Health Information Portal (HIP)

Tickborne Diseases (Lyme, Babesiosis, Rickettsial)

Topic	Priority Priority Alert Conveys the highest level of importance; warrants immediate action or attention. Advisory Provides important information for a specific incident or situation; may not require immediate action. Notification Provides information regarding an incident or situation; unlikely to require immediate action. Update Provides updated information regarding an incident or situation; unlikely to require immediate action.	Date of Alert
Tickborne Diseases in Philadelphia: Recognition, Reporting, and Prevention	Advisory	Jun 24, 2022
Tickborne Diseases: Recognition, Reporting, and Prevention	Advisory	Jun 9, 2021
Tickborne Diseases in Philadelphia: Recognition, Reporting, and Prevention	Advisory	Jul 2, 2020
Tickborne Diseases in Philadelphia: Recognition, Reporting, and Prevention	Advisory	May 22, 2019
Tickborne Diseases in Philadelphia: Recognition, Reporting, and Prevention	Advisory	May 31, 2018

Surveillance

• PDPH Tickborne Disease Surveillance
• PA DOH Lyme Disease Surveillance
• CDC Lyme Disease Data and Surveillance
• Pennsylvania Department of Environmental Protection Tick Surveillance Report

Vaccine Information

No vaccines are currently available for tickborne disease. Click here to learn about research to develop a Lyme disease vaccine.

Prevention of tick bites is the only way to keep patients from contracting a tickborne illness. Advise patients to:

• Use repellent with DEET (20-30%), which can be effective for several hours, or a CDC-approved natural repellent like Oil of Lemon Eucalyptus, which can repel mosquitoes and ticks. The duration of protection will depend on the amount of the active ingredient in the repellent. Patients should be advised to reapply the repellent according to the label instructions.
• Regularly check themselves and their children for ticks after spending time outdoors and know the correct method for tick removal
• Bathe or shower after spending time outdoors
• Avoid tick habitats, including wooded and bushy areas with tall grass

Diagnosis & Management

Patients with tickborne infectious often present with non-specific symptoms including fever, fatigue, and myalgia/arthralgia sometimes making diagnosis challenging.

Diagnostic Tools:
Health care providers can use the Summer Fever Algorithm here to aid in the diagnosis and differentiation of tickborne diseases.

• Laboratory Testing
  • Specialized testing (e.g., PCR) of clinical specimens for tickborne pathogens is available through the CDC
  • Call the PDPH at 215-685-6742 during business hours or at 215-686-4514 after hours to discuss sample collection and testing guidelines.

Lyme Disease

Testing for Lyme Disease:

• The Philadelphia Department of Public Health requires Two-Tier Testing for Lyme Disease

Disseminated Disease and Complications:

Individuals who do not receive prompt treatment often experience disseminated symptoms as the Borrelia burdorferi spreads from the initial site of infection. Important complications of B. burgdorferi infection include arthritis, Bell’s palsy/cranial neuritis, Lyme meningitis and Lyme carditis, which has been identified as a contributing factor in at least three sudden cardiac deaths. While Lyme disease does not frequently result in death, it is important to consider as a contributing factor.

Post-Treatment Lyme Disease Syndrome:

Even after treatment with antibiotics, a small percentage of patients may still experience fatigue, arthralgia, and/or myalgia. Commonly described as “chronic Lyme disease,” this condition is termed Post-treatment Lyme Disease Syndrome (PTLDS). The cause of PTLDS is not well understood, but most medical experts attribute the symptoms to the residual damage of the tissues and immune system initiated prior to treatment. Research into the underlying cause and best methods for treating PTLDS is ongoing. Further information and resources can be found here on the CDC’s webpage.

Reporting to PDPH

Report any suspected or confirmed cases of anaplasmosis, babesiosis, ehrlichiosis, Lyme disease (including erythema migrans without confirmatory lab testing), or Rickettsial diseases to PDPH by calling 215-685-6748 during business hours or by faxing a disease report form to 215-238-6947.

The Philadelphia Department of Public Health relies on the efforts of health care providers and other public health partners to protect the health and wellness of Philadelphia residents by reporting tickborne diseases. As part of routine disease surveillance, PDPH receives reports from healthcare providers and commercial laboratories when a Philadelphia resident tests positive for a tickborne pathogen. After collecting laboratory, symptom, and exposure information from the treating physician, the case is classified using criteria determined by the Council of State and Territorial Epidemiologists (CSTE). Individuals who meet the case criteria are interviewed to obtain more detailed exposure information

Health Educational Materials

• PDPH Lyme Fact Sheet
• PDPH Fight the Bite Website
• PDPH Fight the Bite and Stop Ticks Flyers: (Grades K-5) (Grades 6-8) (Grades 9-12)
• CDC Lyme Disease Tool Kit (Contains patient fact sheets, plus order FREE pamphlets and bookmarks for your office )

Links and Resources

• American Lyme Disease Foundation
• Infectious Diseases Society of America’s Lyme Disease Case Study Course
• Environmental Protection Agency Insect Repellant Search Tool

Guidelines for Management and Control

Clinical Guidelines for Healthcare Providers

• Tickborne Disease of the United States: A Reference Manual for Healthcare Providers

Provider Education on Tickborne Diseases

• CDC Tickborne Diseases Overview
• University of Rhode Island TickEncounter Resource Center: Tick Identification
• Recognizing and Treating Tickborne Diseases
• Infectious Diseases Society of America’s Lyme Disease Case Study Course
• New and Emerging Tickborne Diseases: Agents, Clinical Features, and Surveillance
• Medscape Fast Five Quiz: Lyme Disease

Research for Tickborne Diseases

• Clinical Trials for Lyme Disease / "Borrelia Infections"
• CDC TickNET Research
• HHS Federal Research Update of Lyme Disease Diagnostics Webinar
• HHS Special Webinar on Lyme Disease and Borrelia Persistence

Resources

For Healthcare Providers:

There are no healthcare provider resources available for Tickborne Diseases (Lyme, Babesiosis, Rickettsial).

For Patients and Community Members:

Posters:

There are no posters for Tickborne Diseases (Lyme, Babesiosis, Rickettsial).