Lyme Disease Tracking & Prevention

Virginia Department of Health

What is Lyme Disease?

3 Stages of Infection

Early Localized Infection (3-30 days)Bull’s-eye rash, muscle or joint aches, fever, headache

Early Disseminated Infection (1- 4 months)Severe headaches, pain, neurological symptoms

Late Disseminated Infection (3 months to years)Severe arthritis and swelling of large joints, pain, neurological and cognitive disorders

A Tick-borne bacterial disease

Lone Star Tick American Dog TickBlacklegged Tick

Common Virginia Ticks

Blacklegged Ticks

Inch (fractions)

1/16

Lyme Disease Transmission – Two Year Cycle

http://www.cdc.gov/

Role of the Virginia Department of Health

Preventing disease through education

Tracking Monitoring the annual number and geographic distribution of newly identified Lyme disease cases in VA

Tracking Lyme disease1. Reporting cases to local

health departments by healthcare providers.

2. Reporting positive test results to VDH by private laboratories.

3. Use of the CDC’s Lyme disease case definition to identify new cases.

4. Entering identified cases in a database.

State Reporting Requirements for Lyme Disease

Virginia’s state regulations require that healthcare providers report Lyme disease cases to the local health department (Virginia Administrative Code, 12VAC5-90-80)

Contact information for local health departments can be found at: http://www.vdh.virginia.gov/lhd/

Lyme Disease Case Reporting

Lyme-associated symptoms including erythema migrans (EM) rash (a.k.a., bull’s eye rash) if present

Necessary laboratory results:

VDH uses the CDC’s Lyme Disease Surveillance Case Definition which requires:

Positive or equivocal results from ELISA (or IFA) serology as well as positive Western Blot IgM serology if the blood was drawn within 30 days of onset, or

Positive Western Blot IgG serology, if blood was drawn more than 30 days after onset

Necessary case information:

Date of onset

Complete laboratory testing results

Lyme Disease Cases in Virginia, 1989 - 2009

0

2

4

6

8

10

12

14

198

9

199

0

199

1

199

2

199

3

199

4

199

5

199

6

199

7

199

8

199

9

200

0

200

1

200

2

200

3

200

4

200

5

200

6

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7

200

8

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9

Year

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20032003 20052005

20072007 20092009

Newly Identified Lyme Disease Cases by County

0.1 to 4.9 5 to 9.9 10 to 24.9 25 to 49.9 50 to 99.9 100+

Confirmed and Probable cases per 100,000 population

Lyme Disease Prevention

1. Avoid tick habitats

2. Dress appropriately

3. Use repellents

4. Do tick checks

5. Remove ticks

6. Know the early signs of Lyme disease

1. Avoid Tick Habitats

2. Dress Appropriately

• Light colors• Tucked and buttoned• Prompt clothing

removal• Launder

3. Use Insect Repellents

4. Do a Tick Check

Use pointed tweezers to grasp Use pointed tweezers to grasp the tick by the head; do not the tick by the head; do not squeeze its body! squeeze its body!

Pull slowly and steadily until Pull slowly and steadily until the tick releases; do not jerk or the tick releases; do not jerk or twist the tick. twist the tick.

5. Remove Ticks Promptly

6. Learn the Early Signs of Lyme

• Bull’s Eye rash• Fatigue• Fever• Joint or muscle aches• Headache• Swollen glands

Other Tick-borne Diseases

• Ehrlichiosis/Anaplasmosis (tick must be attached 24 hrs)

• Babesiosis (tick must be attached for 36 hrs)

• Rocky Mountain Spotted Fever (tick must be attached only 4-6 hrs)

Virginia Department of Health

For More Information…

U.S. Centers for Disease Control and Prevention

http://www.vdh.virginia.gov

http://www.vdh.virginia.gov/epidemiology/DEE/Vectorborne/TickBrochure.pdf

http://www.cdc.gov/ncidod/dvbid/lyme/

Acknowledgements

• David Gaines, Ph.D., Public Health Entomologist, Virginia Department of Health

• Division of Environmental Epidemiology, VDH• U.S. Centers for Disease Control and Prevention• CDC Public Health Images Library• American Lyme Disease Foundation• Google Images

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