Lyme Disease 2015

March 9, 2015

Daniel M. Sullivan MD FACP

Medicine Institute

What is it?

• Lyme Disease is a tick borne illness

• The tick transmits a bacteria into our

skin

• Borrelia Burgdorferei in the United

States

- Blacklegged ticks are the source

Ticks need 36 hours of

attachment to transmit disease

• The ticks are often in the nymph stage

• 2 mm in size

Blacklegged Ticks (Ixodes scapularis)

http://www.cdc.gov/lyme/transmission/blacklegged.html

Typical Symptoms

• Fever

• Headache

• Fatigue

• Rash

Erythema Migrans

• Rash is called Erythema Migrans

• Looks like a red bulls eye with a white

center

http://www.cdc.gov/ticks/symptoms.html

If Untreated

• Spreads to Joints

• Heart

• Nervous System

Diagnosis is Based on

Symptoms

Red expanding rash

Fatigue, Chills, Fever

Headache, Muscle, and Joint Aches

Swollen Lymph Nodes

Lab Testing

• Should be done if exposed to

blacklegged ticks and have symptoms

Treatment

• Most cases resolve with a few weeks of

antibiotics

Prevention

• Insect repellent

• Remove the tick promptly

• Reducing Tick Habitat

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

Prevention

http://www.bayexco.com/blog/wp-content/uploads/2014/07/Tick_Removal-300x195.jpg

Where is the Highest Risk

• Northeast and Mid-Atlantic

• Wisconsin and Minnesota

• Northern California

Reported Lyme disease cases in the United

States from 1990-2013

http://module.lymediseaseassociation.net/Maps/

Can the Blood Test be Wrong

• Often the test is negative during the

rash stage of the illness in the first few

weeks

If the Blood test is still

positive is infection still

present?

• The blood test measures antibodies

and stays positive for years.

Standard Treatment

• Early disease is treated with

doxycycline or amoxicillin

• Later disease in the nervous system

may need intravenous antibiotics

Reported 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 person’s county of residence, not they place where they were infected. http://www.cdc.gov/lyme/resources/brochure/lymediseasebrochure.pdf