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Edward P. Romaine, County Executive
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Departments > Health Services > Public Health > Preventive Services > Arthropod-Borne Diseases > Ticks

Human hand with tick

Ticks and Tick-Borne Diseases

Ticks and Tick-Borne Diseases

Ticks can transmit disease, including Lyme disease, ehrlichiosis, babesiosis, Rocky Mountain spotted fever, and Powassan virus. In recent years, researchers have also found that ticks may cause an allergy to meat, known as alpha-gal allergy.

Ticks can be active year-round, even during winter, whenever temperatures are above 40° F. As a result, precautions should be taken against tick bites throughout the year. Smaller nymphal ticks typically carry lower levels of disease than larger adult ticks, however nymphal ticks are responsible for spreading more disease. This is because smaller nymphal ticks are harder to find during tick checks than larger adults, so be sure check yourself carefully after being outdoors!

Also, did you know that different kinds of ticks can transmit different diseases? Keep reading to learn more.

backlegged tick

Photo Credit: CDC

Blacklegged Tick

(also known as Deer Tick) (Ixodes scapularis)

transmits Lyme disease, anaplasmosis, babesiosis, Borrelia miyamotoi disease, and Powassan virus disease.

Lyme disease is caused by the bacterium Borrelia burgdorferi. A characteristic sign of Lyme disease is a red circular rash (bull’s-eye rash) that may appear a few days to a month, at the site of the bite, after being bitten by an infected tick. Multiple rashes may develop. About 60-80% of people who get Lyme disease develop a bull’s-eye rash. Flu-like symptoms, such as fever, headache, fatigue, stiff neck and muscle/joint pain, are also common in early Lyme disease. If left untreated, Lyme disease can cause complications such as recurring swollen and painful joints, temporary facial paralysis or heart problems.

Lyme Disease Information from New York State Department of Health

Lyme Disease Information from Centers for Disease Control and Prevention (CDC)

Babesiosis is a rare and sometimes deadly disease caused by the protozoan Babesia microti. The disease can cause fever, fatigue and anemia (low red blood cell levels) lasting from days to months. It may take from 1-8 weeks for symptoms to appear.

CDC Babesiosis Information

Borrelia miyamotoi Disease is caused by the bacterium Borrelia miyamotoi. Signs and symptoms include fever, chills, and headache. Other common symptoms include body and joint pain and fatigue.

CDC Borrelia miyamotoi Information

Anaplasmosis is caused by the bacterium Anaplasma phagocytophilum and may cause flu-like symptoms 1-3 weeks after the bite of an infected tick. Infection usually produces mild to moderately severe illness, with high fever and headache, but may occasionally be life-threatening or even fatal.

CDC Anaplasmosis Information

Powassan Virus is named after Powassan, Ontario, where it was first discovered in 1958. Signs and symptoms of infection can include fever, headache, vomiting, weakness, confusion, seizures, and memory loss. Long-term neurologic problems may occur. This virus is very rare and has only been detected at extremely low levels in Suffolk County ticks.

CDC Powassan Virus Information

lone star tick

Photo Credit: CDC

Lone Star Tick

(Amblyomma americanum)

transmits ehrlichiosis, tularemia, and southern tick-associated rash illness (STARI), Bourbon virus disease and Heartland virus disease. Also is associated with alpha-gal syndrome (AGS).

Ehrlichiosis is caused by the bacteria Ehrlichia chaffeensis and Ehrlichia ewingii and is similar in many ways to anaplasmosis.

CDC Ehrlichiosis Information

Tularemia is caused by the bacterium Francisella tularensis. One way to become infected is through the bite of an infected tick. Symptoms of tularemia include swollen lymph glands and a skin ulcer at the site of the bite.

CDC Tularemia Information 

Southern Tick-Associated Rash Illness (STARI) is thought to be caused by the bacterium Borrelia lonestari and is similar to Lyme disease. Individuals infected with STARI may develop flu-like symptoms and a bull’s-eye rash. However, STARI itself does not appear to be serious or potentially fatal.

CDC STARI Information

Bourbon Virus Disease was first discovered in 2014 in Bourbon County, Kansas. Cases have been reported in the Midwest and southern United States. This virus is very rare and has only been detected at extremely low levels in Suffolk County ticks.

CDC Bourbon Virus Information

Heartland Virus Disease was first discovered in 2009 in NW Missouri. Most cases have been reported from states in the Midwestern and Southern United States. This virus is very rare and has only been detected at extremely low levels in Suffolk County ticks.

