Curricula designed for use in middle school

Foreword

As parents and educators, we know the significance of teaching our students important health and

safety lessons. We tell them to, “Look both ways when crossing the street,” “Wash your hands before

eating,” and “Never smoke.” However, in the last decade, medical research has shown that there is

another threat to the health and well-being of our children, one not as obvious. This threat is caused by

a tiny and often overlooked deer tick. This small creature can be the carrier of the serious and

debilitating Lyme disease that can affect our children both cognitively and physically.

This curriculum was designed through the collaboration of medical experts, educators and parents of

children with Lyme disease. It provides awareness and education as well as proactive, prevention

strategies that students can use to help protect themselves from this disease. Interactive materials

provide educators and students age appropriate goals, activities and measurable guidelines. They

include lessons on tick awareness, prevention tips, proper tick removal and signs and symptoms of Lyme

disease.

These curricula are designed for use in elementary (grades K and 3) middle, (grade 6) and high schools

(grade 9). The elementary level programs provide an introduction to ticks, their habitats and personal

safety. The 6th grade program includes a 20 minute film, Lyme Disease: A Guide to Prevention. This film,

narrated by Meryl Streep, outlines comprehensive personal and environmental strategies for prevention.

The 9th grade program introduces the psychological, emotional and social ramifications of Lyme disease,

which are poignantly addressed in the real life stories of students living with this disease in a 20 minute

film, Living the Lyme Life.

Our hope is that education will prevent Lyme disease in those who are well, and promote empathy,

understanding and compassion for those who are struggling to overcome their illness. We also look

forward to the day when we can find a cure for everyone afflicted by this disease.

-Sandra Mond, PhD – Educational Consultant Former Principal, Parkway School

Greenwich, CT

The enclosed information and materials are provided for information purpose only. The material (a) is not nor should be considered, or used as a substitute for, medical advice, diagnosis, or treatment, nor (b) does it necessarily represent endorsement by or an official position of Lyme Research Alliance, Inc. or any of its directors, officers, advisors, or volunteers. Advice on the testing, treatment or care of an individual patient should be obtained through consultation with a physician who has examined that patient or is familiar with that patient’s medical history.

Lyme Research Alliance, Inc. Lyme Disease Curriculum

Terms of Use

Lyme Research Alliance, (LRA) provides the information and materials in this Lyme Disease Curriculum (the “Curriculum”) under the following terms and conditions. By using the Curriculum, you indicate your acceptance of these terms and conditions. Introduction The Curriculum contains learning materials for use inside and outside the classroom. These Terms of Use are designed to help pupils, parents, schoolteachers and other educators make maximum use of the Curriculum, while still observing LRA’s rights in the Curriculum. Copyright The Curriculum is, unless stated otherwise, the property of LRA and is protected by copyright and other intellectual property laws. The Curriculum is for informational, research or teaching purposes only. The information is not to be copied for the purposes of re-sale or to be used for commercial use without prior written consent by LRA. The pages are not to be distorted in any way. Any copy of a substantial part of these pages must include a statement as to copyright ownership. The name of LRA is not to be used in advertising or publicity without specific prior written consent of LRA. Use of Curriculum Teachers, pupils, and parents may make a copy, including a print-out or photocopy, or any part of the Curriculum for their own personal, non-commercial use, including for private study or research. Any other use, unless specified below, requires the prior written permission of LRA. Teachers may print and make multiple copies of the pages described in this manual as “Handouts” for use in the classroom or for in-school teacher training. Students may also take home the copies provided to them in the classroom for their own private use or study. Disclaimer This Curriculum is provided “as is” without any warranty of any kind, either express or implied, including, but not limited to the implied usefulness of the publication as a source of reference and as a teaching aid. The material in the Curriculum may include views or recommendations of third parties that do not necessarily reflect the views of LRA or indicate its commitment to a particular course of action. While every effort will made to ensure that information contained in the Curriculum is accurate and up to date, it may include technical inaccuracies or typographical errors. Changes may be made to the Curriculum without notice at any time. Limitation of liability LRA and its affiliates, Officers, Directors, Members, Employees, Agents, Consultants or Licensors thereof shall not be liable to any Curriculum user, or third person for the accuracy or completeness of the information, nor for any direct or inconsequential losses, special or consequential damages, or costs arising from or occasioned by use of the Curriculum, or from the reliance on the information contained in the Curriculum.

