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July 2012 New York City Department of Health and Mental Hygiene Vol.3(3):17-24


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Preventing and Managing Lyme and Other Tick-borne Diseases
  • Advise patients to use tick checks, DEET, and showers to avoid tick bites; if a tick is attached, it should be removed promptly and safely.

  • Ask patients with suggestive symptoms such as fever, headache, malaise, and/or rash about travel history, as most tick-borne infections are acquired outside of New York City.

  • Follow recommended testing protocols, including repeat testing if indicated, because symptoms may be nonspecific and immune response is often delayed.



Most ticks go through 4 life stages: egg, 6-legged larva, 8-legged nymph, and adult, and must eat blood at every stage after egg. Ticks will attach to a host (usually small mammals such as the white-footed mouse) and suck the blood slowly for several days. If the host has a bloodborne infection, the tick will ingest the pathogens with the blood. At the next feeding, the tick can potentially transmit the disease when attaching to a person, pet, or other animal.1,2

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