City Health Information
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.

Image of Tick Size

PDF version of Vectors of Tick-Borne Diseases in NYC

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.

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