Lyme Disease - NYC Health

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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. The yearly number of Lyme disease cases in NYC has ranged from 215 in 2000 to a high of 1,090 in 2017. In 2020, there were 704 reported cases in NYC.

Lyme disease is spread through the bite of an infected blacklegged tick (also called a deer tick), although not all blacklegged ticks carry Lyme disease. 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 Lyme disease.

Lyme disease cannot be 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, be aware of where you may come in contact with ticks and practice tick-protective-behaviors when visiting these areas. Blacklegged ticks have been found in Staten Island and parts of the northern Bronx where deer live. 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.

View an interactive map of U.S. counties that have reported infected ticks.

Symptoms

If you are infected with Lyme disease, you may experience:

Fever

Tiredness/weakness

Headache

Joint and muscle pain

A skin rash called erythema migrans, also known as a bulls-eye or target-shaped rash

Early symptoms usually begin three to 30 days after a tick bite. Late symptoms may appear days to months after a tick bite.

Diagnosis

Lyme disease diagnosis is based on symptoms and possible exposure to infected blacklegged ticks. If you experience symptoms of Lyme disease after spending time in tick-habitat, visit your health care provider.

Blood tests can help diagnose Lyme disease. The Centers for Disease Control and Prevention (CDC) recommends a two-step testing process. If the first blood test is positive or indeterminate, a second test is done. Testing is not recommended if you do not have symptoms typical of Lyme disease.

Blood tests are not necessary to diagnose patients with erythema migrans, also known as a bulls-eye rash. The bulls-eye rash is a diagnosis of Lyme disease and lab tests may be negative in the early stages of Lyme disease when the rash is present.

Treatment

Lyme disease is 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.

Additional Resources

Lyme Disease in NYC, 2021 and 2022 (PDF)

Lyme Disease in NYC, 2020 (PDF)

Lyme Disease in NYC, 2018 (PDF)

Lyme Disease in NYC, 2017 (PDF)

CDC: Lyme Disease

CDC: Public Information Guide on Lyme Disease (PDF)

CDC: The Many Forms of Lyme Disease Rashes (Erythema Migrans) (PDF)

CDC: Lyme Disease for Health Care Providers

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

New York City Tick ID and Removal Wallet Card (PDF)

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All About Ticks: A Workbook for Kids and Their Parents (PDF)
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Tick-borne Disease Diagnostic Reference: Poster for Providers (PDF)

Ticks taking over? Take back your yard (PDF)

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More Information

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EpiQuery: Data on NYC Residents with Lyme Disease