Tick-Borne Disease–Associated Thrombocytopenia Epidemiological Description among United States Veterans and Tick Surveillance Data from Suffolk County, Long Island, New York

Background: North America, and especially Suffolk County, Long Island, New York, is a recognized region for tick-borne diseases. Thrombocytopenia is a common manifestation of certain tick-borne diseases. Our objective was to review cases of thrombocytopenia attributed to tick-borne diseases and to also report local tick surveillance data. Methods: A retrospective chart review was conducted from 2000 to 2018 analyzing confirmed cases of anaplasmosis, ehrlichiosis, and babesiosis seen in our facility. The Suffolk County tick-borne disease pathogen surveillance program reports data annually. We report surveillance data on ticks and the pathogens they harbored. Results: A total of 35 veterans were identified with the following tick-borne diseases: babesiosis, 23; ehrlichiosis, 7; and anaplasmosis, 5. The median temperature on presentation was 102.0°F. The median platelet count for the whole cohort was 95,000/μL, with no statistical difference between the 3 diseases, P = 0.169. Rising incidence is noted on all tick-borne diseases, including coinfections in ticks analyzed in Suffolk County. Conclusions: Based on current epidemiologic trends, and local tick surveillance data, coinfections with tick-borne diseases need to be considered.