What You Should Know About Lyme Disease and Other Tick-Borne Diseases

Transcription

1 What You Should Know About Lyme Disease and Other Tick-Borne Diseases Minnesota Department of Health Disease Prevention & Control 625 Robert St N PO Box Saint Paul, MN (651) Revised October 2009

2 Goal Minnesota residents and visitors will take action to prevent exposure to ticks which may carry Borrelia burgdorferi; will know the signs and symptoms of Lyme disease and other tick-borne diseases; and if present, will seek early diagnosis and treatment Minnesota Lyme Disease Public Education Plan

3 Goals of presentation Be aware of Lyme disease and other tick-borne diseases Recognize basic signs and symptoms Seek early diagnosis and treatment Know whether you live, work or play in endemic areas Practice prevention activities Know whom to contact for more information

4 LYME DISEASE Borrelia burgdorferi, the bacteria that cause Lyme disease

5 History 1975 Juvenile cases of arthritis found in Connecticut Disease named Lyme disease 1985 Lyme disease became reportable in Minnesota

6 Lyme Disease Signs & Symptoms 3 to 30 days after deer tick bite Rash (often bulls-eye ) Fever Chills Headache Muscle and joint pain Fatigue

7 Erythema migrans (EM) rash characteristic of Lyme disease

8 Lyme disease rash without central clearing

9 Lyme Disease Signs & Symptoms Days to weeks after illness onset Multiple rashes Facial paralysis on one side Fever, stiff neck, headache Weakness, numbness, arm/leg pain Irregular heart beat Persistent weakness and fatigue

10 Multiple Rashes Reaction as bacteria move through body Not caused by multiple tick bites

11 Multiple Rashes This is another example of a multiple rash.

12 Lyme Disease Signs & Symptoms Weeks to months after illness onset Fatigue Chronic arthritis Nervous system problems

13 Joint Swelling Joint swelling and pain may occur weeks to months after onset of illness if left untreated.

14 Diagnosis of Lyme Disease Physical examination History of possible exposure to deer ticks Blood tests may be performed A screening test is done first, followed by a confirmatory test for antibodies to Lyme disease bacteria

15 Remember Early recognition of signs and symptoms of Lyme disease is very important for prompt diagnosis and treatment.

16 Treatment Lyme disease can be treated Antibiotics are used to treat Lyme disease Talk to your doctor about specific treatment

17 Questions about Diagnosis or Treatment of Lyme Disease? Call your doctor or Minnesota Department of Health at

18 Blacklegged Tick (deer tick) (spreads Lyme disease) TICKS American dog tick (wood tick) (does not spread Lyme disease) adult male adult female

19 Blacklegged Ticks (Deer Ticks) Nymph Blacklegged ticks have three life stages Larva Adult (female)

20 Blacklegged Tick Larvae Size of period at end of sentence Initially does not have Lyme disease bacteria, so does not transmit the bacteria to a host May get the bacteria from a host who has the bacteria

21 Collecting Immature Blacklegged Ticks Lyme disease researchers often live-trap small mammals to collect blacklegged ticks.

22 Natural Host for Immature Blacklegged Ticks Immature blacklegged ticks can be infected by feeding on mice that are carrying Lyme disease bacteria. Transmission can also occur from the ticks to mice.

23 Blacklegged Tick Nymph

24 Blacklegged Tick Nymph Size of a poppy seed Transmits most cases of disease because they are so difficult to detect Seeks a blood meal from mid-may to mid- July

25 Blacklegged Tick Adults Adult female Adult male

26 Blacklegged Tick Engorgement

27 Male and Female Adult Blacklegged Tick Feed and mate on large animals in the fall or early spring After feeding, females lay eggs, then die Ticks that did not feed or mate go dormant

28 Two-Year Life Cycle of Blacklegged Tick EGGS LARVAE NYMPHS MEAL 1 Mouse Bird Eggs laid, adults die MEAL 3 * For adults that did not feed in fall Person Deer Dog MEAL 2 (peak feeding time May-mid July) Person Mouse Dog SPRING WINTER SUMMER FALL Nymphs molt into adults ADULTS Larvae molt into nymph stage MEAL 3 Person Deer Dog Nymphs dormant

29 Blacklegged Tick Habitat

30 Trails and Edge Habitat Blacklegged ticks live in woody, brushy areas that provide food and cover for hosts such as mice and deer Exposure to these ticks can be greatest along trails and edges of woods

31 Blacklegged Tick Questing Blacklegged ticks search for a host from the tips of lowgrowing vegetation, generally climbing onto a person or animal near ground level.

