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An Outdoor Menace

Don’t be “Ticked” By Lyme Disease

What you may not know

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Did you know? The number of Americans

diagnosed with Lyme Disease is estimated to be about 300,000

Although Lyme Disease is commonly associated with the Northeast part of the U.S., the number of cases are becoming more prevalent in other parts of the country as well

Lyme Disease risk is increasing due to bites from the blacklegged tick

Lyme Disease has recently been confirmed in humans residing in the South

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A Brief History

First discovered in the mid-1970s

Symptoms observed in children from Lyme, Connecticut

Initially diagnosed as juvenile rheumatoid arthritis

Clinicians targeted causative agent as infectious bacteria

Isolated from the gut of ticks endemic to Shelter Island, NY

Confirmation made by Willy Burgdorfer, NIAID researcher

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WHAT IS LYME DISEASE?Infectious Disease Caused by spirochete

bacterium Transmitted by ticks Multi-systemic

Signs & Symptoms Fever Headache Fatigue Skin rash Infection

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WHO CAN GET LYME DISEASE? Hikers Hunters Campers Fishermen Gardeners Landscapers Rural Inhabitants Outdoor Recreation Lovers

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THE CULPRIT

SPIROCHETE BACTERIUM

BORRELIA SPECIES B. burgdorferi B. americana B andersonii

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HOW LYME DISEASE IS TRANSMITTED

An unfed nymph carries spirochete bacteria in the lumenal side of its gut

Spirochetes multiply 17-fold in the midgut Spirochetes travel from midgut through

hemolymph to the salivary glands Regurgitated gut fluid is transmitted

during feeding through salivary glands Salivary glands release spirochetes into

vertebrate host

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THE VECTOR(aka Spirochete Transmitter)

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LYME DISEASE HOSTS

Mice Deer Humans Wild Birds Other Animals

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TICK LIFE CYCLE

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MECHANISM OF ACTION AGENT DUAL PATHWAY

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TICK GEOGRAPHICAL DISTRIBUTION

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How do the cases stack up?

Confirmed cases of Lyme disease by state or locality, 2001-2011

Year

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

U.S. Tota

l

17,029

23,763

21,273

19,804

23,305

19,931

27,444

28,921

29,959

22,561

24,364

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Case Prevalence

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Cases by Age and Sex

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LYME DISEASE SURVEILLANCE Regular surveillance is done by the CDC Reports are submitted by U.S. Health

Departments Lyme Disease information is made

available to the public through the CDC Morbidity and Mortality Weekly Report

Public health practitioners use reported information to tailor interventions especially for endemic populations

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A Look at Some Signs

Classic Bull’s Eye Rash

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Spreading Rash

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PREVENTION!

Outdoor Protection Tick Removal

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A testimony from someone who knows…

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TREATMENT OPTIONS

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If caught early, Lyme Disease can be treated with one of the following antibiotics: Doxycycline Amoxicillin Cefuroxine Axetil

If the illness is related to neurological or cardiac complications, intravenous application of the following may be required: Penicillin Ceftriaxone

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REFERENCES American Lyme Disease Foundation (ALDF). (2011). U.S. maps and statistics. Retrieved

from http://www.aldf.com/usmap.shtml Centers for Disease Control and Prevention (CDC). (2013). Americans diagnosed with Lyme

disease: Number may be 10 times more than reported. ScienceDaily. Retrieved from http://www.sciencedaily.com/releases/2013/08/130819182855.htm

Centers for Disease Control and Prevention (CDC). (2013). Confirmed lyme disease cases by age and sex - - United States, 2001 – 2010. Retrieved from http://www.cdc.gov/lyme/stats/chartstables/incidencebyagesex.html

Centers for Disease Control and Prevention (CDC). (2011). Life cycle of blacklegged ticks. Retrieved from http://www.cdc.gov/lyme/transmission/blacklegged.html

Centers for Disease Control and Prevention (CDC). (2014). Life cycle of hard ticks that spread disease. Retrieved from http://www.cdc.gov/ticks/life_cycle_and_hosts.html

Centers for Disease Control and Prevention (CDC). (2014, May). Lime disease. Retrieved from http://www.cdc.gov/lyme/

Centers for Disease Control and Prevention (CDC). (2014). Lyme Disease. Treatment. Retrieved from http://www.cdc.gov/lyme/treatment/index.html

Centers for Disease Control and Prevention (CDC). (2013). Lyme disease frequently asked questions. Retrieved from http://www.cdc.gov/lyme/faq/index.html#lonestar on

Center for Disease Control and Prevention (CDC). (2013). Reported cases of lyme disease by year, United States, 2003 – 2012. Retrieved from http://www.cdc.gov/lyme/stats/chartstables/casesbyyear.html

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REFERENCES, Cont’d Centers for Disease Control and Prevention (CDC). (2012). Lyme Disease. Reported cases of

lyme disease: United States, 2012. Retrieved from http://www.cdc.gov/lyme/stats/maps/map2012.html

Centers for Disease Control and Prevention (CDC). (2011). Signs and symptoms of lyme disease. Retrieved from http://www.cdc.gov/lyme/signs_symptoms/index.html

Centers for Disease Control and Prevention (CDC). (2008, October). Surveillance for lyme disease – United States, 1996 – 2006. Morbidity and Mortality Weekly Report, 57(SS10):1-9. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5710a1.htm

Clark, K., Leydet, B., & Hartman, S. (2013). Lyme borreliosis in human patients in Florida and Georgia, USA. International Journal of Medical Sciences, 10(7):915-931. doi:10.7150/ijms.6273.