CDC Heartland Virus Information

Alpha-gal Syndrome (AGS) is not caused by an infection but is an allergic reaction to red meat and animal products containing the sugar alpha-gal. Alpha-gal doesn’t naturally occur in people. Evidence suggests that bites from the lone star tick are associated with the development of this allergy. Symptoms include hives, nausea, diarrhea or anaphylactic shock. Lone star tick bites during the summer may result in symptoms occurring months later.

CDC Alpha-Gal Allergy Information

Alpha-gal allergy: Meat Allergy Caused by Lone Star Tick

Alergia Alpha-Gal: Alergia A La Carne Causada Por La Garrapata Estrella Solitaria

american dog tick

Photo Credit: CDC

American Dog Tick

(Dermacentor variabilis)

transmits Rocky Mountain spotted fever and tularemia

Rocky Mountain spotted fever (RMSF) is caused by the bacterium Rickettsia rickettsii. RMSF is characterized by a sudden onset of moderate to high fever (which can last for 2-3 weeks), severe headache, fatigue, deep muscle pain, chills and rash, which begins on the legs/feet or arms/hands, and may spread rapidly to the rest of the body.  Symptoms usually appear within 2 weeks of the bite of an infected tick.

CDC Rocky Mountain spotted fever Information

Tularemia is caused by the bacterium Francisella tularensis One way to become infected is through the bite of an infected tick. Symptoms of tularemia include swollen lymph glands and a skin ulcer at the site of the bite.

CDC Tularemia Information

Diagnosis and Treatment

Be sure to seek medical attention if you become ill after a tick bite. Generally, an evaluation of symptoms and blood tests will be used in making a diagnosis. Most tick-borne disease patients respond well to appropriate antibiotic therapy. Prompt diagnosis and treatment improves outcome. Your physician will choose the medicine that is best for you.

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Personal Protection against Tick-Borne Diseases

Ticks will remain active year-round (when temperatures are above 40°F/4.4°C). Preventive measures should be used whenever tick-exposure is likely. Here are some steps to follow:

Suffolk County Department of Social Services logo
  • Wear light-colored clothing
  • Wear long pants and sleeves
  • Tuck your pants into your socks
  • Tuck your shirt into your pants
  • Consider using repellents as directed
  • Walk along the center of trails
  • Conduct frequent clothing checks
  • Once home, dry clothing on the highest temperature setting for 10 minutes to kill any ticks
  • Carefully inspect your body for ticks
  • Keep pets from tick infested areas and check them before entering the house.

Repellents

Repellents may be used to repel ticks and prevent tick attachment. Always read and follow all label directions carefully.

Tick Removal

Human hand with tick

Studies have shown that the tick must stay on the body for 36 hours to transmit Lyme disease. Prompt and proper tick removal is essential and may decrease your chances of getting tick-borne diseases. The steps are:

  • Use fine-point tweezers or tick-removal tools. Grasp the tick where its mouthparts enter the skin and pull the tick straight out.
  • Do not twist or squeeze the tick’s body. Be patient – proper tick removal takes time.
  • Do not use petroleum jelly, gasoline, lit matches, oils, or any other remedies to remove ticks. These methods may actually increase your chances of contracting a disease.
  • After removing the tick, disinfect the bite area and wash your hands.
  • Monitor the bite area for early signs and symptoms of Lyme disease
  • Call your physician if you get any symptoms.

Ticks do not burrow under the skin, and any remaining mouthparts after tick removal will not transmit disease. However, additional aggravation of the bite site may cause secondary bacterial skin infections.

CDC Tick Bite: What to Do

Tick Management Suggestions for Homeowners

Ticks do not jump, fly, or fall from trees. They crawl close to the ground on leaves, brush and tall grass. Homeowners should consider:

  • Keep lawn mowed and bushes trimmed;
  • Remove lawn debris and leaf litter;
  • Discourage rodents by reducing nesting sites (e.g. wood piles or holes in stone walls) or food sources (e.g. bird seed);
  • Move lawn furniture and children’s toys away from wooded areas or wooded edges of your yard where ticks are more likely to be found.

Additional information regarding tick management: Tick Management Handbook by Kirby C. Stafford III, PhD (PDF file)

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Research, Management & Resources in Suffolk County

In 2011, Suffolk County established a Tick and Vector-Borne Diseases Task Force, which issued its final report in December 2015. The major recommendations of the Tick and Vector-Borne Diseases Task Force Final Report were: 1) survey Suffolk County tick populations in order to evaluate tick density and population ranges and 2) create a countywide tick-borne pathogen surveillance program to better understand pathogens present in tick populations and the related public health risk to county residents. In 2016, Suffolk County established the Tick Control Advisory Committee. The committee has guided Suffolk County tick surveillance and control efforts by Department of Health’s Arthropod-Borne Disease Laboratory (ABDL) and Department of Public Works’ Division of Vector Control. Information on the Department of Public Works’ Division of Vector Control tick research and control efforts can be found on the Vector Control Website.