Acknowledgements

This education program is dedicated to Lauren F. Brooks for her longstanding and steadfast commitment to education, personal support and community awareness about tick borne diseases. Special Thanks Greenwich Public Schools — For establishing Health and Safety Curriculum Goals for Lyme disease Colleen Morey — Program Coordinator for Health, Greenwich Public Schools Kim Gillick — Health Teacher, Greenwich Public Schools Julie Ricciardi — President, Neighbor to Neighbor — Greenwich, Connecticut Dr. Sandra Mond — Former Principal of Parkway School and author of Program Foreword Dr. Maria Melendez — Former Deputy Superintendent, Greenwich Public Schools LRA would also like to express our thanks to the following dedicated team of contributors: Professional Consultants Caroline Baisley — Director of Health, Greenwich Department of Health Sandra Berenbaum, LCSW, BCD — Clinical Social Worker,

Family Connections Center for Counseling, Brewster, NY Jody-Lynn M. Breakell — Director Health & Safety Services, Greenwich Chapter American Red Cross Brian A Fallon, MD, MPH — Assistant Professor — Department of Psychology Columbia University College of Physicians and Surgeons; Director — Columbia Lyme Disease Research Center Sandra Mond, Ph.D. — Former Principal, Parkway School Leo Shea III, Ph.D. — Clinical Neuropsychologist and Asst. Professor of Rehabilitation Medicine, Rusk Institute of Rehabilitation, NY Patricia Smith — President, Lyme Disease Association, Inc. Kirby Stafford III, Ph.D. — Vice Director, Chief Entomologist, State Entomologist Department of Entomology, Connecticut Agricultural Experiment Station Editorial Board Diane Blanchard, BS, MBA, LRA Co-President Lauren Brooks, BS — LRA Co-Vice President, Education Karen Gaudian, BS — Ridgefield Lyme Disease Task Force Fran Herzog, BS — LRA Treasurer David Hunter, BS, MBA, CFA, Committee for Education Reform for Children with Lyme Disease Harriet Kotsoris, MD — Diplomate American Board of Psychiatry and Neurology Maggie Shaw, RN, ADN — Newtown Lyme Disease Task Force Contributors Julie Dumond, BS, MS Reading Barbara Edwards, BS, MS Ed — LRA Member-at-Large Deborah Siciliano — BS — LRA Co-President Dawn Wilson, BS — LRA Co-Vice President, Education Creative Design Mahshid Ehsani, BS, MS, MA — LRA Vice President, Communications Film Producer Mary Shanahan, LCSW — Dunraven Productions

This program was generously funded by Newman’s Own Foundation, The Herzog Foundation and Lyme Research Alliance, Inc.

Copyright © 2013 Lyme Research Alliance, Inc.

LYME DISEASE

SIXTH GRADE

CURRICULUM

©2009 Lyme Research Alliance, Inc. | www.LymeResearchAlliance.org

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6th Grade Lyme Disease Curriculum

Goal: To promote student knowledge and skills regarding

transmission, course of illness, treatment, and

prevention of Lyme disease.

OBJECTIVES:

1. Identify the cause, signs and symptoms, and treatments.

2. Identify measures to prevent Lyme disease including steps to take if a tick is found on their body.

Third Edition


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Topics of Discussion

OBJECTIVE 1

Lyme Disease

Infectious disease caused by a corkscrew shaped bacterium called a spirochete (Borrelia burgdorferi).

Transmitted by the bite of a deer tick (Ixodes scapularis or Ixodes pacificus found in the Western region of the country). The tick is a parasite because it relies on other animals for food. Since it carries and transmits bacterium from one animal to another, it is also called a vector (a carrier).

Lyme disease was first discovered in the US in Lyme, Connecticut.

Lyme disease has been reported throughout the United States, but is most prevalent in the Northeast, Upper Midwest, and Northern California into Oregon and Washington. However, it continues to spread through migratory birds (over 50 species carry ticks), deer overpopulation, and the reforestation of the suburbs which have allowed ticks in your own backyard.

Over 100 strains of the bacteria have been identified in the US, 300 strains worldwide.

A single tick bite may simultaneously transmit Lyme disease, as well as other diseases, referred to as co-infections, such as Babesiosis and Anaplasmosis (Ehrlichiosis). Future research may uncover other co-infections.

Early diagnosis and adequate treatment are essential to avoid late stage problems.

You cannot catch Lyme disease from other people.


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Symptoms

Symptoms may appear days, weeks, months or even years after an infected tick bite. They may vary over time.

Erythema Migrans (expanding red rash) is a definitive symptom of Lyme disease.

Rash may present in many forms (the expanding red rash is the most widely recognized) and may vary in size and shape. NOT everyone with Lyme disease gets a rash.

