Transcript Lyme Disease

Maduabuchi Prince Gabriel PhD Epidemiology
Walden University
PUBH 8165 Environment Health
Instructor: Dr. Donald Goodwin.
Winter Quarter, 2011.
The target audience:
General Public & Public Health Student
Objectives Of the Presentation
 Define Lyme disease and the vector that causes Lyme
disease.
 Review the significance, prevalence, incidence,
statistics and the effect of Lyme disease.
 We will evaluate how Lyme disease is screened.
 Ways to stop transmission .
Objectives Of the Presentation
cont.
 Prevention, control and eradication of the Ixodes
scapularis and Ixode pacificus that causes Lyme
Disease.
 We will look at some recent development and policies
on the prevention of this disease, and eradication of
the, host, vector, and Lyme disease.
 Finally, Provide more reading materials.
Definitions and overview
 What is Lyme disease. Lyme disease is a vector borne
disease, caused by a spirochete bacteria called
Borrelia burgdorferi.
 What are the signs and symptoms of Lyme disease.
The first signs and symptoms of Lyme disease is a red
rash called erythema migrans, flu like symptoms, and
joint pain.
American Lyme Disease Foundation, (2006); Center for Disease Control, (2011).
Erythema migrans
Google images, (2011).
What vector causes Lyme disease
 Deer tick or Blacklegged tick. The scientific name is
Ixodes scapularis. When the Ixodes scapularis have a
blood meal on its host, they will leave them infected
with Borrelia burgdorferi after 36-48hours of
engorging.
 The infected nymphal is the main cause of Lyme
disease than the adult blacklegged tick.
 If the tick is removed before the first 36hours, then
the individual will not be infected by the disease.
Picture of Ixodes scapularis
(Deer tick) on human body
Google images, (2011).
Picture of Ixodes scapularis. This
tick is very tiny in size.
Minnesota Department of Health, (2011)
Three host life cycle of Ixodes
scapularis
Image scratched by Maduabuchi Gabriel with information from the
Stafford, (2007)
.
Explanation to the three host life
cycle of Ixodes scapularis
 The tick have four stages in their life cycle, egg, larva,
nymph and the adult (male and female).
 The larvae and the nymphs changes to another stage
after digesting a blood meal by shedding the molting
or the cuticles.
 The Larvae feeds on an animal and drop to the ground
and molts to a nymph. First host.
Stafford, (2007)
Explanation to the three host life
cycle of Ixodes scapularis cont.
 The nymph feeds on small mammals and birds,
engorged drop to the ground and molt to an adult.
Second host.
 The adult tick feeds on medium and large mammals
(third host) and the female tick will produce one
single batch of eggs and die.
Stafford, (2007)
3D Illustration of B.burgdorferi
Google Images, (2011)
Areas with Lyme disease
Center For Disease Control, (2009)
Significance and prevalence of
Lyme disease.
 Most frequently reported vector borne disease in the
US.
 Northeastern and North Central states of the United
States more at risk.
American Lyme Disease Foundation, (2006).
st
1
Statistics : five state with
highest incidence rate in 2009.
 In 2009, Delaware had highest incidence of Lyme
disease.
 Connecticut the second
 New Hampshire the third.
 Massachusetts the fourth.
 Maine was the fifth state.
Center for Disease Control, (2010).
Incidence of Lyme disease
 During 1992-2006 there was a total of 248,074 cases
of Lyme disease reported to CDC in the 50 states,
District of Columbia and the US territories.
 Out of these total number, 93% of the total reported
was from Connecticut, Delaware, Massachusetts,
Maryland, Minnesota, New Jersey, New York,
Pennsylvania, Rhode Island and Wisconsin.
 The highest incidence was among children 5-
14years of age, 53% of the cases reported was
among male.
Center for Disease Control, (2006).
Where do you find the vectors
 In the woods
 Around deer.
 In homes closes to bushes.
 Leaves around the home.
 Piles of woods.
 Untrimmed trees around the home.
Control of transmission:
 Non human host-mice, deer, birds.
 Vectors: Deer tick (Ixodes scapularis).
 Vector controlling agents: insecticides, incent
repellants.
Steeve, Coburn & Glickstein, (2004 p 1100)
Tick management strategies for
the control of Ixodes scapularis.
 Personal protection: prevention of tick bites, tick checks
after visiting the woods and bushes, and tick removal.
 Landscape management: cutting of the grasses, tick safe
landscape modification to make it unsuitable for ticks.
 Management of host abundance: fencing, host reduction
and destruction of the host habitats.
 Host targeted Acaricides: the treatment of the host like the
white footed mice, chipmunks or deer through passive
tropical applications.
 Biological or natural control: use of fungal pathogens and
biopesticides to control tick.
Stafford, (2007)
Personal protection to prevent
Lyme disease.
 Wearing long sleeve and long pants in wooded
areas.
 Use of Insect repellants.
 Shower immediately coming out from the
woods
 Self checks after visiting the woods.
 Call your doctor for check up for un-usual
Rash.
Center for Disease Control, (2006).
Environmental prevention for
Lyme disease.
 Clearing the surroundings. Keeping the lawns mowed,
and removing things from the edge of the lawn.
