Lyme Disease: Take the Time to Prevent Lyme Terresa Erickson, MPH student Walden University PUBH 6165-4 Instructor: Dr. Stephen Arnold Spring Quarter, 2010 Welcome and thank you for joining me! My name is Terresa Erickson and today we are going to talk about Lyme Disease. My goal with this presentation today is to educate you, the public, about Lyme Disease. My hope is that you will be “armed” with the necessary information in order to protect yourselves.

Today’s Agenda What is Lyme Disease? Signs and Symptoms Diagnosis Treatment Prevention Additional Information Today’s agenda includes defining Lyme Disease and how it is transmitted, the signs and symptoms, along with the diagnosis and treatment of Lyme Disease. Lastly, I will discuss how to protect yourselves in order to prevent Lyme disease and provide you with a list of additional resources you may access in order to find more information relating to Lyme Disease.

What is Lyme Disease? What is Lyme Disease?

Lyme Disease is… Caused by the bacterium Borrelia burgdorferi Transmitted by infected deer ticks Lyme Disease is an illness caused by the bacteria Borrelia burgdorferi. It is transmitted to humans by infected deer ticks. Centers for Disease Control and Prevention (2010). Lyme Disease. Retrieved from http://www.cdc.gov/ncidod/dvbid/lyme/index.htm

Life Cycle How is Lyme Disease spread? It is spread through the bite of an infected tick. The deer ticks become infected with the bacteria when the immature stage of the tick feeds on infected field mice. The infected tick then passes the bacteria on to its next host (humans or animals). In order for the tick to pass the bacteria on to another host, it must be attached to a person’s skin for about 24 hours. As you can see in this illustration, ticks enter a dormant portion of their life cycle during the fall and winter months. American Lyme Disease Foundation (2010). Deer Tick Ecology. Retrieved from http://www.aldf.com/deerTickEcology.shtml

When Does Lyme Disease Occur? Since ticks enter the dormant phase of their lifecycle during the winter months, the majority of cases occur during the spring and summer months. Typically, the incidence of Lyme Disease peaks during the summer months (May – August). Centers for Disease Control and Prevention (2006). Reported Cases of Lyme Disease by Month of Illness Onset United States, 1992-2004. Retrieved from http://www.cdc.gov/ncidod/dvbid/Lyme/ld_rptmthofill.htm

Where Does Lyme Disease Occur? Lyme Disease can occur in any state that has deer ticks, but as you can see by this map of the United States…it occurs more frequently in the Northeastern portion of the US. Wisconsin and Minnesota also have a higher incidence of Lyme Disease when compared to the rest of the nation. Centers for Disease Control and Prevention (2009). Reported Cases of Lyme Disease United States – 2008. Retrieved from http://www.cdc.gov/ncidod/dvbid/lyme/ld_Incidence.htm

Who Gets Lyme Disease? Who gets Lyme Disease? Anyone at any age can contract Lyme Disease. We can see from this graph that Lyme Disease is more prevalent in children ages 5 to 14 years and also among adults greater than 30 years of age. Centers for Disease Control and Prevention (2006). Average Annual Incidence of Reported Cases of Lyme Disease by Age Group and Sex, United States, 1992-2004. Retrieved from http://www.cdc.gov/ncidod/dvbid/Lyme/ld_MeanAnnualIncidence.htm

Signs and Symptoms What are the Signs and Symptoms of Lyme Disease?

Common Signs and Symptoms Consist of: Fever Headache Fatique Skin Lesions (Bull’s Eye Rash) The common signs and symptoms consist of fever, headache, fatigue, and skin rash. Symptoms will often occur 3-30 days after being bit by an infected tick. Often times, the presence of a skin rash will be the first indication of Lyme Disease. Typically, the rash will appear as a “bulls eye” and can grow in size after a period of time. Mayo Clinic (2008). Lyme Disease. Retrieved from www.mayoclinic.com

Less Common Signs and Symptoms Include: Joint Pain Neurological Symptoms Paralysis of one side of the face (Bell’s palsy) Weakness in limbs Impaired muscle movement Irregular heartbeat If left untreated, Lyme Disease can progress causing more severe symptoms (joint pain, neurological symptoms, and an irregular heartbeat). Mayo Clinic (2008). Lyme Disease. Retrieved from www.mayoclinic.com

Diagnosis How is Lyme Disease diagnosed?