Common Early Symptoms may include rash, flu-like symptoms such as fevers, stiff neck, stomachaches, headaches, swollen lymph nodes, migratory pains in joints and muscles, and fatigue.

Physical Symptoms (at any stage of the disease) may mimic Bell’s palsy (facial paralysis) and may include motor or sensory problems, meningitis, encephalitis, various heart problems, conjunctivitis and other eye problems, speech difficulty, dizziness, motor tics, stabbing and shooting pains, numbness, tingling and swollen joints. Severe fatigue may occur requiring vast amounts of sleep.

Psychiatric and Cognitive Symptoms may include trouble with attention and concentration, planning and organization, memory problems, changes in sleep patterns (often dramatic) and behaviors (violent outbursts, irritability). Psychiatric problems could also include OCD (Obsessive Compulsive Disorder), anxiety, depression, panic attacks, eating disorders and psychosis.

Diagnostic Testing

Currently, the blood tests widely used, ELISA and Western Blot, are not always reliable to make a definitive diagnosis of Lyme disease. The accuracy of testing to support the Lyme diagnosis depends on a number of variables including the labs used and the types of tests.

Most tests look for antibodies (the immune system’s response to the disease), not the bacteria.

The diagnosis should be a clinical one based upon symptoms, tick exposure and evaluation of test results.

Currently, no tests can rule out Lyme disease.

An Erythema Migrans is definitive for diagnosis of Lyme disease and requires immediate medical treatment.

A neuropsychological/neurocognitive evaluation to determine decline in cognitive and emotional functioning should be considered as part of the medical evaluation.


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Treatment

Treatment protocols vary due to duration of undetected infection, presence of co-infections and individual’s immune system response and genetic predisposition.

Oral and Intravenous medications may be used in the treatment of tick-borne illness.

When a patient is bitten by a tick in a Lyme endemic area, doctors may consider prescribing a short course of antibiotics, as a preventive measure. Doctors who make this decision do so as a precaution to prevent the development of a more serious form of the illness which might occur if left untreated in the early stage.

The enclosed information and materials are provided for information purpose only. The material (a) is not nor

should be considered, or used as a substitute for, medical advice, diagnosis, or treatment, nor (b) does it

necessarily represent endorsement by or an official position of Lyme Research Alliance, Inc. or any of its directors,

officers, advisors, or volunteers. Advice on the testing, treatment or care of an individual patient should be

obtained through consultation with a physician who has examined that patient or is familiar with that patient’s

medical history.


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OBJECTIVE 2

Deer Tick Life Cycle

The female deer tick has a 2 year life cycle, consisting of 4 stages. The last stage ends in the laying of up to 3,000 eggs in the spring.

The eggs hatch into larvae which feed on small mammals (rats, chipmunks, & mice) and birds. If the host mammal is infected, the larvae become infected.

After spending the winter in the ground, the larvae molt to the nymphal stage the following spring. The nymph, the size of a pinhead, also needs a blood meal before it can molt into an adult. The adult ticks prefer a large mammal for their 3rd and last feeding, such as a deer or human.

Due to its tiny size, the nymph is most likely to cause Lyme disease because it is the most difficult to detect, therefore people may not realize they’ve been bitten.

By the time a tick reaches the adult stage, it has had two feedings and thus is more likely to be infected.

Tick tend to be most prevalent in the spring and summer, however, ticks may be active any day of the year when the temperature is above 36 degrees Fahrenheit.

Prevention

Wear light colored clothing, so ticks are more visible to you.

Wear long sleeves, tucked in shirts and long pants tucked into your socks to prevent ticks from attaching to your skin.

Avoid tall grassy, moist, wooded, leaf littered areas where ticks love to hide.

Use tick or insect repellent on clothing, and use appropriate repellents on skin, under adult supervision.

Perform frequent tick checks on both yourself and your pet after exposure to possible tick environment.

Ticks love to hide in warm moist places, such as the groin, back of the knees, armpits, the back of the neck, navel and ears, but the ticks will feed anywhere on the body, so look carefully.

The nymph is only the size of a pinhead and may be missed during your daily examination. Be sure to feel skin for any tiny bumps that might indicate a tick, especially on the scalp. If a bump is found, do not squeeze or press the bump.