The following activities are underway:

Surveillance

  • The Department of Health Services and the Department of Public Works are conducting tick surveillance in all 10 of Long Island's towns in order to study pathogens present in tick populations and the related public health risk to county residents.
  • The Department of Public Works (DPW) is conducting surveillance at four locations year round to evaluate tick density and population ranges.
  • Suffolk County's Tick Pathogen Surveillance Program

Tick Management for Municipalities and Commercial Pesticide Applicators

Suffolk County’s Division of Vector Control is conducting field trials using selected pesticides used by commercial applicators to test efficacy against ticks. Trials have been completed for some of the products. Municipalities, commercial pesticide applicators and other entities that are conducting tick control, may contact Suffolk County DPW Division of Vector Control for advice on best practices in Integrated Pest Management. Contact: 631-852-4270.

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Resources

Partnerships

Suffolk County closely collaborates with its partners to provide information and education regarding ticks and tick-borne diseases.

The Regional Tick-Borne Disease Resource Center at Stony Brook Southampton Hospital educates the public, promotes collaboration in the medical community, and facilitates access to diagnosis and treatment of tick-borne diseases.

Cornell Cooperative Extension of Suffolk County (CCE) offers classes about ticks and tick-borne diseases, tick identification services, and phone consultations. CCE also serves as liaison to the Northeast Regional Center for Excellence in Vector Borne Diseases at Cornell to assure that our citizen’s interests are represented and considered in the regional center’s work as it develops.

Reported Cases of Tick-Borne Disease in Suffolk County

New York State Reportable Disease Case Counts
for Suffolk County1
Disease 2014 2015 2016 2017 2018 2019 2020 2021 2022
Anaplasmosis 46 50 31 31 36 21 12 37 34
Babesiosis 197 214 153 138 157 131 80 142 135
Ehrlichiosis 67 50 84 55 44 39 15 55 48
Lyme
Disease 2,3 		654 669 644 523 476 433 340 496 2668
Rocky Mountain Spotted Fever 8 8 12 6 9 5 0 1 0
Powassan Virus Disease 0 0 0 0 0 0 1 0 1
Tularemia 1 0 0 0 1 3 1 0 1

1 Data obtained from NYS Dept of Health Communicable Disease Annual Reports (confirmed and probable cases only) health.ny.gov/statistics/
2 2009-2021: A sample of positive laboratory results was investigated in order to estimate total Lyme disease cases per year.
3 2022-Present: The Lyme disease case definition was changed so that all positive laboratory results are now considered cases with no further investigation needed.
4 2023 case numbers are still pending.

For total case number estimates for all conditions by year:
https://www.health.ny.gov/statistics/
diseases/communicable/


In 2010, NY State adopted a “surveillance using sampling estimation” or “sentinel” approach to Lyme disease surveillance, in which Lyme disease case numbers for each county are estimated based on a 20% random sample of positive laboratory reports. In 2007-2009 and 2011, estimated Lyme disease case numbers were compared to observed cases from traditional surveillance for select counties. Few significant differences between the two approaches were found (Lukacik et al., 2016). Specifically, in Suffolk County, sampling estimation was trialed in 2007 and fully adopted in 2009 (with traditional surveillance used in the intervening year 2008). This surveillance approach was used from 2009-2021. In 2022, the Lyme disease case definition was changed so that all positive laboratory results are now considered cases with no further investigation needed.

It is important to take note that Lyme disease case reporting parameters have changed over the years, making trend analysis challenging. Lyme disease case definitions changed in 1995, 1996, 2008, 2011, 2017 and 2022. These changes may have impacted the number of Lyme disease cases reported each year.

For more information about CDC Lyme disease case definitions:
https://ndc.services.cdc.gov/conditions/lyme-disease/

References

Lukacik, G., J. White, C. Noonan-Toly, C. DiDonato & P.B.Backenson, 2016. Lyme disease surveillance using sampling estimation: evaluation of an alternative methodology in New York State. Zoonoses and Public Health, 65(2): 260-265.

Additional Information

NYSDOH-Ticks: New York State Department of Health information on ticks and tick-borne diseases

CDC-Ticks: Centers for Disease Control information on ticks and tick-borne diseases

CDC Centers of Excellence in Vector-Borne Disease: Regional information on tick-, mosquito-, and other vector-borne diseases in the United States

Tick Encounter: The Tick Encounter Resource Center promotes tick-bite protection and tick-borne disease prevention by engaging, educating, and empowering people to take action.

NY Integrated Pest Management-Ticks: New York State Integrated Pest Management resources on ticks and tick-borne diseases

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