32 Blacklegged Tick Feeding

33 To Get Lyme Disease Blacklegged tick must be infected with Lyme disease bacteria Only the nymphs and adult females can transmit the Lyme disease bacteria Tick must be attached hours before it passes bacteria to host

34 Lyme Disease Cases by State, 2002 (n = 23,763) D.C D.C

35 Kittson Marshall Roseau Beltrami Lake of the Woods Koochiching St. Louis Lyme Disease Areas of Highest Risk Polk Pennington Red Lake Clear Water Itasca Lake Cook in Minnesota Norman Clay Wilkin Mahnomen Becker Ottertail Grant Douglas Hubbard Wadena Todd Cass Morrison Crow Wing Aitkin Mille Lacs Kanabec Carlton Pine Tick-borne disease risk in Minnesota is highest in forested areas within the shaded zones. Traverse Big Stone Lincoln Stevens Swift Lac Qui Parle Yellow Medicine Lyon Pope Chippewa Renville Redwood Stearns Kandiyohi Brown Meeker Sibley McLeod Nicollet Benton Wright Sherburne Carver Le Sueur Anoka Washington Ramsey Hennepin Scott Isanti Rice Dakota Chisago Goodhue Wabasha Blacklegged ticks may also be found at lower levels in some forested areas outside this zone. Pipestone Murray Cottonwood Watonwan Blue Earth Waseca Rock Nobles Jackson Martin Faribault Freeborn Steele Dodge Mower Olmsted Winona Fillmore Houston Minnesota Department of Health May 2008

36 1,300 1,200 1,100 1, Reported Cases of Lyme Disease in Minnesota, (n = 9,726) 1,239 1,050 1, Year Number of Cases

37 Reported Cases of Lyme Disease in Minnesota by Location of Residence, (n=6,905) Metro Area Greater Minnesota Number of Cases Year

38 Reported Cases of Lyme Disease by County of Exposure, Twin Cities Metropolitan Area, County Anoka Washington Ramsey Dakota Hennepin Scott Carver Total No. of Cases

39 Top Ten Counties of Exposure for Reported Cases of Lyme Disease, County 1. Crow Wing 2. Cass 3. Pine 4. Aitkin 5. Anoka 6. Washington 7. Houston 8. Morrison 9. Hubbard 10. Itasca Wisconsin Other No. (%) of Cases 966 (20%) 370 (8%) 302 (6%) 207 (4%) 187 (4%) 183 (4%) 125 (3%) 124 (3%) 103 (2%) 103 (2%) 940 (20%) 1,120 (24%) Total Cases with Known Exposure 4,730

40 45% 40% Reported Cases of Lyme Disease by Month of Onset, Minnesota, (n = 6,277*) 41% Percent of Cases 35% 30% 25% 20% 15% 10% 5% 0% 22% 19% 9% 4% 4% 0% 0% 0% 0% 1% 0% Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec Month * Excluding 1,415 cases without erythema migrans or with unknown onset dates

41 25% 24% Reported Cases of Lyme Disease by Age at Onset, Minnesota, (n=7,610*) 20% 16% 16% Percent 15% 10% 11% 8% 9% 10% 6% 5% 0% Age at Time of Onset * Excluding cases with unknown age at time of onset

42 Reported Cases of Lyme Disease in Minnesota by Sex, Male 4,732 (62%) Female 2,960 (38%) Total 7,692

43 Human Anaplasmosis Signs and Symptoms Fever (over 102 degrees) Chills and shaking Severe headache Muscle aches

44 Reported Cases of Human Anaplasmosis in Minnesota by Year, (n = 1,602) Number of Cases Year

45 30% Reported Cases of Human Anaplasmosis by Age at Onset, Minnesota, (n = 1,530) 25% 25% 22% 20% 20% Percent 15% 16% 10% 7% 5% 5% 2% 3% 0% Age at Time of Onset * Excluding cases with unknown age

