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Lyme Disease – Watch out for Spring and Summer! Presentation by Naomi Azunie Ph.D student in Public Health – Community health Education Walden University Professor : Dr. Denise Feda Environmental Health – Summer 2012. Objectives of this presentation.

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  1. Lyme Disease – Watch out for Spring and Summer!Presentation by Naomi AzuniePh.D student in Public Health – Community health EducationWalden UniversityProfessor : Dr. Denise FedaEnvironmental Health – Summer 2012

  2. Objectives of this presentation • Improve corporation between community partners and resources available to create awareness. • Identify organizations with goals to improve public health effort on environment to stop Lyme disease • Provide communities with updated statistics and educative materials on Lyme disease • To encourage hospitals and clinics to provide effective diagnosis and treatment of Lyme disease

  3. Quick Facts on Lyme Disease • Described in 1975 and was nationally a notifiable disease in 1991. • The 5th most commonly reported vector borne illness in the United States in 2009 • A tick-borne disease caused by spirochete Borreliaburgdorferi • First identified in 1982 • In humans can cause abnormalities of the skin, joint , heart, and the nervous system. • Affects all ages, sex, and attack rates higher in children under 15 and in adults ages 45 to 65 (GAO, 2001)

  4. Endemic distribution of Lyme Disease in the United States Over the past 10 years cases have been reported mostly in States of the northeastern, mid-Atlantic, and the north-central regions of the United States. Many cases have been reported from counties in northwestern California http://www.cdc.gov/lyme/stats/maps/interactiveMaps.html

  5. Distribution • Prevalent in the Northeast, the upper Midwest, and Pacific Northwest. • More than 9,600 cases reported in 1992 to the CDC • About 94% of cases were reported from 12 states in 2010 with Delaware ranking highest. • Common during spring and summer time • Wooded and grassy areas where deer and mice are encroach by residential homes are common habitats for ticks

  6. Causes of Lyme Disease • A tick-borne vector caused by the spirochete, Borreliaburgdorferi. • The vector – ixodesscapularis carry the bacteria from host- the deer and white mouse. • Blacklegged tick carry bacteria to humans through bite. • Ticks must feed for 72 hours before transmitting enough spirochetes to infect humans • Have an incubation period of seven to ten days. • Pets can carry ticks because of their hairy skin and spread to humans.

  7. Transmission of Lyme Disease In humans infections are through bites of ticks called nymphs and adult ticks Pets are common carriers to humans No known fact about human to human transmission Infected persons not allowed to donate blood http://www.acponline.org/clinical_information/resources/lyme_disease/patient/prevention.htm

  8. Transmission of Lyme Disease • Fetus infection occurs through placenta. • May result in still birth if infected during pregnancy • Can survive in blood stored for donation • No scientific evidence of transmission through blood transfusion

  9. Three clinical stages of disease manifestation. Stage one – about 3- 30 days after bite. Erythemamigrans develops 1-4 weeks after the bite. flu-like symptoms including fever, headache, stiff-neck, body aches, and fatigue, malaise, nervousness, and depression. Stage two – dissemination to multiple organ systems Symptoms includes: severe headache, stiffness neurological and cardiac abnormalities, arthritis or nervous system problems and in rare cases heart problems. Lyme disease can also resolve to eye inflammation, hepatitis and severe fatigue Stage three – chronic infection which result muscle pain, inflammation, recurrent attacks of arthritis, myocarditis, Lyme meningitis, and unilateral Bell’s palsy. Nervous system problems like memory loss, difficulty concentrating Signs and Symptoms of Lyme Disease

  10. Diagnosis • Distinctive features of the lesions makes easy diagnoses. • Western Blot assay- best antibody test used in diagnosing at later stage. • Western Blot technique provides serum IgM or IgG results. • Serologic tests available but not essential to diagnosis in early stage. • CDC recommends ELISA - a very sensitive like -IFA for first weeks of infection – effective at later stage. • Other test like the echocardiogram to look at the heart and electrocardiogram and MRI of the brain are examined to detect late stage of disease

  11. Treatment • Antibiotics treatment not suitable for pregnant women and children younger than 9years. • Treatment effective in early stage • Doxycycline- 100mg orally twice daily • Amoxicillin – 500mg orally 3 times daily • Cefuroximeaxetil – 500mg orally, twice daily • Oral treatment taken within 14 to 21 days • Duration of treatment varies depending on the stage.

