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Lyme Disease 2015 March 9, 2015Daniel M. Sullivan MD FACPMedicine Institute

1What is it?Lyme Disease is a tick borne illnessThe tick transmits a bacteria into our skinBorrelia Burgdorferei in the United StatesBlacklegged ticks are the source

2Ticks need 36 hours of attachment to transmit diseaseThe ticks are often in the nymph stage2 mm in sizeBlacklegged Ticks (Ixodes scapularis)

http://www.cdc.gov/lyme/transmission/blacklegged.htmlTypical SymptomsFeverHeadacheFatigueRashErythema MigransRash is called Erythema MigransLooks like a red bulls eye with a white center

http://www.cdc.gov/ticks/symptoms.htmlIf UntreatedSpreads to JointsHeartNervous SystemDiagnosis is Based on SymptomsRed expanding rashFatigue, Chills, FeverHeadache, Muscle, and Joint AchesSwollen Lymph Nodes

Lab TestingShould be done if exposed to blacklegged ticks and have symptomsTreatmentMost cases resolve with a few weeks of antibioticsPreventionInsect repellentRemove the tick promptlyReducing Tick Habitat

http://www2.epa.gov/insect-repellents

Prevention

http://www.bayexco.com/blog/wp-content/uploads/2014/07/Tick_Removal-300x195.jpgWhere is the Highest RiskNortheast and Mid-AtlanticWisconsin and MinnesotaNorthern CaliforniaReported Lyme disease cases in the United States from 1990-2013

http://module.lymediseaseassociation.net/Maps/Can the Blood Test be WrongOften the test is negative during the rash stage of the illness in the first few weeksIf the Blood test is still positive is infection still present?The blood test measures antibodies and stays positive for years. Standard TreatmentEarly disease is treated with doxycycline or amoxicillinLater disease in the nervous system may need intravenous antibioticsReported cases of Lyme disease by year in the United States 1995-2013

The graph displays the number of reported cases of Lyme disease from 1995 through 2013. The number of confirmed cases ranged from a low of 11,700 in 1995 to high of 29,959 in 2009.http://www.cdc.gov/lyme/stats/chartstables/casesbyyear.html

Reported cases of Lyme disease in the United Stated, 1991-2012

This figure shows the annual incidence of Lyme disease, which is calculated as the number of new cases per 100,000 people. The graph is based on cases that local and state health departments report to CDC's national disease tracking system.http://www.epa.gov/climatechange/science/indicators/health-society/lyme.html

Confirmed Lyme disease cases by age and sex in the United States, 2001-2010

Reported cases of Lyme disease are most common among boys aged 5-9.

http://www.cdc.gov/lyme/stats/chartstables/incidencebyagesex.html

Reported cases of Lyme disease, United States, 2013

Though Lyme disease cases have been reported in nearly every state, cases are reported from the infected persons county of residence, not they place where they were infected. http://www.cdc.gov/lyme/resources/brochure/lymediseasebrochure.pdf

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