New Hampshire Tickborne Disease Update, 2019

On June 17, 2019, NH DHHS issued a health alert update on tickborne disease in New Hampshire.

KNH Division of Public Health Services Health Alert Networkey Points and Recommendations:

  1. Tickborne diseases (TBDs) are increasing nationally with Lyme disease accounting for 82% of all TBDs in the U.S.: https://www.cdc.gov/mmwr/volumes/67/wr/mm6717e1.htm
  2. NH continues to have a high-incidence of Lyme disease (Borrelia burgdorferi infection), and also has increasing numbers of Anaplasma and Babesia infections. 
  3. Two additional emergent TBDs are present in NH: Powassan virus and Borrelia miyamotoi.
    • Borrelia miyamotoi was identified in two NH residents in 2018. Infection usually presents with symptoms of fever, headache, myalgia, fatigue, and arthralgia.
    • Powassan was identified in three NH residents in 2013, 2016 and 2017. Infection often presents with neurologic illness, including meningoencephalitis. 
  4. Healthcare providers are encouraged to use the CDC’s “Tickborne Diseases of the United States: A Reference Manual for Healthcare Providers” to aid with TBD diagnosis and testing. 
  5. Providers should consider testing for TBDs in patients presenting with compatible signs and symptoms, especially if there are risk factors for tick bites. Further details about disease-specific testing are outlined below in the “Diagnostic Testing” section.
  6. Ticks and TBDs are very difficult to control due to the tick life cycle, abundant habitat, and animal reservoirs. Prevention needs to focus on personal protective measures (see information in full alert). Additional educational resources can be found here.
  7. Providers should report all TBDs, confirmed or suspected, to the Bureau of Infectious Disease Control at 603-271-4496 (after hours 603-271-5300).

Full DHHS Alert