Diagnosis is Based On… Clinical signs and symptoms History of possible tick exposure Laboratory tests Your provider will base his or her diagnosis on your clinical signs and symptoms and whether or not you have been exposed to ticks (been in a wooded area lately). They may also order some laboratory tests in order to confirm the diagnosis of Lyme Disease.

Treatment If you are diagnosed with Lyme Disease, what can you expect as far as treatment is concerned?

What Should I Do? Seek Medical Advice Lyme Disease can be treated more effectively with antibiotics if caught early Lyme Disease can be effectively treated with antibiotics. Although, it is important to note that people treated in the early stages of the disease recover more rapidly and completely than those who are diagnosed later in the disease. Therefore, if you are at all concerned that you may have Lyme Disease please seek medical advice as soon as possible.

Prevention How can you prevent Lyme Disease?

Preventing Lyme Disease Avoid areas with lots of ticks Wooded areas Areas with overgrown grass High leaf litter Apply insect repellent with 20 – 30% DEET Use Permethrin There are multiple ways to prevent Lyme Disease and the most obvious way is to avoid the places where ticks like to live (wooded areas, areas with tall grass and excess leaf litter). As we know, avoidance isn’t necessarily possible, so in those instances it is best to take precautions. Applying insect repellent with 20 – 30 % DEET or using permethrin (a natural product that is applied to clothing, but not skin) can prevent Lyme Disease. Centers for Disease Control and Prevention (2010). Lyme Disease. Retrieved from http://www.cdc.gov/ncidod/dvbid/lyme/index.htm

Preventing Lyme Disease (cont’d) Wear long pants, shirts, and socks Check yourself for ticks Immediately remove ticks In addition to using permethrin and DEET, it is best to also wear long pants (tucked into your socks, if possible), long-sleeved shirts, and long socks. Don’t forget to check yourself and others for ticks and immediately remove any you find. Proper removal of a tick involves grasping it with narrow-bladed tweezers as close to the skin as possible (head of tick), and pull upward and out with a firm and steady tension. Once the tick has been removed, disinfect the site and wash your hands. Centers for Disease Control and Prevention (2010). Lyme Disease. Retrieved from http://www.cdc.gov/ncidod/dvbid/lyme/index.htm

Where Can I Find Additional Information? Centers for Disease Control and Prevention – www.cdc.gov Mayo Clinic – www.mayoclinic.com WI Department of Health Services - http://dhs.wi.gov/ Here is a list of where you can find more information regarding Lyme Disease. The Centers for Disease Control and Prevention, the Mayo Clinic, and the WI Department of Health Services are all great resources. You can also get additional information from your healthcare provider or from your local library.

Questions? Does anyone have any questions? Thank you for joining me today. Don’t forget “Take the time…to prevent Lyme.”

References American Lyme Disease Foundation (2010). Deer Tick Ecology. Retrieved from http://www.aldf.com/deerTickEcology.shtml Centers for Disease Control and Prevention (2006). Average Annual Incidence of Reported Cases of Lyme Disease by Age Group and Sex, United States,1992-2004. Retrieved from http://www.cdc.gov/ncidod/dvbid/Lyme/ld_MeanAnnualIncidence.htm Centers for Disease Control and Prevention (2006). Reported Cases of Lyme Disease by Month of Illness Onset United States, 1992-2004. Retrieved from http://www.cdc.gov/ncidod/dvbid/Lyme/ld_rptmthofill.htm

References (cont’d) Centers for Disease Control and Prevention (2009). Reported Cases of Lyme Disease United States – 2008. Retrieved from http://www.cdc.gov/ncidod/dvbid/lyme/ld_Incidence.htm Centers for Disease Control and Prevention (2010). Lyme Disease. Retrieved from http://www.cdc.gov/ncidod/dvbid/lyme/index.htm Mayo Clinic (2008). Lyme Disease. Retrieved from www.mayoclinic.com