IN THIS ISSUE
Vectors of Tick-borne Diseases in New York City Residents
Box 1. What to Tell Your Patients About Preventing Tick-borne Diseases
Box 2. For Patients Who Have Found a Tick on the Skin
Box 3. How to Safely Remove an Embedded Tick
Figure 1. Petechial Rash - Rocky Mountain Spotted Fever
Figure 2. Erythema Migrans Rash - Lyme Disease
Table 1. Brief Guide to Diagnosing Tick-borne Diseases
Table 2. Treatment of
Printable version (PDF)
Lyme disease is the most commonly reported vector-borne disease in the United States (US). In New York City (NYC), there were 439 cases of Lyme disease as well as 57 of babesiosis, 36 of anaplasmosis, 12 of Rocky Mountain spotted fever (RMSF), and 4 of ehrlichiosis diagnosed in 2011. Most cases of tick-borne diseases, with the exception of Rocky Mountain spotted fever, are acquired outside NYC. In 2005-2007, 95% of infected patients traveled to areas surrounding NYC, most commonly to upstate New York and Long Island, but also Connecticut, New Jersey, Massachusetts, and Pennsylvania. Tick-borne diseases can have serious consequences, and the only means of prevention are patient awareness, protective measures, and prompt detection and removal of ticks.
Differential diagnosis of tick-borne diseases may be challenging because of nonspecific signs and symptoms, delayed antibody responses to infection, and coinfection with other diseases. Primary care providers (PCPs) must understand the epidemiology and clinical features of these diseases to initiate prompt testing and treatment.