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Health Department Announces Lyme Disease Cases Decreased in 2018

Cases of Lyme disease decreased in every borough to 753 in 2018, the lowest since 2013

Health Department encourages New Yorkers to protect themselves from mosquito and tick-borne illnesses as summer approaches

June 3, 2019 — As summer nears, the Health Department urges New Yorkers to protect themselves from mosquito- and tick-borne illnesses. Last year, there were 753 cases of Lyme disease among New Yorkers, compared to 1090 in 2017, with decreases in all five boroughs. In 2018, there were 36 cases of West Nile virus, a mosquito-borne illness, among New Yorkers.

“The summer is one of the best times to explore all that the city has to offer,” said Health Commissioner Dr. Oxiris Barbot. “The Health Department encourages residents to enjoy our beautiful parks, beaches and outdoor activities, but to also take necessary precautions to protect themselves and their families from mosquito- and tick-borne diseases.”

In 2018, every borough experienced a decrease in cases of Lyme disease cases, reversing a trend. Lyme disease cases had been on the rise since 2014. In 2018, there were 264 reports of Lyme disease in Manhattan; 282 in Brooklyn; 85 in Queens; 88 in Staten Island; and 34 in the Bronx, compared to 2017 with 385 in Manhattan; 384 in Brooklyn; 150 in Queens; 124 in Staten Island; and 47 in the Bronx.

The City has an extensive surveillance system to monitor mosquito and tick populations. Visit the Health Department homepage to learn more about mosquito- and tick-borne illness. The City also released an advisory (PDF) to health care providers about tick-borne diseases.

“The reduction in the reported number of Lyme Disease cases in all five boroughs gives us cause to wonder,” said Staten Island Borough President James Oddo. “Certainly, there has been a concerted effort in the last five years to raise awareness and New Yorkers are now more likely to avoid tick-prone environments and check themselves for ticks. However, we also know that Lyme and other tick-borne illnesses are woefully underreported. In fact, the Health Department has stated that only 55% of health care providers respond to the Health Department’s requests for clinical confirmation of Lyme diagnoses. We will continue full-throttle, to work with our partners at the city and state levels on raising awareness, reaching out to physicians and hospitals for increased reporting, and deploying tick control devices in our parks and natural areas. At a time when we’re encouraging Staten Island families to play and exercise outdoors in the ‘borough of parks,’ we want to be sure they can do so safely. Moving ahead, we appreciate the efforts of the Health Department and Columbia University teams working on tick-borne illnesses and tick control and look forward to more progress on this public safety issue.”

“Lyme disease is a serious threat to New Yorkers,” said Manhattan Borough President Gale A. Brewer. “Many thanks to the Health Department for working to combat these diseases. I’m relieved to see cases have decreased over the last year, but I urge everyone to continue to protect themselves from mosquitos and ticks as the summer season approaches.”

“I am happy and thankful to hear that the Health Department’s tick surveillance initiative on Staten Island led to a decrease in Lyme disease cases this past year. Tick-related illnesses have been a prevalent issue for quite some time,” said Council Member Joe Borelli. “As warmer weather approaches, there is no better time to experience the Island’s natural beauty — aptly nicknamed the Borough of Parks — than now. I urge all those who intend to be outdoors more often to take the necessary preventative measures in order to protect themselves and to ensure that this positive trend continues.”

“A 30 percent drop in Lyme disease cases year-to-year is a very encouraging sign, and I am optimistic that our robust public awareness campaign and continuing efforts to keep the tick population in check will result in even fewer cases in the next few years,” said Council Minority Leader Steve Matteo. “As we venture outdoors this summer, I encourage all Staten Islanders and New Yorkers to visit the Department of Health and Mental Hygiene’s website to get more information on how to protect themselves and their families from tick bites.”

About Lyme disease and other tick-borne diseases

Lyme disease is the most commonly reported tick-borne illness in New York City. Early symptoms of Lyme disease include a skin rash that expands over several days, fever, headache, muscle and joint aches and swollen lymph nodes. If left untreated, the infection may spread to the joints, heart or the nervous system. For those New Yorkers for whom we have data, most were infected with Lyme disease and other tick-borne diseases including anaplasmosis and babesiosis, after traveling to surrounding areas, including Long Island and upstate New York, and other areas where blacklegged and lone star ticks are well-established. However, these ticks are also present and spreading disease throughout Staten Island and northern Bronx.