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If tick is attached to your skin, get adult help. Have an adult remove properly and promptly. Use fine point tweezers or special tick removal tweezers as close to the skin as possible and gently pull straight out (the Red Cross tick removal kit is available for purchase through the Red Cross or www.LymeResearchAlliance.org). DO NOT SQUEEZE THE BELLY OF THE TICK, AS IMPROPER REMOVAL INCREASES RISK OF INFECTION.

o The longer the tick is attached, the greater likelihood of transmission of disease.

o Place tick in a zipper type plastic sealed bag with a blade of grass and bring to your local health department or private lab for testing, if they provide this service. The blade of grass provides moisture to keep the tick alive. Both dead and live ticks may be tested but live ticks yield quicker test results.

There is no vaccine currently available since the Lymerix Vaccine was withdrawn from the market in February 2002. Therefore, you cannot be vaccinated against Lyme disease. No vaccine has ever been available to prevent the co-infections.

Once you’re bitten and already diagnosed with Lyme disease, you can be re-infected a second time. This can make you sicker, even if you’re still on medication.

Most Lyme disease cases are associated with the bite of

a nymphal stage of the blacklegged tick, of which 10-36%

may be infected with Lyme disease spirochetes (CT

Agriculture Experiment Station—Tick Management

Handbook).


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MATERIALS: Teacher Resources: Topics of Discussions, Anatomy of a Tick, Tick Life Cycle,

“Let’s Get Well” by Mary Wall, Teacher’s Video Discussion Sheet Video: Lyme Disease: A Guide to Prevention (22 minutes) Handouts: Different Tick Types, Lyme Disease: A Tale of Two Students, What to

Consider if Bitten by a Tick, Symptom List, What EM Rashes Could Look Like, Tick Checklist

Assessments: Teacher observation, class participation, Tick Crossword Puzzle, Symptoms of Lyme Disease Word Search

OBJECTIVE & SUGGESTED ACTIVITIES: Objective 1:

A. Emphasize that preventing a disease is much easier and less painful than treating a disease.

Ask students: 1) Can you prevent Lyme disease? 2) What can you tell me about Lyme disease?

B. Show the video, “Lyme Disease: A Guide to Prevention,” and tell the students to focus on the cause, symptoms, and prevention of Lyme disease.

1) Discuss the video. 2) Review the new information and correct any misinformation from

earlier discussion. 3) Review handouts: Anatomy of a Tick, Symptoms of Lyme Disease

Word Search, Lyme Disease: A Tale of Two Students, What EM Rashes Could Look Like, Symptom List, What to Consider if Bitten by a Tick.

Objective 2: A. During springtime when nymphal ticks are most active, have the

students make posters about the prevention of Lyme disease to display around the school. These posters will create an awareness and educate the school staff, students and parents about Lyme disease. The most important thing to remember is that Lyme disease is preventable through education.

B. Enter the school’s science fair by doing a Lyme project. C. Review handouts: Tick Life Cycle, Different Stages of the Blacklegged

Tick, Tick Checklist.


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OBJECTIVE 1

ANATOMY OF A TICK

Dorsal view of Ixodes ticks Ticks and insects are arthropods, but ticks are arachnids and not insects. The body of a tick consists of a “false head” (the capitulum) and a thorax and abdomen fused into a single oval, flattened body. A larval tick has six legs, while nymphs and adults have eight legs present like spiders and mites (insects have six legs). Hard ticks get their name from a tough dorsal shield or plate called the scutum present on all mobile stages of the tick. The scutum on the larva, nymph, and female tick covers almost 1/3 to 1/2 of the dorsal anterior; females are reddish brown in color. By contrast, the scutum on a male tick covers almost the entire dorsal surface and is black to dark brown in color. The capitulum in hard ticks is visible dorsally in all stages. The digestive system includes: the mouth parts (hypostome and chelicerae), foregut, midgut, and salivary glands. These structures are important because when feeding, the tick inserts its hypostome into the skin of a host until a capillary is reached, and blood flow is detected. It is in the midgut that B. burgdorferi reside in infected ticks. The salivary gland secretes anticoagulants (chemicals to prevent the blood from clotting) and digestive enzymes into the skin of the host. Cement that bonds hypostome to the skin is secreted along with salivary gland fluids (Slansky and Rodriguez, 1987).


