Lyme Disease Tracking & Prevention Virginia Department of Health

1. Lyme Disease Tracking & Prevention Virginia Department of Health

2. What is Lyme Disease? A Tick-borne bacterial 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

3. Lone Star Tick Blacklegged Tick American Dog Tick Common Virginia Ticks

4. 1/16 Inch (fractions) Blacklegged Ticks

5. Lyme Disease Transmission – Two Year Cycle

7. Role of the Virginia Department of Health • Tracking Monitoring the annual number and geographic distribution of newly identified Lyme disease cases in VA • Preventing disease through education

8. Tracking Lyme disease • 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.

9. 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/

10. Lyme Disease Case Reporting VDH uses the CDC’s Lyme Disease Surveillance Case Definition which requires: • Necessary case information: Lyme-associated symptoms including erythemamigrans (EM) rash (a.k.a., bull’s eye rash) if present Date of onset Complete laboratory testing results • Necessary laboratory results: 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

11. 14 12 10 8 100,000 Population Lyme Disease Cases per 6 4 2 0 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2009 2004 2008 1992 1989 1990 1991 2005 2006 2007 Year Lyme Disease Cases in Virginia, 1989 - 2009

12. Newly Identified Lyme Disease Cases by County 2003 2005 2007 2009 Confirmed and Probable cases per 100,000 population 0.1 to 4.9 5 to 9.9 10 to 24.9 25 to 49.9 50 to 99.9 100+

13. Lyme Disease Prevention 1. Avoid tickhabitats 2. Dress appropriately 3. Userepellents 4. Do tick checks 5. Remove ticks 6. Know the early signs of Lyme disease

14. 1. Avoid Tick Habitats

15. 2. Dress Appropriately • Light colors • Tucked and buttoned • Prompt clothing removal • Launder

16. 3. Use Insect Repellents

17. 4. Do a Tick Check

18. 5. Remove Ticks Promptly Use pointed tweezers to grasp the tick by the head; do not squeeze its body! Pull slowly and steadily until the tick releases; do not jerk or twist the tick.

19. 6. Learn the Early Signs of Lyme • Bull’s Eye rash • Fatigue • Fever • Joint or muscle aches • Headache • Swollen glands

20. 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)

21. For More Information… • Virginia Department of Health http://www.vdh.virginia.gov http://www.vdh.virginia.gov/epidemiology/DEE/Vectorborne/TickBrochure.pdf • U.S. Centers for Disease Control and Prevention http://www.cdc.gov/ncidod/dvbid/lyme/

22. 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 We invite you to complete the following survey: http://www.zoomerang.com/Survey/WEB22ALUM8JJD7