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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.



Providers should become familiar with the epidemiology, diagnostic challenges, and treatment of the tick-borne diseases their patients are most likely to acquire. Primary care providers should educate patients about simple measures they can take to prevent tick bites and tick-borne diseases, and what to do if they are bitten or have concerning symptoms. Presumptive diagnosis should be based on local patterns of disease, history, symptomatology, and testing according to recommended protocols. Treatment in most cases should begin pending confirmatory laboratory testing.


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