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NAME: _____________________________ DATE: _________________________

OBJECTIVE 1

Symptoms of Lyme Disease

R G N I T N O I S S E R P E D X F R A G I R R I T A B I T B R U S P A Z S C C O N F U S I O N S S E N Y T I Z R O R A S G R I H S A R E B U I A S H A N N A I U I M D S I U T L G R S A X E F T C S D E N E A R B L U M R O O B G U A L N P I R G I A T E O O I R S X N E I U O I D Z A E S U M R S T E S L I S X M I Z A A Z N A O T H N A T X A G S N S S Z N P D I R T A T I B H Y W N E A E I R X A T D N N R E Z I R T A I N I P V S O R E N X E S R Z L O E R R I N K Y G X M I Z I L S O O I A I D S D M C R I A S E N Z O M S R T T X H U O O A R T N S O R G I J O R Y S N T F O S D U A Z I O O T V I O L E N A I N M N A L F Z H E A D A C H E S I R W O E I E B L U R R Y S S E N I S M U L C D

DIZZINESS A.D.D. FATIGUE RASH

ANXIETY HEADACHES RINGING EARS BLURRY VISION INSOMNIA SORE THRAOT

CLUMSINESS IRRITABILITY TREMORS CONFUSION JOINT PAIN VIOLENT OUTBURSTS DEPRESSION MOODINESS WITHDRAWAL

The above list contains only some of the possible symptoms of Lyme disease. Most people do

not experience all the symptoms. Symptoms can range from subtle to severe, can come and

go over time, and vary from person to person.


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OBJECTIVE 1

LYME DISEASE:

A TALE OF TWO STUDENTS

In many ways, Mike and Lori were a lot alike. Both lived in Connecticut and enjoyed sports. Lori played high school basketball and Mike played varsity soccer. Like many teens, they had numerous friends, social interests and enjoyed hiking in the woods.

Unfortunately, Mike and Lori shared another thing in common. Both became ill from Lyme disease. Lyme disease is an illness caused by a spirochete, a corkscrew shaped bacterium. People and animals, including dogs, are infected with the bacteria through the bite of a tiny Ixodes (ICK-oh-deez) or black legged tick.

While neither Mike nor Lori ever noticed a tick, they both began noticing the symptoms of Lyme disease. But this is where their stories diverge. Mike found a 4-inch red rash on his back on a summer afternoon and within days, the rash became darker around the outside and in its center. Lori never noticed a rash, but instead developed debilitating headaches and suffered flu-like symptoms. Weeks later, she experienced fainting spells, memory problems, achy joints and a racing heart.

After observing Mike’s rash, his physician diagnosed him with Lyme disease, prescribed antibiotics and soon his symptoms disappeared. Lori was not as fortunate. Since Lori’s symptoms were consistent with many possible illnesses, Lori underwent extensive testing. Eventually, a blood test revealed that Lori was suffering from Lyme disease. She was lucky to have had a positive blood test. Many people test negative despite having Lyme disease due to the unreliability of currently available blood tests and may go for years without a proper diagnosis and the necessary treatment. She was eventually treated with antibiotics, and her symptoms improved, but four years later, Lori still suffers the debilitating effects of this disease.

Most of the people who get Lyme disease respond to antibiotic treatment and improve quickly. Sometimes however, people, like Lori, continue to suffer long term, and often debilitating symptoms, despite extended treatment. Research is currently being done to prevent the spread of this disease, as well as to develop improved tests to accurately identify those infected and provide more effective treatments for those who continue to suffer the long term effects of this disease.


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OBJECTIVE 1

What EM Rashes Could Look Like

Photos of rashes courtesy of Dr. Charles Ray Jones, Dr. Emilia Eiras, Dr. John Drulle (deceased) and the

Lyme Disease Association


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OBJECTIVE 1 – Symptom List SOME OF THE MANY SYMPTOMS OF LYME DISEASE ARE:

Head, Face, Neck: Headahce Facial paralysis (like Bell’s palsy) Tingling of nose, check, or face Stiff neck Sore throat, swollen glands Heightened allergic sensitivities Twitching of facial/other muscles Jaw pain/stiffness (like TMJ) Change in smell, taste Digestive/excretory System: Upset stomach (nausea, vomiting) Irritable bladder Unexplained weight loss or gain Loss of appetite, anorexia Respiratory/Circulatory Systems: Difficulty breathing Night sweats or unexplained chills Heart palpitations Diminished exercise tolerance Heart block, murmur Chest pain or rib soreness Psychiatric Symptoms: Mood swings, irritability, agitation Depression and anxiety Personality changes Malaise Aggressive behavior/Impulsiveness Suicidal thoughts (rare cases of suicide) Overemotional reactions, crying easily Disturbed sleep: too much, too little, difficulty falling or staying

asleep Suspiciousness, paranoia, hallucinations Feeling as though you are losing your mind Obsessive-compulsive behavior Bipolar disorder/manic behavior Schizophrenic-like state, including hallucinations Cognitive Symptoms: Dementia Forgetfulness, memory loss (short or long term) Poor school or work performance Attention deficit problems, distractibility Confusion, difficulty thinking Difficulty with concentration, reading, spelling Disorientation: getting or feeling lost Reproduction and Sexuality Females: Unexplained menstrual pain, irregularity Reproduction problems, miscarriage, stillbirth, premature birth,

neonatal death, congenital Lyme disease, extreme PMS symptoms Males: Testicular or pelvic pain

