1. History of Arboviruses in New York State: West Nile Virus

2. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 1999 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

3. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2000 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

4. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens 2001 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

5. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2002 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

6. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2003 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

7. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2004 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

8. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2005 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

9. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2006 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

10. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2007 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

11. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2008 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

12. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2009 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

13. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2010 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

14. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2011 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

15. NIAGAR A MONROE SUFFOLK NASSAU ROCKLAND NEW YORK CITY CHAUTAUQUA CATTARAUGUS ALLEGANY WYOMING GENESEE ORLEANS LIVINGSTON WAYNE ONTARIO YATES SCHUYLER STEUBEN CHEMUNG SENECA TOMPKINS BROOME CORTLAND CAYUGA ONONDAGA OSWEGO LEWI S MADISO N CHENANGO OTSEGO DELAWARE HERKIMER FULTON MONTGOMERY SCHOHARIE GREENE COLUMBIA ALBAN Y RENSSELAER SCHENECTADY SARATOGA WASHINGTON WARREN HAMILTON SULLIVA N ULSTER DUTCHESS JEFFERSON ST LAWRENCE FRANKLIN CLINTON ESSEX ORANGE PUTNAM ONEID A ERIE TIOG A WESTCHESTER QUEENS KING S RICHMOND BRONX NEW YORK West Nile Virus Positive Specimens, 2012 No Confirmed Activity Birds &/or Mosquitoes Humans (and Birds &/or Mosquitoes)

16. Laboratory Confirmed WNV Infections, NYS, 1999-2012 ‘99‘00‘01‘02‘03‘04‘05‘06‘07‘08‘09‘10‘11‘12 Humans (Deaths) 62 (7) 14 (1) 15 (2) 82 (5) 71 (10) 10 (0) 33 (2) 23 (4) 22 (2) 46 (6) 7 (0) 129 (5) 44 (2) 103 (5) Mosquito Pools 154003004454752383923802643511009074531005 Mosquito Pools Submitted 7783622367437676676575916848515165057183739066555808 Birds14212637311410136820729626483159---- Birds Submitted 813051596980465529771766 Horses2028223632512031047 Through 1 December 2012

34. So What Happened in 2010 and 2012? Climate? Very hot and very dry leads to reduced availability of water. Reduction in routine mosquito control? Kept WNV in check before? Role of volunteer blood donor positives Had 19 volunteer donor positives—more than all other years combined. Most not symptomatic or unknown. Initially thought test may be flawed, but better reporting Surveillance system worked in identifying WNV

35. Ticks

36. Lyme disease 2012 vs. 2011 (reported cases through 12/4 each year) COUNTY20112012%change ALBANY36483--- ALLEGANY25150.0 BROOME606711.7 CATTARAUGUS440.0 CAYUGA220.0 CHAUTAUQUA65-16.7 CHEMUNG660.0 CHENANGO1913-31.6 CLINTON119-18.2 COLUMBIA229183-20.1 CORTLAND4775.0 DELAWARE81362.5 DUTCHESS190116-38.9 ERIE129-25.0 ESSEX162768.8 FRANKLIN91011.1 FULTON82-75.0 GENESEE110.0 GREENE139104-25.2 HAMILTON00--- HERKIMER122175.0 JEFFERSON42 0.0 LEWIS27250.0 LIVINGSTON52-60.0 MADISON1312-7.7 MONROE224186.4 MONTGOMERY2820-28.6 NASSAU2915-48.3 NIAGARA13200.0 ONEIDA4639-15.2 ONONDAGA8625--- ONTARIO28300.0 ORANGE293182-37.9 ORLEANS00--- OSWEGO820150.0 OTSEGO3429-14.7 PUTNAM9478-17.0 RENSSELAER258193-25.2 ROCKLAND9180-12.1 SARATOGA161122-24.2 SCHENECTADY2920-31.0 SCHOHARIE2810-64.3 SCHUYLER71385.7 SENECA74-42.9 ST LAWRENCE405947.5 STEUBEN48100.0 SUFFOLK314260-17.2 SULLIVAN364216.7 TIOGA24268.3 TOMPKINS14020--- ULSTER19067-64.7 WARREN193584.2 WASHINGTON27275--- WAYNE330.0 WESTCHESTER16249-69.8 WYOMING15400.0 YATES4525.0 sentinel 2011 & 20122,215 1,511-31.8 non-sentinel 2011 & 201252059213.8

