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Tick Borne Disease

On our island, the best treatment is prevention



The Centers for Disease Control and Prevention estimate that there are more than 30,000 new cases of tick-borne diseases in the U.S. every year, and Nantucket has one of the highest incidence rates in the country. At Nantucket Cottage Hospital, our physicians have extensive experience diagnosing and treating Lyme disease, Babesia, Anaplasmosis, along with other  m ore rarely seen tick-borne diseases. Longtime NCH physician and surgeon Dr. Tim Lepore is recognized as one of foremost experts in the field of tick-borne disease research, and has published numerous articles with researchers from the Harvard Public School of Health, Tufts University School of Medicine, and the Yale School of Public Health.

On Nantucket, it is important to remember that it is possible to become infected with more than one tick-borne diseases, in what is known as “co-infection.” The diseases can appear together or sequentially. As Dr. Lepore says, protection and prevention are always cheaper and easier than treatment.

The Best Treatment is Prevention:

  • Avoid known tick habitats: brushy and moist areas
  • Tuck your pants inside your socks
  • Use repellant
  • Control your environment
  • Regularly check yourself for ticks, paying close attention to armpits, groin and back

About Lyme Disease:

  • Not an insignificant problem, but not fatal
  • Treatment is highly effective if disease is caught early
  • Delayed treatment is effective, but damage can occur
  • Long-term prognosis is excellent in treated cases
  • Associated skin rash (often a “bulls-eye”) expands and may occur at the site of a bite, but can also be found at the hair line, torso, or elsewhere
  • Blood tests at the time of the rash are likely not useful
  • Doxycycline and Amoxicillin are the drugs of choice for treatment.
  • Treatment is typically two to three weeks
  • Blood tests are recommended several weeks after treatment concludes
  • Swollen joints, facial palsy or heart block are all indicators of later stage Lyme disease, but all symptoms are highly treatable

About Babesia

  • Malaria-like illness characterized by high fever and chills
  • No rash
  • Lab tests will likely show organism in blood smear and abnormal blood count
  • Treatment of one week of Mepron and Zithromax is very effective
  • Babesia has been fatal but usually in patients without a spleen or with a weakened immune system
  • Serologic blood tests may be negative early, but newer PCR tests promise to be positive even early in the disease

About Anaplasmosis

  • Transmitted by the nymphal deer tick
  • Characterized by high fever and chills, but organism not usually seen as compared to Babesia
  • No rash
  • Blood tests may be suspicious, but recent PCR testing may provide early confirmation of the disease
  • Treatment: Doxycycline for two weeks

About Powassan virus

  • Transmitted to humans by infected ticks.
  • Approximately 75 cases  reported in the United States over the past 10 years.
  • Most cases occurred in Northeast and Great Lakes region.
  • Signs and symptoms include fever, headache, vomiting, weakness, confusion, seizures, and memory loss.
  • Long-term neurologic problems may occur.
  • No specific treatment, but people with severe POW virus illnesses often need to be hospitalized to receive respiratory support, intravenous fluids, or medications to reduce swelling in the brain.

Helpful Links & Resources

Meet our Team

Meet our Team

Tick Bite Protocol

What to do if you’re bitten by a tick


  • Don’t panic. It is more than likely that you have not acquired a tick-borne disease.


  • Get out the tweezers. Remove the tick promptly by carefully going under its head and pulling it out by the mouth, being mindful not to squeeze the body of the tick.


  • Tick check. If you’ve found one tick, there could be more. Carefully check the rest of your body to make sure there are no other ticks.


  • Monitor your health. Do you need to see a doctor? First you should monitor your health and watch for any symptoms of tick-borne diseases, such as an expanding rash that may look like a circle or bull’s eye, as well as fever or flu-like symptoms. If you notice any of these symptoms, seek out medical attention. If you know the tick has been embedded for more than 24 hours, remove it immediately as directed above, then call your provider and they will determine whether preventative treatment is appropriate.


Learn how to protect yourself, family and pets from tick borne diseases.

Nantucket Cottage Hospital and the Nantucket Board of Health teamed up to produce this video on how to prevent tick-borne diseases.

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