A Model Community Response to Lyme Disease

Transcription

1 A Model Community Response to Lyme Disease Neeta Pardanani Connally, MSPH, PhD Western Connecticut State University Jennifer Reid Ridgefield Health Department Amber Butler, MPH Danbury Hospital

2 Western Connecticut State University: the university partner

3 Lyme disease is #2 in New England Source: CDC MMWR 2013 New England = CT, ME, MA, NH, RI, VT

4 Source: CDC

5 Source: CDC

6 Source: CDC

7 Lyme disease symptoms Early stage: erythema migrans (red, expanding rash) fatigue chills/fever headache muscle and joint pain swollen lymph nodes Steere A. NEJM 2001;345: Kruger, H et al. Acta Neuro Scand 1990;82:59-67 Kalish, RA et al. J Infect Dis 2001;183: CDC Late stage: arthritis nervous system abnormalities Bell s palsy cardiac/neurological complications

8 How can we prevent Lyme disease?

9 Tick-borne disease prevention laboratory at WCSU

10

11 How to prevent Lyme disease?

12 Opportunities for primary prevention of Lyme disease during transmission cycle Hayes and Piesman, N Engl J Med 2003;348:

13 How can we prevent Lyme disease? Hayes and Piesman, N Engl J Med 2003;348:

14 Peridomestic risk 67% 22% 2% Maupin et al. J Med Entomol. 1991

15 Case-control study: objective To evaluate the effectiveness of peridomestic control measures on the prevention of Lyme disease. Landscape Modification Personal Protection Chemical Control

16 Results of a CT study Subjects who bathed within 2 hours were significantly less likely to get Lyme disease. N= 698, OR=0.42, 95% CI Connally et al. Am J Prev Med 2009;37:

17 Results of a CT study Subjects who checked for ticks within 36 hours were significantly less likely to get Lyme disease. N= 698, OR=0.55, 95% CI Connally et al. Am J Prev Med 2009;37:

18 How can we prevent Lyme disease?

19 CT bait box intervention study PURPOSE Evaluate the effectiveness of rodent bait boxes in reducing the incidence of tick borne illnesses

20 Other WCSU activities: ongoing tick monitoring

21 Other WCSU activities: permethrin treated clothing studies

22 Other WCSU activities: repellent studies

23 Revised CDC trail sign

24 BLAST program out of the Ridgefield Health Department: the community partner

25 Connecticut Lyme disease intervention programs The CT DPH worked with the CDC to conduct Lyme disease prevention research through March DPH worked collaboratively with: Connecticut Agricultural Experiment Station (CAES) CT Emerging Infections Program at the Yale University School of Medicine University of Connecticut s Geography Department and Center for Survey Research and Analysis Three Health Districts: Ledge Light Health District Torrington Area Health District Westport Weston Health District

26 The BLAST program 2008 DPH Grant Teamwork scientists, health educators, community members working together with the Ridgefield Health Dept. Develop and disseminate a tick-borne disease prevention and early symptom identification program for Fairfield County Base on Health Belief Model Edit prevention research down to top recommendations Create a memorable acronym to highlight top five tips Develop affordable teaching tools for health educators, health departments and volunteers to use in their communities Host trainings to share information, answer questions

27 LAST

28 Bathe or shower soon after coming indoors Bathing or showering within 2 hours of outdoor activity helps remove ticks that haven t attached.

29 B AST

30 Look for ticks and rashes Tick bites are usually painless, therefore most people are unaware when they have a tick attached to them. Do a tick check every night! Ticks are very small, and may feed anywhere on the body so check thoroughly. CDC photo

31 BL ST

32 Apply repellents SKIN If you choose to use a tick repellent on your skin, we recommend using a product that contains DEET at a concentration of at least 20%. CLOTHING A permethrin based product is recommended for clothing. It provides great protection against ticks!

33 BLA T

34 Spray the edges of your yard A single perimeter spraying for tick control once in the Spring can reduce the number of ticks in your yard by up to 80% - 90% If you decide to spray your yard, it is best to hire a professional that is trained to do this job efficiently and safely.

35 Create a tick-safe zone Clear tall grasses and brush Add a 3-ft wide barrier of wood chips or gravel between lawns and wooded areas Mow the lawn frequently and keep leaves raked. Stack wood neatly in a dry area Keep playground equipment and patio furniture away from yard edges and in a sunny location. Choose deer resistant plants Avoid feeding wild animals & birds

36 BLAS

37 Treat your pets Check your pets for ticks after coming indoors. Ask your vet about vaccines and products that will help your pet repel ticks. Don t sleep with your pet because ticks on your pet may crawl on to you.

38 The BLAST tool kit Age appropriate power points BLAST rack card (English and Spanish) Literature from key resources Health fair display available to purchase Banners Giveaways- magnet, stickers, tattoos, crafts Raffle prize baskets All focused on prevention and early symptom identification

39 Building the health fair display

40 Age-appropriate PowerPoints Key points include: Explanation of tick-borne diseases Early signs and symptoms Potential seriousness Statistics for Connecticut Life cycle of tick Habitat of tick Strategies for prevention- the BLAST acronym Invitation to help spread the BLAST message

41 Importance of partnerships When solving a community health problem: You cannot reach enough people by yourself to make a significant impact You need other people to sustain a health program

42 BLAST community partners Community Newspaper, radio, TV Community Leaders/Elected Officials Regional Councils of Government Health Directors and Health Educators Hospitals and Health Care Professionals Visiting Nurse Assoc. Veterinarians Corporations and Local Businesses Schools and PTA s Libraries Chamber of Commerce Colleges and Universities Master Gardeners/Garden Club CT AHEC Program Religious Groups Parish Nurses Day care centers, preschools Neighborhood groups Parks and Rec. Boy Scouts, Girl Scouts Camps Children and youth groups Religious groups Nature Center or Nature Conservancy Service associations ( Rotary, Lions, etc.) Hunters Hiking Groups Lyme Disease Task Force These organizations, agencies, and businesses have participants to educate and potential volunteers.

43 Town leaders and health directors

44 Hospitals, medical practitioners, VNA s

45 Corporations, local businesses and chambers of commerce

46 Libraries

47 Scouts, camps and youth groups

48 Pharmacists

49 Veterinarians, trainers and animal rescue groups

50 Elementary, middle & high schools

51 University health/science departments Western CT State University Fairfield University Southern CT State University UConn Health Center

52 Moms groups, preschools & camps

53 New for 2016 Social media (created by Discovery Communications) Updated town of Ridgefield BLAST website (coming soon!)

54 Resources to start your tick-borne disease prevention program CDC CT DPH CAES EPA State and Local Health Departments Tick Research Centers Lyme Organizations BLAST Program

55 Western Connecticut Health Network: the medical partner

56 WCHN Lyme Disease Registry

57 WCHN Lyme Disease Registry

58 Diagnostic testing development

59 Community-based studies

60 What lies ahead