37. Lyme disease in New York State 1986 – 2005 by zip code 0501000+500100 Incidence per 100,000 population

38. Lyme Disease Incidence Rates, CNY Counties, 2005-2010

42. Table 1: Borrelia burgdorferi prevalence in Ixodes scapularis (Blacklegged tick) adults collected by the NYSDOH from 21 Upstate New York counties during October and November of 2011. LocationCountyTownshipRegionTotal TestedNPBb% %∆ from 2009* Albany Pine Bush PreserveAlbanyGuilderlandCap. District50262448.026.3 Mine Kill State ParkSchoharieNorth BlenheimCap. District5145611.8202.6** OlanaColumbiaGreenportCap. District50331734.030.8 Parcel 45SaratogaWiltonCap. District50351530.00 Calvary CemeteryTompkinsIthacaCNY77374051.962.2 Green Lakes State ParkOnondagaManliusCNY50173366.094.7 Three Mile Bay Game Management AreaOswegoWest MonroeCNY53242954.782.9 Highland Lakes State ParkOrangeWallkillMARO50331734.00 Kakiat County ParkRocklandRamapoMARO5042816.0-55.6 Louisa PondUlsterEsopusMARO50341632.0-11.1 Mohansic Golf CourseWestchesterYorktownMARO5045510.0-80 Old Heritage Canal ParkSullivanMamakatingMARO50341632.0-27.3 Ryder FarmPutnamSoutheastMARO50351530.0-28.6 Taconic-Hereford****DutchessPleasant ValleyMARO50401020.0-16.7 Allegany State ParkCattaraugusRedhouseWNY686268.8-38.5 Gargoyle ParkCattaraugusAlleganyWNY87483944.8142 Hanging BogAlleganyNew HudsonWNY54120.0-34.6 Letchworth State ParkLivingstonPortageWNY88 0.0n/a*** Moss LakeAlleganyRushfordWNY74342.912.3 Newtown Battlefield State ParkChemungElmiraWNY50272346.05.7 Powder Mill ParkMonroePerintonWNY68462232.4n/a*** Sampson State ParkSenecaRomulusWNY52302242.315.3 Watkins Glen State ParkSchuylerReadingWNY50401020.024.2 TOTALS112674937733.56.7 * 2010 adult ticks have not yet been screened for pathogens. ** Comparison to 2008 data *** These sites were not sampled for adult ticks in 2009 and/or prior data are not available. **** An adult male tick from this site was simultaneously infected with B. burgdorferi, A. phagocytophilum, and B. microti.

