Health Alert: Tickborne Diseases in NH

On May 18, 2018,, NH DHHS issued a health alert regarding tickborne diseases in New Hampshire.

NH DPHS Health Alert NetworkKey Points and Recommendations:

  1. Blacklegged ticks transmit at least five different infections in New Hampshire (NH): Lyme disease, Anaplasma, Babesia, Powassan virus, and Borrelia miyamotoi.
  2. NH has one of the highest rates of Lyme disease in the nation, and 50-60% of blacklegged ticks sampled from across NH have been found to be infected with Borrelia burgdorferi, the bacterium that causes Lyme disease.
  3. NH has experienced a significant increase in human cases of anaplasmosis, with cases more than doubling from 2016 to 2017. The reason for the increase is unknown at this time.
  4. The number of new cases of babesiosis also increased in 2017; because Babesia can be transmitted through blood transfusions in addition to tick bites, providers should ask patients with suspected babesiosis whether they have donated blood or received a blood transfusion.
  5. Powassan is a newer tickborne disease which has been identified in three NH residents during past seasons in 2013, 2016 and 2017. While uncommon, Powassan can cause a debilitating neurological illness, so providers should maintain an index of suspicion for patients presenting with an unexplained meningoencephalitis.
  6. Borrelia miyamotoi infection usually presents with a nonspecific febrile illness similar to other tickborne diseases like anaplasmosis, and has recently been identified in one NH resident. Tests for Lyme disease do not reliably detect Borrelia miyamotoi, so providers should consider specific testing for Borrelia miyamotoi (see Attachment 1 in the full alert) and other pathogens if testing for Lyme disease is negative but a tickborne disease is still suspected.
  7. Report all tickborne diseases, confirmed or suspected, to the Bureau of Infectious Disease Control at 603-271-4496 (after hours 603-271-5300). For more information about testing for specific pathogens, please review the “tickborne disease diagnostic testing” section in the full alert.

Read the full DHHS Alert