Clark, K. (2014, May 14). Lyme disease is spreading. [Video File]. Retrieved from http://www.youtube.com/watch?v=NwVuzx3RdZc

Eisen, R., Piesman, J., Zielinski-Gutierrez, E., & Eisen, L. (2012). What do we need to know about disease ecology to prevent Lyme disease in the northeastern United States? Journal of Medical Entomology, 49(1):1-236. doi: http://dx.doi.org/10.1603/ME11138

Fallon, B., & Nields, J. (1994, November). Lyme disease: A neuropsychiatric illness. The American Journal of Psychiatry, 151(11):1571-1583. Retrieved from http://ajp.psychiatryonline.org/article.aspx?articleID=170646

Gathany, J. & Nicholson, W. (2013). Americans diagnosed with Lyme disease: Number may be 10 times more than reported. ScienceDaily. [Photo]. Retrieved from http://www.sciencedaily.com/releases/2013/08/130819182855.htm

Hamer, S., Tsao, J., Walker, E., & Hickling, G. (2010, August). Invasion of the lyme disease vector ixodes scapularis: Implications for Borrelia burgdorferi endemicity. Ecohealth, 7(1):47-63. doi: 10.1007/s10393-010-0287-0.

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REFERENCES, Cont’d

Hear Nebraska. (2012). Concert to benefit lyme disease treatment, education. [Photo]. Retrieved from http://hearnebraska.org/feature/concert-benefit-lyme-disease-treatment-education-guest-column/

Lime Disease.org. (2013). Touched by lyme: How to protect yourself in tick territory. Retrieved from http://lymedisease.org/news/touchedbylyme/protect-yourself-from-ticks.html

Lime Disease Guide.org. (LDG) (n.d.). Lime disease morphology. [Photo]. Retrieved from http://lymediseaseguide.org/lyme-disease-morphology

Lyme Disease Guide.org. (n.d.). Lyme disease prevention – vaccination. [Photo]. Retrieved from http://lymediseaseguide.org/lyme-disease-prevention-vaccination

Middlesex-London Health Unit (MLHU). (2014). How to properly remove a tick. [Photo]. Retrieved from https://www.healthunit.com/submit-tick-health-unit

Munderloh, P. & Kurtti, T. (2005). The abc’s of lyme disease spirochaetes in ticks. The Lancet, 366:962. [PDF].

New York State Department of Health (NYSDH). (2011). Lyme disease (tick-borne borreliosis, lyme arthritis). Retrieved from https://www.health.ny.gov/diseases/communicable/lyme/fact_sheet.htm

Nuttall, P. A., & Labuda, M. (2004). Tick-host interactions: Saliva-activated transmission. Parasitology, 129, S177-89. Retrieved from http://search.proquest.com/docview/750573476?accountid=14872

Piesman, J., & Schneider, B. (2002). Dynamic changes in lyme disease spirochetes during transmission by nymphal ticks. Experimental & Applied Acarology, 28(1-4), 141-5. Retrieved from http://search.proquest.com/docview/220128404?accountid=14872

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REFERENCES, Cont’d

Radolf, J., Caimano, M., Stevenson, B. & Hu, L. (2012, February). Of ticks, mice, and men: understanding the dual host lifestyle of lyme disease spirochaetes. Nature Reviews Microbiology, 10:87-99. doi: 10.1038/nrmicro2714.

Sheil, W. Jr. (2014). Lyme disease pictures slideshow: Symptoms and treatment. MedicineNet.com. [Photo]. Retrieved from http://www.medicinenet.com/lyme_disease_pictures_slideshow/article.htm

University of North Florida (UNF). (2014, May). Lyme disease confirmed in humans from southern states. ScienceDaily. Retrieved from www.sciencedaily.com/releases/2014/05/140513091115.htm

U.S. Department of Health and Human Services. National Institutes of Health. National Institute of Allergy and Infectious Diseases (NIAID). (2012). A history of lyme disease, symptoms, diagnosis, treatment and prevention. Retrieved from http://www.niaid.nih.gov/topics/lymedisease/understanding/Pages/intro.aspx

Virginia Department of Public Health (VDPH). (2014). Vector-borne disease control. Retrieved from http://www.vdh.virginia.gov/epidemiology/DEE/Vectorborne/

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