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Lyme Disease

Lyme disease is caused by the bacterium Borrelia burgdorferi and is the most common tick-borne infection in NYC and in the U.S. This disease can affect both humans and animals. Since 2020, over 2,000 cases are reported each year in NYC.

Lyme disease is spread through the bite of an infected blacklegged tick (also called a deer tick). However, not all blacklegged ticks are infected. If you are bitten by an infected tick, in most cases the tick must stay attached to you for 24 to 36 hours before it can pass on the bacteria that cause Lyme disease. If left untreated, an infection can spread to the joints, heart and nervous system.

Lyme disease cannot spread from one person to another.

If left untreated, an infection can spread to the joints, heart and nervous system.

Prevention

To prevent Lyme disease, learn to recognize habitats where you may come in contact with ticks such as wooded, brushy, and tall grassy areas and practice tick-protective-behaviors when visiting these areas.

In NYC, blacklegged ticks are most often found in Staten Island and parts of the northern Bronx where deer live. Small numbers have also been found in eastern Queens, and on rare occasion in areas of Brooklyn and northern Manhattan. However, most NYC patients with Lyme disease become infected after traveling to nearby areas where blacklegged ticks are common, including Long Island, upstate New York, and surrounding states.

Blacklegged ticks are most common in Northwestern and Midwestern states. Besides Lyme disease, they can also transmit anaplasmosis, babesiosis, and Powassan virus.

Prevention for Pets

Pets (mainly dogs) can get Lyme disease. It is important to remember to check your pet for ticks especially after spending time outdoors. Run your fingers through their fur to feel for any small bumps and check for areas that look irritated. Ask your veterinarian about ways to keep ticks off your pet.

Symptoms

If you are infected with Lyme disease, you may experience a variety of symptoms.

Early symptoms that usually begin three to 30 days after a tick bite:

  • Fever
  • Fatigue
  • Headache
  • Joint and muscle pain
  • Weakness
  • An erythema migrans rash — also described as a bulls-eye or target-shaped rash.
    • Not everyone will develop a rash.
    • This rash is different from normal redness around a tick bite.

Late symptoms that may appear days to months after a tick bite:

  • Arthritis with joint pain and swelling
  • Headache or stiff neck
  • Persistent weakness and fatigue
  • Problems with the nervous system (facial palsy, numbness)
  • Problems with the cardiac system (heart palpitations, irregular heartbeat)

Diagnosis

If you experience symptoms of Lyme disease after spending time in a tick habitat, visit your health care provider.

Blood tests can help diagnose Lyme disease. The Centers for Disease Control and Prevention (CDC) recommend a two-step testing process. If the first blood test is positive or indeterminate, a second test is done. If the second test is positive or indeterminate, your health care provider can make a diagnosis. Testing is not recommended if you do not have symptoms consistent with Lyme disease.

Blood tests are not necessary to diagnose patients who have an erythema migrans rash. Patients with an erythema migrans rash should be treated for Lyme disease as laboratory tests may be negative in the early stages when the rash is present.

Treatment

Lyme disease can be treated with prescription antibiotics. If you take oral antibiotics in the early stages of Lyme disease, you are likely to recover fully within a few weeks. People with certain neurological or cardiac forms of Lyme disease may need intravenous (IV) antibiotics.

In rare cases, symptoms may persist for more than six months, a condition known as Post-treatment Lyme Disease Syndrome.

Questions about treatment should be discussed with your health care provider.

Additional Resources

Print copies of the below materials may be requested by calling 311.

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