Prepared by Mr. Shoup

LYME DISEASEShould We Be Concerned?

• One of the fastest growing diseases in the United States today.

• Lyme disease is the most commonly reported 

vector borne illness in the U.S. • Lyme disease from 2004-2013, over 40,224 cases

have now been confirmed in New York State. •More information go to:

•http://www.health.state.ny.us/diseases/communicable/lyme/•http://www.cdc.gov/lyme/stats/index.html•http://www.cdc.gov/lyme/stats/chartstables/reportedcases_statelocality.html

What Are We Going To Learn?

• Brief History

• Life Cycle of the Tick

• Three signs and symptom Three stages

• How to Avoid Lyme Disease

Brief History

• Medical Literature in Europe in 1883-Called ECM- found in sheep.• 1969-Wisconsin grouse hunter-1st documented case. • Was editor of the Guns Digest at one time.• 1975-First Outbreak in state of Old Lyme, Connecticut.• 1982-Bacteria found in a tick. 11 states record lyme disease 497 cases• 1985-25 states report lyme disease• 1988-43 states report lyme disease• 1992-49 states report lyme disease• 1998-49 states report lyme disease but numbers almost • double from 1992• 2001-49 states report Lyme disease over doubled from 1998• 2005 Highest number of tick cases since documentation 5,565 per 100,000 people• 2006-2007 number of cases dropped in the 4,000+ per 100,000 people• 2008-23.1 per 100,000 people confirmed Lyme disease • 2013-8.6 per 100,000 people. 9.104 probable per 100,000 (27,203)

In 2013, 95% of confirmed Lyme disease cases were reported from 14 states:

• #4 Connecticut 58.7/100,000• #6 Delaware 43.2/100,000• #3Maine 84.8/100,000• #13Maryland 13.5/100,000• #5Massachusetts 57/100,000• #10Minnesota 26.4/100,000• #2New Hampshire100/100,000

• #9 New Jersey 31.3/100,000• #12New York 17.9/100,000• #8 Pennsylvania 39/100,000• #7Rhode Island42.2/100,000• #1 Vermont 107.6/100,000• #14Virginia 11.2/100,000• #11Wisconsin 25.2/100,000

http://www.cdc.gov/lyme/stats/chartstables/incidencebystate.html

New York Cases Only

1993-2002

• 2818-1993• 5200-1994• 4438-1995• 5301-1996• 3327-1997• 4640-1998• 4402-1999• 4329-2000• 4083-2001• 5535-2002

2003-2013

• 5399-2003• 5100-2004• 5565-2005• 4460-2006• 4165-2007• 5741-2008 highest to date/1yr.

• 4134-2009• 2385-2010• 3118-2011• 2044-2012• 3512-2013 confirmed

Area for Risk for Lyme Disease

Cases by Year for Lyme Disease-All States

Lyme Disease by Age

Cases by Month

Name for the Ticks

• Eastern Tick: Ixodes Dammini Deer/Bear Tick• Western Tick: Ixodes Pacificus Western Black Legged Tick• Southern Tick: Ixodes Scapularis Black Legged Tick

• Lone Star Tick: Kentucky

Bacteria-Spirochete

Bacteria-Spirochete under microscope

Tick before and after feeding

Actual size before feeding

Size of tick after feeding (raisin or sesame seed size)

Normal Size of parasite: larva, nymph, adult

Four stages of life cycle:

Egg, Larva, Nymph, Adult

Feeding ticksTick increase in size

Increase in size

Feeding ticks

Ticks that carry Lyme Disease

Life Cycle of The Tick

Difference between sign and symptom

• A symptom is any subjective evidence of disease, while a sign is any objective evidence of disease. Therefore, a symptom is a phenomenon that is experienced by the individual affected by the disease, while a sign is a phenomenon that can be detected by someone other than the individual affected by the disease.