Last year, the city announced a $600,000 initiative to enhance tick surveillance, outreach and control measures on Staten Island. This summer, the Health Department will be launching bait boxes as part of the initiative. Tick surveillance by the Health Department has identified several types of ticks throughout New York City, though only some types of ticks are known to transmit diseases. Staten Island currently has the most tick surveillance sites ever, having increased from 14 to 24 since 2017. Learn more about ticks in New York City and the diseases they spread.

A citywide decrease was also seen for anaplasmosis and babesiosis. In 2018 there were 65 anaplasmosis cases, compared to 84 cases in 2017. There were 83 babesiosis cases in 2018 compared to 90 in 2017.

Recommendations to prevent tick bites and tick-borne illnesses

  • Reduce your risk at home — if ticks are present, create a tick-safe zone.
    • Keep grass short and don’t let piles of brush or leaves build up.
    • Trim shrubs and tree branches around your yard to let in more sunlight.
    • Create a barrier to define a tick-safe zone around your yard.
    • Keep playground equipment and outdoor furniture in a sunny location, away from yard edges and trees.
    • Don’t leave out food that attracts deer and other wildlife.
  • Repel, don’t attract, ticks.
    • Use insect repellent that contains DEET, picaridin, IR3535 or oil of lemon eucalyptus extract (also known as PMD).
    • Permethrin products can be used on clothing or shoes (but not the skin) to repel and kill ticks.
    • Stay in the center of cleared paths and hiking trails when walking in heavily-wooded areas.
    • Wear light-colored clothing to see ticks easier.
    • Tuck pants into socks and shirts into pants to prevent ticks from attaching to your skin.
    • Tie hair up or wear a hat.
    • Wear gloves when gardening.
  • Pets
    • Ask your veterinarian which flea and tick repellents are best to use on your pet.
    • Dogs can also get sick from ticks. If you think your dog may have been bitten by a tick and you see changes in your dog’s behavior or appetite, speak with your veterinarian.
  • After being outdoors in wooded, brushy or tall, grassy areas.
    • Check for ticks on your body and clothing and remove any ticks you find on yourself, your child or your pet.
    • Young ticks are very small (about the size of a poppy seed), so seek help to inspect not easily reachable areas. Be sure to look carefully in areas of the body where hair is present, since it may make it difficult to see the ticks. Adult ticks are about the size of an apple seed.
    • Bathe or shower as soon as possible after coming indoors, preferably within two hours.
    • Use hot water when washing clothing to kill ticks. If hot water cannot be used, tumble dry on low heat for 70 minutes or high heat for 40 minutes.
    • Place dry clothing in a dryer on high heat for 10 minutes to kill ticks. Wet or damp clothing might need more time in the dryer.
    • If you get a rash or a fever, let the doctor know if you may have been exposed to ticks, even if you don't remember having a tick bite.

About West Nile virus

West Nile virus is a disease spread by mosquitos found in New York City. West Nile virus can cause severe illness, including meningitis and encephalitis most often among individuals over 50 or with a weakened immune system. Others may experience milder symptoms, which include headache, fever, fatigue, and rash. New Yorkers who travel are also at risk for other diseases spread by mosquitos such as Zika, chikungunya and malaria and dengue. There have been no local transmissions of these diseases in New York City.

The Health Department uses an integrated vector management program to control West Nile virus, which was first detected in New York City 20 years ago. Starting in early June, and continuing throughout the summer, the Department uses data from mosquito surveillance to direct control efforts. Larvicide is used to kill mosquito larvae before they grow into adults and is applied by helicopter, truck or backpacks. When needed, trucks are used to apply pesticides to targeted areas in order to kill adult mosquitoes and prevent them from spreading disease.

To further reduce mosquito populations, the Health Department also removes standing water and applies larvicide to sites that cannot be emptied or drained; investigates standing water complaints filed through 311; and educates the public about mosquito-borne illnesses through outreach.

Recommendations to prevent infection with West Nile virus

  • Reduce your risk at home.
    • Remove standing water that collects on your property and remind or help neighbors to do the same. Report standing water by calling 311 or visiting here.
    • Make sure your windows have screens, and repair or replace screens that have holes.
    • Add a large fan to a small deck of your home.
  • Repel, don’t attract, mosquitos.
    • Use an EPA-approved insect repellent containing picaridin, DEET, oil of lemon eucalyptus (not for children under 3), or products that contain the active ingredient IR3535.
  • Cover up.
    • Wear protective clothing outside, such as long pants and long-sleeved shirts, especially during the evening, night and dawn, when mosquitoes that transmit West Nile virus are most active.
  • Remind your loved ones to protect themselves.
    • If you have family or friends who are older or may have a weakened immune system (e.g., on chemotherapy), encourage them to use insect repellents and cover up when outdoors.

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