The New York City Department of Health issued an tick-borne disease (TBD) advisory today, alerting physicians to be on the alert for patients with TBD.

Ixodes scapularis/CDC

Locally acquired cases of Lyme disease and babesiosis continue to be reported from Staten Island, and smaller numbers have been reported from the Bronx.

Isolated cases of locally acquired anaplasmosis and ehrlichiosis have also been reported from Staten Island.

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Recent travel to upstate New York, Long Island, and other parts of the northeast, mid-Atlantic and upper mid-west should prompt consideration of TBDs. A history of a tick bite is not a prerequisite for considering TBDs for patients with compatible illness, since only a small proportion of patients diagnosed with these diseases recall being bitten by a tick.

Incidence rates of TBD are typically significantly higher in residents of Manhattan (and Brooklyn for Lyme disease) compared with other boroughs. However, since 2015, Staten Island has had the highest incidence rate of Lyme disease in NYC, which may be due to an increasing number of locally acquired cases.

Tick-borne diseases in NYC have been trending upward since 2000, with fluctuations from year to year. However, in 2018, the number of Lyme disease, anaplasmosis and babesiosis cases decreased across all boroughs from the previous year.

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This decrease was also seen in neighboring jurisdictions. In comparison, from 2016 to 2017, the number of Lyme disease cases increased by 15%, and anaplasmosis and babesiosis cases approximately doubled in all boroughs except Queens.

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