• For examples, anxiety pain, and fatigue are all symptoms. In contrast, a bloody nose is a sign of injured blood vessels in the nose that can be detected by a doctor, a nurse, or another observer.

• Medical Author: William C. Shiel Jr., MD, FACP, FACR

Signs and Symptoms Stage 1 Flu-Like Symptoms

• Not everyone infected with the bacteria gets ill. • If a person does become ill, the first symptoms include one

or more of these symptoms: (3-30days+) (7days average)

• Headache• Rash-EM-Erythema Migrans 70%-80%• Fever 102 • Chills• Stiff Neck• Nausea/Fatigue• Joint Pain stiffness in the joints • Muscle Pain, muscle weakness • Swollen Lymph glands• Lethargy• Jarisch Herxheimer Reaction http://www.righthealth.com/topic/Lyme_Disease_Rash_Photos

Up to 12 inches

Stage 1 Symptoms

1st Stage Symptoms-Rasheshttp://www.canlyme.com/rash.html

Signs and Symptoms Stage 2

• Rash may get bigger• Severe headaches light and sound sensitivity• Dizziness• Pain in muscles and joints especially in the areas of the knee, elbow

and shoulders.• Arthritis• Neurological effects:• Bell’s Palsy-facial paralysis• Facial twitches• Jerking movements• Difficulty concentrating, confusion, difficulty thinking• Disorientation or getting lost-memory loss• Seizures• Speech errors• Tingling in the hands and feet• Lymph glands get swollen

Stage 2 Signs & Symptoms Continued

• Irregular heart beats• Blurred Vision• Ringing, Buzzing of the ear• Sore Throat, Dry Cough• Nausea• Diarrhea• Insomnia• Menstruation Problems• Encephalitis

Encephalitis-inflammation to the brain

Bells Palsy

Beginning look After look

Bells Palsy

Signs & SymptomsStage 3

• Skin-hard leathery patches of skin around bite area.• Heart Damage/Muscular Damage• Arthritis most often in the knees• Neurological disorders:• Encephalitis• Uncontrollable walk-Cerebrum-voluntary actions• Mental confusion loss of short term memory• Partial Paralysis• Loss of memory-long term• Eyes to inflammation of the cornea to blindness• Kidney Damage/Bladder dysfunction• Liver Damage

Summary: Lyme Disease Three Stages

Cases by Symptom, 2001-2010

How To Prevent Lyme Disease

• Wear light/protective clothing• Use tick repellents-Permethrin-on clothes only not skin• Use Deet Ex: Deep Woods Off over the age of 12• Check yourself from the woods• Bathe as soon as possible from the woods• Wash clothing in hot water/Hot Dryer heat• Pay special attention to your: Back, Underarms, Groin Area, Head Area• Look for something that looks like a black freckle size.• Check your pet from a woods before they enter the

house• Remove ticks carefully: gentle firm tugging motion

• Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible.

• Pull upward with steady, even pressure. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone go to your doctor for removal.

• After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

• Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, take to doctors.

• Never crush a tick with your fingers.

How to Remove a Tick

Review: How to remove a tick!http://www.health.state.ny.us/diseases/communicable/lyme/

What To Do If You Find A Tick

• Monitor tick bite area• Put tick in a container and give to Health

Department or Doctor• Check for Rash for 1-8 weeks after the

bite

Treatment• Penicillin WASH AREA OF THE BITE WITH SOAP/WATER/ANTISEPTIC• CDC recommends a two-step process when testing blood for evidence of

Lyme disease. • Both steps can be done using the same blood sample. • 1) ELISA or IFA test. These tests are designed to be very "sensitive," meaning that almost everyone with Lyme disease, and some people who don't have Lyme disease, will test positive. 

• If the ELISA or IFA is negative: it is highly unlikely that the person has Lyme disease, and no further testing is recommended. 

• If the ELISA or IFA is positive or indeterminate (sometimes called "equivocal")

a second step should be performed to confirm the results.

• Step 2 Western Blot Test