46 Human Anaplasmosis Sex Distribution, Male Female Total 980 (64%) 554 (36%) 1,534

47 Percent of Cases 35% 30% 25% 20% 15% 10% 5% 0% Reported Cases of Human Anaplasmosis by Month of Onset, Minnesota, (n = 1,519*) 0% 0% 0% 2% 10% 30% 27% 10% Jan Feb Mar Apr May Jun Jul Aug Sept Oct Nov Dec 6% 8% 5% 1% Month * Excluding 15 cases with unknown onset

48 Kittson Marshall Polk Norman Clay Wilkin Traverse Big Stone Pennington Red Lake 1 Lincoln Pipestone Roseau Ottertail Grant Stevens Lac Qui Parle Becker Swift Yellow Medicine Lyon 1 Mahnomen Murray Douglas Pope Chippewa Beltrami Clear Water 2 7 Renville Redwood Cottonwood Lake of the Woods Hubbard Wadena Todd Kandiyohi Brown 12 Stearns Watonwan Cass Morrison Meeker Sibley Koochiching Itasca Nicollet Crow Wing Benton Wright Blue Earth Sherburne Carver Le Sueur Aitkin Mille Lacs Hennepin Scott Waseca Isanti Rock Nobles Jackson Martin Faribault Freeborn McLeod Reported Cases of Human Anaplasmosis in Minnesota by County of Exposure, St. Louis (n = 1,323) Kanabec Anoka 2 Rice Steele Washington Ramsey Dakota 1 Carlton Pine 9 Chisago Goodhue Dodge Mower Olmsted 2 Wabasha Fillmore Winona Lake Houston 1 Cook Cases with unknown exposure = 266 Cases with known exposure = 1,057 Minnesota = 722 Wisconsin = 99 Other State = 7 * Includes confirmed and probable cases

49 Babesiosis Signs & Symptoms High fever Chills Headache Muscle aches Fatigue Loss of appetite

50 Summary of Tick-Borne Diseases, Minnesota, (n = 9,333) ,692 (82%) Number of Cases (16%) 0 Lyme disease Human anaplasmosis 107(1%) Babesiosis

51 Prevention Actions Campers, hikers, hunters, people in outdoor occupations, and people who live near the woods may be at risk in the counties known to have blacklegged ticks. Know whether you live, work or play in an area that has blacklegged ticks Take precautions when in blacklegged tick habitat, especially from May through July Remember, preventing exposure to blacklegged ticks requires diligence

52 Lyme Disease Vaccine Discontinued in 2002

53 Prevention Use repellents (DEET or permethrin), according to label directions. Tucking pants into socks creates a barrier to ticks. Wearing light-colored clothing helps to more easily spot ticks.

54 Checking for Ticks It is a good idea to check yourself and your children for ticks after spending time in a wooded or brushy area.

55 Pets Check your dog or cat for ticks before bringing them inside. There is a Lyme disease vaccine for dogs, but it does not prevent them from bringing ticks into the home.

56 Avoid Deer Tick Bites Be aware of high-risk times and places Walk in the center of trails to avoid picking up ticks from brush Wear long pants, lightcolored clothing, and repellent

57 Avoiding Blacklegged Ticks at Home If you live in area with ticks, they are usually located around the fringe of your yard and a wooded area.

58 Removing Attached Ticks Ticks have barbed mouth parts. This means that ticks attached to the skin should be pulled out slowly and steadily.

59 To Remove a Deer Tick Use tick forceps or tweezers Grasp the tick close to the skin Pull outward S-L-O-W-L-Y, gently, and steadily Do not squeeze the tick Use an antiseptic on the bite

60 Important Messages Know whether you live, work or play in an area that has deer ticks Take preventive actions Seek early diagnosis and treatment

61 Whom to Contact Minnesota Department of Health Metropolitan Mosquito Control District

62 Minnesota Department of Health s Lyme Disease Web Site Scroll down to Diseases and Conditions and click on Diseases A to Z Click on Lyme Disease