Lyme Disease Is Widespread in the New York City Metro Area
Lyme disease is not confined to rural areas—Borrelia burgdorferi is widespread throughout the New York City metropolitan region.
This has important implications for both clinicians and patients who may underestimate risk based on location alone.
Evidence of Widespread Infection
According to Herrin and colleagues, Lyme disease remains concentrated in the Northeast, with 9.7% of reported cases occurring in New York State.
Animal data supports this pattern. Approximately 7.1% of pet dogs in New York State tested positive for B. burgdorferi, with regional rates ranging from 1.2% to 27.3%.
Infected animals were found in both urban and rural environments.
Human Cases Across Urban and Rural Areas
Human infection rates varied widely:
- 0.5 cases per 100,000 in some counties
- Up to 438.7 cases per 100,000 in others
Importantly, higher-than-expected case rates were observed in densely populated areas including:
- Queens
- Bronx
- Kings (Brooklyn)
- New York County (Manhattan)
- Hudson County
This challenges the assumption that Lyme disease is primarily a rural problem.
Why Lyme Disease Appears in Urban Areas
Several factors may explain this pattern:
- Travel between urban and suburban or rural environments
- Pets transporting ticks into homes
- Forest fragmentation increasing human exposure to tick habitats
The “crossroads effect” occurs when fragmented forests increase exposure at the edges where people, pets, and ticks interact.
Dogs as Sentinels of Risk
Dogs serve as important indicators of Lyme disease risk.
Higher rates of infection in urban dogs may reflect travel to endemic areas or local exposure in parks and green spaces.
Where dogs are infected, humans are also at risk.
Clinical Implications
Clinicians should not exclude Lyme disease from the differential diagnosis based solely on a patient’s urban residence.
Patients living in metropolitan areas may still be exposed through:
- Travel to nearby endemic regions
- Outdoor activities in parks and green spaces
- Contact with pets
Public Health Perspective
The expansion of Lyme disease into metropolitan regions underscores the need for increased awareness, prevention strategies, and public health funding.
Efforts to address tick-borne disease risk must include both rural and urban populations.
Clinical Takeaway
Lyme disease is widespread in the New York City metro area. Urban residence does not eliminate risk. Clinicians should consider Lyme disease in patients with compatible symptoms regardless of geographic assumptions.
Related Articles:
Babesia microti in Suffolk County, New York
Urban Ticks Carry Lyme and Miyamotoi
References:
- Herrin BH, Beall MJ, Feng X, Papes M, Little SE. Canine and human infection with Borrelia burgdorferi in the New York City metropolitan area. Parasit Vectors. 2018;11(1):187.
Dr. Daniel Cameron, MD, MPH
Lyme disease clinician with over 30 years of experience and past president of ILADS.
Symptoms • Testing • Coinfections • Recovery • Pediatric • Prevention
Can dogs that have ticks on them come off of them and attach there self to you in your home and get lyme that way?
Ticks have fed twice. See my blog
I don’t think anyone knows for sure
Can neuropathy of your feet ,waking up with headaches ,a eye that mussels are weak so your eye wonders ,the eye won’t stay aligned ?Also can lyme raise glucose and blood pressure ,can these symptoms come and go?