  12. Prevention and Control of Lyme Disease • Avoid walking outdoor during tick season between spring to summer time • Light-colored clothing to easily identify ticks • Long sleeve shirt and tuck into long pants before going outdoor to wooded area • Spray insect repellent with DEET • Walk in the center of trails to avoid grass and bushes. • Bath immediately after outdoor walks, wash and dry clothes. • Check body and carefully remove any attached ticks • People 15 years and over should consider getting a vaccine especially those in high risk areas

  13. Suggested sites for information on Lyme disease • Lyme disease is a public health concern and many people may or will get infected. • Here are some important websites that have valuable information concerning Lyme disease. Information concerning repellent registered by the Environmental Protection Agency (EPA) can be found at http://cfpub.epa.gov/oppref/insect/ For more understanding of Lyme disease visit these websites http://www.cdc.gov/lyme/ http://www.acponline.org/clinical_information/resources/lyme_disease/patient/prevention.htm http://lymediseaseassociation.org/index.php?option=com_content&view=article&id=552:what-is-lyme-disease&catid=64:medical&Itemid=403 http://www.hopkins-arthritis.org/arthritis-info/lyme-disease/clinical-presentation.html http://www.healthunit.org/hazards/documents/lyme.htm http://vsearch.nlm.nih.gov/vivisimo/cgi-bin/query-meta?v%3Aproject=medlineplus&query=lyme+disease&x=0&y=0 http://www.webmd.com/a-to-z-guides/lyme-disease-nord

  14. References American College of Physicians. (2012). Lyme Disease: a patient guide. Retrieved on July 23, 2012 from http://www.acponline.org/clinical_information/resources/lyme_disease/patient/prevention.htm Bratton, R. L., Whiteside, J. W., Hovan, M. J., Engle, R. L., and Edwars, F. D. (2008). Diagnosis and treatment of Lyme disease. Clinic Proceedings. Vol.83. Issue 5, p 566-571. Retrieved on August 4,2012 from http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/ Center for Disease Control. (2012). Lyme disease Fast Facts. Retrieved on July 23, 2012 from http://www.cdc.gov/lyme/stats/index.html Center for Disease Control. (2012). Lyme disease transmission. Retrieved on July 23,2012 from http://www.cdc.gov/lyme/transmission/index.html Center for Disease Control. (2012). Preventing tick bite. Retrieved on July 23,2012 from http://www.cdc.gov/lyme/prev/index.html

  15. References continue • Center for Disease Control. (2012). Interactive map of Lyme disease. Retrieved on August 3, 2012 from http://www.cdc.gov/lyme/stats/maps/interactiveMaps.html • Center for Disease Control (CDC) (2012). Reported Lyme disease cases by states 2000- 2010. Retrieved on August 3, 2012 from http://www.cdc.gov/lyme/stats/chartstables/reportedcases_statelocality.html • DeSanna, E. T., and Malawista, S. E. (1983). Treatment of the early manifestations of lyme disease. Annals of internal medicine. Vol, 99, Issue 1, p22. • General Accounting Office. (2001). Lyme disease programs and Resources. Retrieved on July 23, 2012 from www.gao.gov/new.items/d01755.pdf • Halsey, N. A. and Abramson, J. S. (2000). Prevention of Lyme disease. American academy of pediatrics. Vol. 105 Issue 1. Retrieved on August 3, 2012 from http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/detail? • Goldsmith, C. (1999). How to avoid Lyme disease. Current health. Vol. 25, Issue 8, p16. Retrieved on August 4, 2012 from walden library.

  16. References cont’d Lyme Disease Association. (2012). What is Lyme disease. Retrieved on July 23, 2012 from http://lymediseaseassociation.org/index.php?option=com_content&view=article&id=552:what-is-lyme-disease&catid=64:medical&Itemid=403 MedicineNet.Inc. (2004). Tick – Lyme disease. Retrieved on July 23, 2012 from http://www.medicinenet.com/ticks/article.htm National Library of Medicine. (2011). Lyme disease. Retrieved on July 23,2012 from http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0002296/ National Institute of Allergy and Infectious Diseases. (2012). Lyme Disease. Retrieved on July 23, 2012 from http://www.niaid.nih.gov/topics/lymedisease/understanding/pages/into.aspx Selius, B. A. and Alper, B. S. (2004). Lyme disease. Cortlandt Forum. Vol. 17 Issue 6, p73-79 Stanhope, M. and Lancaster, J. (2008). Public health nursing population-centered health care in the community. (2nd Ed). Mosby Inc

  17. References cont’d • Steere, A. C., Hutchison, G. J., Rahn, D. W., Sigal, L. H., Craft, J. E., DeSanna, E. T., and Malawista, S. E. (1983). Treatment of the early manifestations of lyme disease. Annals of internal medicine. Vol, 99, Issue 1, p22.tlandt Forum. Vol. 17 Issue 6, p73-79. • Willen, J.L. (1994). Lyme disease: A seasonal risk. Nation’s Business. Vol. 82, Issue 8. Retrieved on August 3, 2012 from http://web.ebscohost.com.ezp.waldenulibrary.org/ehost/lyme disease

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