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Lyme Disease

Department of Health
Kari Reiber, MD, Acting Commissioner

Lyme Disease Diagnosis:
Erythema Migrans (EM)  (.pdf)
Diagnosing Tick-borne disease  (.pdf)
Clinical Practice Guidelines by the Infectious Diseases Society of America

Also See Information About:
Rocky Mountain Spotted Fever
Tick Paralysis
Tick Identification

  • Where can I find more updated information about Lyme Disease?

  • See Tick-Borne Diseases in the Hudson Valley - A Physician's Reference Manual (.pdf)  -or-  Centers for Disease Control and Prevention - Lyme Disease.

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  • What is Lyme disease?

  • Lyme disease is caused by a bacterial infection transmitted by the deer tick (lxodes scapularis). Lyme disease may cause symptoms affecting the skin, nervous system, heart and/or joints of an individual. The New York State Department of Health is aware of nearly 20,000 cases in the state occurring since Lyme disease became reportable in 1986.

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  • Why is it called Lyme disease?

  • The first cluster of disease cases associated with this infectious agent was discovered near Old Lyme, Connecticut.

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  • Who gets Lyme disease?

  • Lyme disease can affect people of any age. People who spend time in grassy and wooded environments are at an increased risk of exposure. The chances of being bitten by a deer tick are greater during times of the year when ticks are most active. Deer ticks in the nymphal stage are active from mid-May to mid-August and are about the size of poppy seeds. Adult ticks, which are approximately the size of sesame seeds, are most active in mid to late fall. The risk of exposure to infected deer ticks may be statewide.

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  • How is Lyme disease spread?

  • Not all deer ticks are infected with the bacteria that cause Lyme disease. Ticks can become infected if they feed on small animals that are infected. The disease can be spread when a tick infected with the bacteria bites a person and stays attached for a period of time. Person-to-person spread of Lyme disease does not occur.

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  • What are the symptoms of Lyme disease?

  • Early symptoms may develop within 3 to 30 days after the bite of infected tick. Some people may develop an expanding rash   around or near the site of the bite. It may or may not look like a bulleye. Sometimes, multiple rash sites appear. Other symptoms, such as fever, headache, fatigue, stiff neck, muscle and/or joint pain, may develop. If left untreated, within a few weeks to months, complications, such as meningitis, facial palsy, swelling and pain in the large joints,  or heart abnormalities, may occur. Later symptoms may develop in people who did not have early symptoms or not recognize them.

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  • Does past infection with Lyme disease make a person immune?

  • Information available at present indicates that re-infection is possible.

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  • Is there a vaccine to prevent Lyme Disease?

  • While the FDA has licensed a vaccine for Lyme Disease in humans, there is only one manufacturer of this product and it is no longer available in the United States. The best way to reduce your risk of acquiring Lyme Disease is to follow the other suggestions on this page.

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  • What is the treatment for Lyme disease?

  • Current therapy includes the use of antibiotics. Prognosis is improved with prompt diagnosis and appropriate, early treatment.

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  • Are there laboratory tests for Lyme Disease?

  • Serologic testing methods such as: IFA, EIA, Western Blot and ELISA are readily available. However, diagnosis is still based on clinical manifestations and only supported by laboratory findings. Laboratory tests should be viewed with caution. Other testing methods include culture, urine antigen and PCR.

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  • How can I prevent Lyme Disease?

  • Special precautions to prevent exposure to ticks should be taken such as wearing light-colored clothing and tucking pants into socks and shirts into pants. Repellents containing DEET applied to skin or clothing may prevent tick attachment. Permanone, a product capable of killing ticks, can be sprayed onto clothing; make sure to follow label instructions carefully. Use repellents sparingly and with care, as they may cause adverse reactions in some individuals. Avoid applications to damaged or exposed skin, and avoid prolonged or excessive applications, especially in children. If exposed to tick-infested areas, family members should check body surfaces for attached ticks. Keep grass mowed and shrubbery trimmed and maintained. The control of rodents around the home may be helpful.

    Additional tips can be found at:

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  • How should a tick be removed?

  • To remove an attached tick, grasp the tick's mouthparts with tweezers or forceps as close as possible to the attachment (skin) site, and pull upward and out with a firm and steady pressure. If tweezers are not available, use fingers shielded with tissue paper or rubber gloves. Do not handle with bare hands. Be careful not to squeeze, crush or puncture the body of the tick which may contain infectious fluids. After removing the tick, thoroughly disinfect the bite site and wash hands. See or call a doctor if there is concern about incomplete tick removal. It is important that a tick be removed as soon as it is discovered. Check after every two to three hours of outdoor activity for ticks attached to clothing or skin. If removal occurs within 24 hours of attachment, the risk of tick-borne infection is substantially reduced. Do not attempt to remove ticks by using petroleum jelly, lit cigarettes or other home remedies because these methods may actually increase the chance of contracting a tick-borne disease.

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  • Deet Tips

  • Visit our Information About Insect Repellents webpage for more information.

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Kari Reiber, MD,Commissioner of Health Kari Reiber, MD
Commissioner of Health
Dutchess County Seal



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