43. Table 2: Anaplasma phagocytophilum prevalence in Ixodes scapularis (Blacklegged tick) adults collected by the NYSDOH from 21 Upstate New York counties during October and November of 2011. LocationCountyTownshipRegionTotal TestedNPAp% %∆ from 2009* Albany Pine Bush PreserveAlbanyGuilderlandCap. District50401020.0400 Mine Kill State ParkSchoharieNorth BlenheimCap. District51 000** OlanaColumbiaGreenportCap. District504824.0-71.4 Parcel 45SaratogaWiltonCap. District504824.0100 Calvary CemeteryTompkinsIthacaCNY777345.2-13.3 Green Lakes State ParkOnondagaManliusCNY50 00-100 Three Mile Bay Game Management AreaOswegoWest MonroeCNY53 000 Highland Lakes State ParkOrangeWallkillMARO5044612.00 Kakiat County ParkRocklandRamapoMARO50401020.0900 Louisa PondUlsterEsopusMARO504824.0-66.7 Mohansic Golf CourseWestchesterYorktownMARO5042816.033.3 Old Heritage Canal ParkSullivanMamakatingMARO5045510.0**** Ryder FarmPutnamSoutheastMARO5041918.080 Taconic-Hereford*****DutchessPleasant ValleyMARO5042816.0100 Allegany State ParkCattaraugusRedhouseWNY68 000 Gargoyle ParkCattaraugusAlleganyWNY878433.4100 Hanging BogAlleganyNew HudsonWNY5500-100 Letchworth State ParkLivingstonPortageWNY8800n/a*** Moss LakeAlleganyRushfordWNY7700-100 Newtown Battlefield State ParkChemungElmiraWNY50 00-100 Powder Mill ParkMonroePerintonWNY686268.8n/a*** Sampson State ParkSenecaRomulusWNY52 00-100 Watkins Glen State ParkSchuylerReadingWNY50 000 TOTALS11261051756.752.3 * 2010 adult ticks have not yet been screened for pathogens. ** Comparison to 2008 data *** These sites were not sampled for adult ticks in 2009 and/or prior data are not available. **** No adult ticks were infected with A. phagocytophilum from this site in 2009; previous rate 0%. Unable to calculate %∆ (denominator = zero). ***** An adult male tick from this site was simultaneously infected with B. burgdorferi, A. phagocytophilum, and B. microti. Counties with B. burgdorferi/A. phagocytophilum co-infected ticks include: Albany (n=4), Cattaraugus (n=1), Columbia (n=1), Dutchess (n=2), Orange (n=1), Putnam (n=2), Sullivan (n=2), and Westchester (n=1).

44. Table 3: Babesia microti prevalence in Ixodes scapularis (Blacklegged tick) adults collected by the NYSDOH from 21 Upstate New York counties during October and November of 2011. LocationCountyTownshipRegionTotal TestedNPBm% %∆ from 2009* Albany Pine Bush PreserveAlbanyGuilderlandCap. District504824.00 Mine Kill State ParkSchoharieNorth BlenheimCap. District51 0** OlanaColumbiaGreenportCap. District50 0 Parcel 45SaratogaWiltonCap. District50 0 Calvary CemeteryTompkinsIthacaCNY77 0 Green Lakes State ParkOnondagaManliusCNY50 0 Three Mile Bay Game Management AreaOswegoWest MonroeCNY53 0 Highland Lakes State ParkOrangeWallkillMARO50 0 Kakiat County ParkRocklandRamapoMARO504736.0200 Louisa PondUlsterEsopusMARO50 0 Mohansic Golf CourseWestchesterYorktownMARO50 -100 Old Heritage Canal ParkSullivanMamakatingMARO50 0 Ryder FarmPutnamSoutheastMARO504912.0-66.7 Taconic-Hereford****DutchessPleasant ValleyMARO504824.0100 Allegany State ParkCattaraugusRedhouseWNY68 0 Gargoyle ParkCattaraugusAlleganyWNY87 0 Hanging BogAlleganyNew HudsonWNY55 0 Letchworth State ParkLivingstonPortageWNY88 n/a*** Moss LakeAlleganyRushfordWNY77 0 Newtown Battlefield State ParkChemungElmiraWNY50 0 Powder Mill ParkMonroePerintonWNY68 n/a*** Sampson State ParkSenecaRomulusWNY52 0 Watkins Glen State ParkSchuylerReadingWNY50 0 TOTALS1126111880.716.7 * 2010 adult ticks have not yet been screened for pathogens. ** Comparison to 2008 data *** These sites were not sampled for adult ticks in 2009 and/or prior data are not available. **** An adult male tick from this site was simultaneously infected with B. burgdorferi, A. phagocytophilum, and B. microti. Counties with B. burgdorferi/B. microti co-infected ticks include: Albany (n=2), Dutchess (n=2), Putnam (n=1), Rockland (n=1).

45. 2013 Plans: Evaluation, Media Day Part 2?