ticks are active during the spring and summer months.

However, some adult ticks, which are about the size of a sesame seed, are more active in the fall. They can also be active in winter during mild weather when there isn't much snow on the ground.