Lyme disease: Children and Outdoors School Activities Germaine Banza PUBH 6165 Walden University

INTRODUCTION Lyme disease is an infectious disease caused by spirochetal agent (Borrelia burgdorferi) Most common vector-borne disease in U.S. Humans are infected from tick bite Symptoms mimic many others diseases such as stroke Environmental and behavioral approaches for reducing tick bites among children Public health interventions and community wide efforts in managing and controlling tick population.

INTRODUCTION (CON’T) Ranks among top 10 notifiable diseases in the U.S. Rates are highest among children ages 5 to 9 (8.6 cases per 100,000 population). Lowest rate among adult 20 to 22 years (3 cases per 100,000 population). Research effort should be focused on vaccines for Lyme disease prevention Key factors in public health include - Steady increase in reported cases - Threat of geographic expansion of area of endemicity - Insufficiency of current alternative prevention methods

OVERVIEW Inflammatory disease caused by infected ticks. Etiologic agent: bacteria called Borrelia burgdoferi. Reservoirs: Small mammals and birds People are infected in summer by the immature ticks: nymphs

Incidence and Prevalence About 30,000 people are diagnosed annually in the U.S. Estimated ten fold are underreported Prevalent in New England, the Upper Midwest, Great Lakes region, and the Pacific Northwest

Incidence and Prevalence (Con’t.) The disease is more prevalent from May to August in the Northeast and Great Lake regions and from January to May in the Pacific Northwest. Became notifiable in 1991.

EPIDEMIOLOGY and SURVEILLANCE Information generates from several sources. Data collection obtained from surveillance programs, laboratory services, medical and general communities, and agencies. Cases reported according to the county of residence, not the place of exposure. The geographic distribution of cases is highly focused. About 10% of the disease are underreported.

EPIDEMIOLOGY AND SURVEILLANCE (CON’T)

RISK FACTORS Prolong time in wooded or grassy areas Exposed skin / failure to wear appropriate clothes and shoes Indoor/outdoor pets Improper removal of the tick.

SIGNS AND SYMPTOMS Redness, rash like called Erythema migrans (EM) at the infected area. Swollen lymph nodes, chills, fever, headache, muscles and joints aches, severe fatigue, Left untreated will result to: Rheumatologic symptoms Cardiac symptoms Neurologic symptoms

SIGNS AND SYMPTOMS (Cont) Facial Paralysis Bull’s eye rash Arthritis knee

DIAGNOSTIC AND TREATMENT History of exposure to the infected ticks Signs and symptoms Blood and CSF testing Appropriate antibiotics

PREVENTION Management of the environment for tick control. Education and arise awareness. Community-based management Early detection, diagnosis, and treatment for favorable outcome Dermatologist: skin care and treatment of erythema migrans

PREVENTION (Cont.) Insect repellents in absence of Vaccine Daily check for ticks after possible exposure Prompt bath after outdoor activities: camping, walking in the wood, gardening. Tick removal with tweezers as soon as possible

TICK CONTROL Environmental Management Chemical control

PUBLIC HEALTH INTERVENTION EDUCATION is crucial Educate the community, school, parents, and children about the disease and preventive measures. Adopt the TickNET network program for Lyme disease

LYME DISEASE: CHALLENGES Public health practice: Old guidelines used. Need for new guidelines for Lyme disease education and prevention information. Clinical misdiagnosis, and delay in treatment Prevention: vaccine unavailability Underreported cases Inadequate funds High standards needed regarding safety, efficacy, cost, and public acceptance

SKATEBOARDS IMPLICATION Increase Lyme disease awareness Prompt surveillance system Reconsider the use of vaccine Establish effective testing and diagnosis measures Guidelines update for school Promote research

AUDIENCE / STAKEHOLDERS Parents Health care providers (doctors, nurses, social workers) Faculty members from schools Grand Prairie Health Department Infection Disease Society of America (ISIDA) guidelines TickNET program

CONCLUSION Lyme disease is caused by bacterium Borrelia burgdorferi. Rate are highest in children ages 5 to 9. Relevant to public health due to incidence and prevalence. Can become a chronic and serious illness if left untreated. Early diagnostic and antibiotic treatment are essential. Education and effective prevention measures contribute to disease control. Prevention efforts focused on combination of efforts and approaches such as management of deer population. Lyme disease is a multi-faced condition requiring joint efforts and adequate funding for further research.

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