Eye, Vision: Double or blurry vision, vision changes Wandering or lazy eye Conjunctivitis (pink eye) Oversensitivity to light Eye pain or swelling around eyes Floaters/spots in the line of sight Red eyes Ears/Hearing: Decreased hearing Ringing or buzzing in ears Sound sensitivity Paint in ears Musculoskeletal System: Joint pain, swelling, or stiffness Shifting joint pains Muscle pain or cramps Poor muscle coordination, loss of reflexes Loss of muscle tone, muscle weakness Neurologic System: Numbness in body, tingling, pinpricks Burning/stabbing sensations in the body Burning in feet Weakness or paralysis of limbs Tremors or unexplained shaking Seizures, stroke Meningitis Poor balance, dizziness, difficulty walking Increased motion sickness, wooziness Lightheadedness, fainting Encephalopathy (cognitive impairment from brain involvement) Encephalitis (inflammation of the brain) Meningitis (inflammation of the protective membrane around the

brain) Encephalomyelitis (inflammation of the brain and spinal cord) Academic or vocational decline Difficulty with multitasking Difficulty with organization and planning Auditory processing problems Word finding problems Slowed speed of processing Skin Problems: Benign tumor-like nodules Erethyma Migrans (rash) General Well-being: Decreased interest in play (children) Extreme fatigue, tiredness, exhaustion Unexplained fevers (high or low grade) Flu-like symptoms (early in the illness) Symptoms seem to change, come and go Other Organ Problems: Dysfunction of the thyroid (under or over active thyroid glands) Liver inflammation Bladder & Kidney Problems (including bed wetting)


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OBJECTIVE 1

WHAT TO CONSIDER IF BITTEN BY A TICK

According to the International Lyme and Associated Diseases Society (ILADS) guidelines, the test performed on ticks for the presence of Borrelia burgdorferi, the bacterium that causes Lyme disease is NOT 100% accurate. It is possible for a tick to test negative and be infected.

You can contract many tick-borne diseases simultaneously from the same tick bite. Present tick testing does NOT test for other tick-borne infections.

Being bitten by an infected tick does not always mean that you will get Lyme disease.

The longer the tick is attached the greater the chance of infection.

Not everyone infected with Lyme disease will develop a rash, however if you get the Erythema Migrans rash, you do have Lyme disease. Seek immediate medical attention.

The rash or rashes may be raised, hot to touch, itchy, crusty, oozy, circular, spreading out, oval, triangular, long-thin line, disappear and return, at the site of the bite or on other parts of your body.

Current tests for Lyme disease are not definitive and according to ILADS guidelines, people with the disease may test negative yet be infected.

Centers for Disease Control (CDC) guidelines suggest that the diagnosis of Lyme disease be clinical, based on exposure and symptoms. According to CDC estimates, the real incidence of Lyme disease is 8-10 times the reported number.

If infected, symptoms may not appear for days, weeks, months, or years after being bitten.

Symptoms may range from subtle to severe, may come and go, and difficult to recognize because it mimics other diseases (The Great Imitator).

According to the CDC, the bacteria that cause Lyme disease can potentially enter the central nervous system within days of a tick bite, making treatment more difficult.

According to ILADS guidelines, treatment length varies from patient to patient. Treating a tick bite generally requires a shorter course of treatment than treating a central nervous system/brain infection

CONSIDER THE ABOVE WHEN DECIDING WHETHER TO REQUEST PREVENTIVE ANTIBIOTIC TREATMENT

FROM YOUR HEALTH CARE PROFESSIONAL.