 Removing brushes and leaves around stonewalls and
wood piles.
 Discouraging rodents activities.
 Keep dogs cats and other mammal pets away from the
woods to reduce them bringing tick back to the house.
 Fencing homes to exclude deer and planting plants
that do not attract Deer.
 Using pesticide :DEET or permethrin-based mosquito
and tick repellants should be used in the yard when
working in the lawns.
American Academy of Pediatrician, (2000); Stafford, (2007)
Clinically treatment of Lyme
disease.
 You can treat Lyme disease clinically by the
use of antibiotics after diagnosis through
laboratory test. Antibiotics can also be used
as a prophylaxes to prevent Lyme disease.
Wormser, et al. (2006)
Laws and policies about Lyme
disease.
 Lyme disease is a reportable disease. By this I mean
that when you are infected by Lyme disease, the
hospital where you are diagnosed with the disease will
report the incidence to the health department and then
this will be reported to center for Disease control.
Recommendations and
conclusion
 More work is needed on better vaccines and
insecticides to be used to prevent the disease and
eradicate the vectors. The last vaccine that was in use
for Lyme disease was discontinued in 2002 due to
lack of demand for the vaccine.
 Education and information is the key. Pass on
information to your friends, colleagues and family
members on the need to prevent tick bite especially
the blacked legged tick and ways to prevent its spread.
Stafford, (2007)
Reference:
American Academy of Pediatricians, (2000) Prevention of Lyme disease. Pediatrics, 105, 142-147
http://pediatrics.aappublications.org/cgi/reprint/105/1/142
American Lyme Association , (2006) Lyme disease. Retrieved January 15, 2011 from
http://www.aldf.com/lyme.shtml
Center For Disease Control, (2010) reported cases of Lyme disease United States 2009. Retrieved January, 15th from
http://www.cdc.gov/ncidod/dvbid/lyme/ld_Incidence.htm
Center For Disease Control, (2006) Lyme disease I Incidence. Retrieved January, 15th from
Http://www.cdc.gov/ncidod/dvbid/lyme/ld_MeanAnnualIncidence.htm
Google Images, (2011) Images of tick and Erythema Migrans Retrieved January, 15th 2011 from
http://www.google.com/images?hl=en&source=imghp&biw=1596&bih=695&q=lyme+disease&gbv=2&aq=0&aqi=g10&aql=
&oq=Lyme
Reference cont.
Minnesota Department of Health, (2010). Blacklegged tick . Retrieved February, 5th 2011 from
http://www.health.state.mn.us/divs/idepc/dtopics/tickborne/ticks.html
Stafford, K. C. (2007). Tick management handbook. Produced by The Connecticutt Agricultural experimental station. Retrieved
February, 6th 2011 from: http://www.ct.gov/caes/lib/caes/documents/publications/bulletins/b1010.pdf
Steers, A., Coburn J., & Glickstein, L. (2004) The emergency of Lyme disease. The Journal of clinical investigation, 115(8),
1093-1101. Retrieved January, 15, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC385417/pdf/JCI0421681.pdf
Wormser, G. P., Dattwayler, R. J., Shapiro, E. D., Halperin, J. J., Steere, A. C., Klempner, M. S.,… Nadelman R.O., (2006) The
Clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: Clinical
practice guidelines by the infectious disease society of America. Clinical Infectious Disease, 43, 1089-1134. Retrieved
January, 15, 2011 from http://cid.oxfordjournals.org/content/43/9/1089.full.pdf+html
Resources on Lyme disease from
CDC
 NEW Free Lyme Disease Continuing Medical Education for Clinicians
 Brochures and educational materials
 Protect Yourself from Tick-Borne Diseases.
( PDF - 1 page, 782KB)
 Lyme Disease: A Public Information Guide
( 16 pages, 4.94MB)
 Tickborne Diseases in Massachusetts, a physicians’ reference manual
(26 pages, 2MB)
 Tick Management Handbook: An integrated guide for homeowners, pest control
operators, and public health officials for the prevention of tick-associated diseases.
( 84 pages, 8,800KB) (From Connecticut Agricultural Experiment Station, New
Haven CT)
 Lyme Disease: The Facts, the Challenge
(29 pages, 407KB) (From U.S. DEPARTMENT OF HEALTH AND HUMAN
SERVICES National Institutes of Health)
 Information about repellents:
 Insect repellent use and safety , Insect repellent protection times
More Resources From CDC
 Prevention
 How Can We Prevent Lyme Disease?
Edward B. Hayes, M.D., and Joseph Piesman, D.Sc.
(Access granted courtesy of New England Journal of Medicine)
 Ecology and transmission
 Surveillance for Lyme Disease --- United States, 1992--2006
MMWR,October 3, 2008 / 57(SS10);1-9
 Lyme Disease --- United States, 2003--2005
June 15, 2007 / 56(23);573-576
 Case definition and report forms
 Lyme Disease Surveillance Case Definition (revised Jan 2008)
 Lyme Disease Surveillance Case Report Form
-For Public Health Officials Use
( 2 pages, 737 KB)
Other helpful Resources
 American Lyme disease foundation.
http://www.aldf.com/lyme.shtml
Questions
ANY QUESTION ??????