In July 2019, Bourbon virus RNA was detected in an Amblyomma americanum tick removed from a resident of Long Island, New York, USA. Tick infection and white-tailed deer (Odocoileus virginianus) serosurvey results demonstrate active transmission in New York, especially Suffolk County, emphasizing a need for surveillance anywhere A. americanum ticks are reported.

Background North America, and especially Suffolk County, Long Island, New York, is a recognized region for tick-borne diseases. Thrombocytopenia is a common manifestation of certain tick-borne diseases. Our objective was to review cases of thrombocytopenia attributed to tick-borne diseases and to also report local tick surveillance data. Methods A retrospective chart review was conducted from 2000 to 2018 analyzing confirmed cases of anaplasmosis, ehrlichiosis, and babesiosis seen in our facility. The Suffolk County tick-borne disease pathogen surveillance program reports data annually. We report surveillance data on ticks and the pathogens they harbored. Results A total of 35 veterans were identified with the following tick-borne diseases: babesiosis, 23; ehrlichiosis, 7; and anaplasmosis, 5. The median temperature on presentation was 102.0 degrees F. The median platelet count for the whole cohort was 95,000/mu L, with no statistical difference between the 3 diseases, P = 0.169. Rising incidence is noted on all tick-borne diseases, including coinfections in ticks analyzed in Suffolk County. Conclusions Based on current epidemiologic trends, and local tick surveillance data, coinfections with tick-borne diseases need to be considered.

Background North America, and especially Suffolk County, Long Island, New York, is a recognized region for tick-borne diseases. Thrombocytopenia is a common manifestation of certain tick-borne diseases. Our objective was to review cases of thrombocytopenia attributed to tick-borne diseases and to also report local tick surveillance data. Methods A retrospective chart review was conducted from 2000 to 2018 analyzing confirmed cases of anaplasmosis, ehrlichiosis, and babesiosis seen in our facility. The Suffolk County tick-borne disease pathogen surveillance program reports data annually. We report surveillance data on ticks and the pathogens they harbored. Results A total of 35 veterans were identified with the following tick-borne diseases: babesiosis, 23; ehrlichiosis, 7; and anaplasmosis, 5. The median temperature on presentation was 102.0°F. The median platelet count for the whole cohort was 95,000/μL, with no statistical difference between the 3 diseases, P = 0.169. Rising incidence is noted on all tick-borne diseases, including coinfections in ticks analyzed in Suffolk County. Conclusions Based on current epidemiologic trends, and local tick surveillance data, coinfections with tick-borne diseases need to be considered.

During 2018, Heartland virus RNA was detected in an Amblyomma americanum tick removed from a resident of Suffolk County, New York, USA. The person showed seroconversion. Tick surveillance and white-tailed deer (Odocoileus virginianus) serosurveys showed widespread distribution in Suffolk County, emphasizing a need for disease surveillance anywhere A. americanum ticks are established or emerging.

In North America, Lyme disease (LD) is caused predominantly by the spirochete Borrelia burgdorferisensu stricto, and is transmitted by blacklegged ticks. Long Island, New York, is highly endemic for the disease. The C6 peptide (C6P) is currently used as a screening test for LD in our institution. Our objective was to examine how screening with C6P concorded with diagnosis of LD at the Veterans Affairs Medical Center, Northport, Long Island. A retrospective chart-review of 2558 C6P tests was performed during the period of 1/1/2010 to 12/31/2016. Patients were categorized by Lyme Disease (LD) or no LD groups. LD group was defined as having an erythema migrans (EM) rash, or ≥ 2 IgM bands or ≥ 5 IgG bands on immunoblot. Out of the 409 patients with positive or equivocal C6P, 181 patients with LD were based on presence of EM, or Western blot IgM and IgG test results; 228 did not have LD. The positive predictive value of C6P was 44.5%. EM was the most common presentation. In the LD group, history of tick bite (P: 0.0001), headache (P: 0.0036), joint swelling (P: 0.0086) and myalgias (P: 0.0005) were more likely to be present. Zip code mapping of our cases mirrored those previously reported in the Suffolk County Department of Health. In our review we encountered a significant number of false positive C6 assays. False positive C6P tests were ordered by primary care physicians (PCP) (37%) followed by neurologists (33%). A history of tick exposure and clinical findings of early Lyme disease such as headaches or joint aches were more likely to denote a true positive C6 peptide test. Rigorous education of physicians about Lyme disease and pitfalls of our available diagnostic tests are needed for their proper utilization.