Some of the 200 other diseases Lyme symptoms may mimic include:

Alzheimer’s Infectious Mononucleosis Attention Deficit Disorder Lou Gehrig’s Disease (ALS)

Autism Multiple Sclerosis Chronic Fatigue Syndrome Parkinson’s

Fibromyalgia Rheumatoid Arthritis Guillain-Barre Syndrome Systemic Lupus

For More Information, please contact: Lyme Research Alliance, Inc. Affiliate of LDA, Inc. 2001 West Main St, Suite 280 Stamford, CT 06902 Tel: (203) 969-1333 Email: [email protected] www.LymeResearchAlliance.org

Center for Disease Control/Lyme disease: http://www.cdc.gov/lyme/ International Lyme and Associated Diseases Society (ILADS): www.ilads.org

Lyme Disease Association, Inc. www.LymeDiseaseAssociation.org Lyme Disease Network: www.lymenet.org LymeDisease.org (formally CALDA) www.lymeDisease.org

mailto:[email protected]

http://www.lymeresearchalliance.org/

http://www.cdc.gov/lyme/

http://www.ilads.org/

http://www.lymediseaseassociation.org/

http://www.lymenet.org/

http://www.lymedisease.org/


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OBJECTIVE 2

TICK LIFE CYCLE

The tick has a two-year life cycle. The cycle begins in late July and early August with the

hatching of larval ticks from up to 3,000 eggs laid by an engorged female tick. The larvae

will disperse roughly 1 meter (3 feet) from the egg mass. Through August and

September, the larvae feed on whatever animal passes by, usually a white-footed

mouse, chipmunk, or bird, but also deer and humans. They drop off from the host after

engorging with blood, molt, develop into nymphs with four (rather than three) pairs of

legs and reappear the following summer, mainly May through July, which is the peak

period of risk for Lyme disease. After feeding, nymphs molt to an adult tick during the

summer. The adult stage which seeks larger hosts (such as deer and humans), appears in

the fall and is also active in warm days of winter and the following spring. BE AWARE:

Humans are at risk for being host to a tick at the larval, nymphal or adult stage of its

life cycle. From September through December, the tick mate while on their host. The

adult male tick dies following mating and the female drop from their hosts, overwinters

in leaf litter, or underbrush, and later dies in the spring or early summer after laying

eggs.


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OBJECTIVE 2

“LYME DISEASE: A GUIDE TO PREVENTION”

TEACHER’S VIDEO DISCUSSION SHEET 1. Q: What is the cause of Lyme disease?

A: A bacterial infection transmitted by the blacklegged (deer) tick. 2. What are the carriers of Lyme disease?

A: Animals such as ice, birds, opossums, squirrels, chipmunks, deer, and dogs can carry infected ticks.

3. What are the 4 stages of the tick’s life cycle? A: Larva, nymph, adult and egg.

4. The nymph can be compared to the size of a(n) a. Poppy seed (correct answer) b. Dime c. Apple seed

5. The adult tick can be compared to the size of a(n) a. Poppy seed b. Dime c. Apple seed (correct answer)

6. Q: Lyme disease is often called the Great Imitator. Why is it so? A: The symptoms often imitate those of the flu, common cold and/or other more

serious diseases. 7. Q: What are some common early symptoms of Lyme disease?

A: Reddish rash, fever, headache, fatigue, stiff neck, stomachache, muscle or joint pain, and swollen lymph nodes.

8. Q: What should you do if you find a tick on your body and how should the tick be removed? A: Find a trusted adult to remove the tick by using a pair of fine-tipped needle point

tweezers. Grasp the tick as close to the skin as possible, and pull upward and out. After removal, thoroughly disinfect the bite site and wash hands. Save the tick for testing.

9. Q: If you are bitten by a tick, what should you do? A: See a physician, consider preventive treatment and watch for symptoms.

10. Q: What steps can you take to keep from being bitten by a tick? A: Wear light clothing, tuck pants into socks and shirt into pants, wear long sleeves, use

repellents containing DEET or Permethrin with adult supervision, do body checks for ticks, control rodents around home. Avoid known tick habitat.

Note: Permethrin should be sprayed only on clothes in an open area, not on the skin. The Permethrin should be dry on clothes before you wear them.


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OBJECTIVE 2

TICK CROSSWORD PUZZLE — TEACHER’S KEY

ACROSS

1. The body does not develop an immunity to Lyme disease. 2. After removing a tick, thoroughly disinfect the bite site and wash hands. 3. To remove an attached tick, grasp with fine-tipped tweezers as close as possible

and pull upward and out. 7. Lyme disease was first recognized in 1975 10. Not all Lyme disease cases get a red rash. 12. You need to be extra careful of ticks when you walk in the woods. 16. Do not handle ticks with bare hands. 17. Symptoms may appear days, weeks, months or years after exposure. 19. If tick removal occurs within several hours after attachment, the risk of infection

is greatly reduced, although not entirely eliminated.

Down

1. Suffocating the tick with nail polish or petroleum jelly on a tick is ineffective. 3. Check your clothing and skin every 2-3 hours for ticks when outdoors. 4. People who spend time outside in tick infested environments are at increased risk

for Lyme disease. 5. The first cluster of cases associated with this disease was near Lyme, Connecticut. 6. Males and females of all ages can get Lyme disease. 8. Repellents containing DEET may help to prevent tick attachment. 9. Fatigue is a symptom of Lyme disease. 11. Pets, mice, birds, raccoons, chipmunks, and deer are hosts to infected ticks. 14. Antiseptic is used to disinfect the bite site. 15. If Lyme disease is left untreated, complications such as heart abnormalities and

problems with attention and memory may occur.


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OBJECTIVE 2

TICK CROSSWORD PUZZLE — CLUES

ACROSS

1. The body does not develop an ____________ to Lyme disease. 2. After removing a tick, thoroughly ____________ the bite site and wash hands. 3. To remove an attached tick, grasp with fine-tipped ____________ as close as

possible and pull upward and out. 7. Lyme disease was first ____________ in 1975 10. Not all Lyme disease cases get a ______ ______. 12. You need to be extra careful of ticks when you ____________ in the woods. 16. Do not handle ticks with bare ____________. 17. Symptoms may appear days, weeks, months or years after ____________. 19. If tick removal occurs within several hours after ____________, the risk of

infection is greatly reduced, although not entirely eliminated.

Down

1. Suffocating the tick with nail polish or petroleum jelly on a tick is ____________. 3. Check your clothing and skin every 2-3 hours for ____________ when outdoors. 4. People who spend time outside in tick infested ____________ are at increased

risk for Lyme disease. 5. The first cluster of cases associated with this disease was near ____________,

Connecticut. 6. Males and females of all ____________ can get Lyme disease. 8. Repellents containing ____________ may help to prevent tick attachment. 9. ____________ is a symptom of Lyme disease. 11. Pets, mice, birds, raccoons, chipmunks, and deer are ____________ to infected

ticks. 14. Antiseptic is used to ____________ the bite site. 15. If Lyme disease is left ____________, complications such as heart abnormalities

and problems with attention and memory may occur.

KEY WORDS (may be used twice)

Ages Exposure Ineffective Tweezers Attachment Fatigue Lyme Untreated DEET Hands Recognized Walk Disinfect Hosts Red Rash Environments Immunity Ticks


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NAME: _____________________________ DATE: _________________________

OBJECTIVE 2

TICK CROSSWORD PUZZLE

1

2

3

4

5

6

7

8

9

10

10

11

15

12

14

16

17

19


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OBJECTIVE 2

DIFFERENT STAGES OF THE BLACKLEGGED TICK


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OBJECTIVE 2

TICK CHECKLIST

Tick Removal

Take the time to remove the tick properly because improper removal can increase your risk of infection

o Grasp the tick close to the skin o Pull the tick straight out o Disinfect the tick bite site o Disinfect the tweezers o Wash hands thoroughly

Do not panic and remove the tick with your fingers Do not burn or smother a tick Do not grasp, squeeze or twist the tick body Contact physician for information on testing and treatment

Tick Testing

Keep the tick alive, if possible (not necessary for testing) Place tick in an airtight container or zip lock bag Place a moist cotton ball or a few blades of grass in the container Have a tick identified and tested by a lab, health department, or veterinarian if that service is

available in your area

Prevention

Perform frequent and thorough tick checks; the longer the tick is attached, the greater the risk of infection

Wear light-colored clothes Tuck pants into socks Spray insect and tick repellent on skin and/or clothing, following directions carefully Put clothes in the dryer on high for thirty minutes to kill ticks

Get the Facts

You can test negative and still have Lyme disease You can contract many tick-borne diseases simultaneously from the same tick bite If you have an erythema migrans (EM) rash, then you have Lyme disease; NOT EVERYONE

infected with Lyme disease gets a rash Lyme disease is a clinical diagnosis, based on a patient’s symptoms and history Lyme symptoms can develop within days, months or years of a tick bite Once you’re bitten and already diagnosed with Lyme disease, you can be re-infected a second

time. This can make you sicker, even if you’re still on medication.

Get Involved…

2001 WEST MAIN STREET, SUITE 280, STAMFORD, CT 06902 LYMERESEARCHALLIANCE.ORG (203) 969-1333

Lyme Research Alliance (previously Time for Lyme)

funds cutting-edge research into the prevention

diagnosis and treatment of Lyme disease in a

relentless campaign to end Lyme and other tick-

borne diseases

Curricula designed for use in middle school

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