Maduabuchi Prince Gabriel PhD EpidemiologyWalden University

PUBH 8165 Environment HealthInstructor: Dr. Donald Goodwin.

Winter Quarter, 2011.The target audience:

General Public & Public Health Student

Objectives Of the PresentationDefine Lyme disease and the vector that causes Lyme

disease.Review the significance, prevalence, incidence,

statistics and the effect of Lyme disease.We will evaluate how Lyme disease is screened.Ways to stop transmission .

Objectives Of the Presentation cont.

Prevention, control and eradication of the Ixodes scapularis and Ixode pacificus that causes Lyme Disease.

We will look at some recent development and policies on the prevention of this disease, and eradication of the, host, vector, and Lyme disease.

Finally, Provide more reading materials.

Definitions and overviewWhat is Lyme disease. Lyme disease is a vector borne

disease, caused by a spirochete bacteria called Borrelia burgdorferi.

What are the signs and symptoms of Lyme disease. The first signs and symptoms of Lyme disease is a red rash called erythema migrans, flu like symptoms, and joint pain.

American Lyme Disease Foundation, (2006); Center for Disease Control, (2011).

Erythema migrans

Google images, (2011).

What vector causes Lyme disease

Deer tick or Blacklegged tick. The scientific name is Ixodes scapularis. When the Ixodes scapularis have a blood meal on its host, they will leave them infected with Borrelia burgdorferi after 36-48hours of engorging.

The infected nymphal is the main cause of Lyme disease than the adult blacklegged tick.

If the tick is removed before the first 36hours, then the individual will not be infected by the disease.

American Lyme Disease Foundation, (2006)

Picture of Ixodes scapularis (Deer tick) on human body

Google images, (2011).

Picture of Ixodes scapularis. This tick is very tiny in size.

Minnesota Department of Health, (2011)

Three host life cycle of Ixodes scapularis

Image scratched by Maduabuchi Gabriel with information from theStafford, (2007)

.

Explanation to the three host life cycle of Ixodes scapularis

The tick have four stages in their life cycle, egg, larva, nymph and the adult (male and female).

The larvae and the nymphs changes to another stage after digesting a blood meal by shedding the molting or the cuticles.

The Larvae feeds on an animal and drop to the ground and molts to a nymph. First host.

Stafford, (2007)

Explanation to the three host life cycle of Ixodes scapularis cont.

The nymph feeds on small mammals and birds, engorged drop to the ground and molt to an adult. Second host.

The adult tick feeds on medium and large mammals (third host) and the female tick will produce one single batch of eggs and die.

Stafford, (2007)

3D Illustration of B.burgdorferi

Google Images, (2011)

Areas with Lyme disease

Center For Disease Control, (2009)

Significance and prevalence of Lyme disease.

Most frequently reported vector borne disease in the US.

Northeastern and North Central states of the United States more at risk.

American Lyme Disease Foundation, (2006).

Statistics : 1st five state with highest incidence rate in 2009.

In 2009, Delaware had highest incidence of Lyme disease.

Connecticut the secondNew Hampshire the third.Massachusetts the fourth.Maine was the fifth state.

Center for Disease Control, (2010).

Incidence of Lyme diseaseDuring 1992-2006 there was a total of 248,074 cases of

Lyme disease reported to CDC in the 50 states, District of Columbia and the US territories.

Out of these total number, 93% of the total reported was from Connecticut, Delaware, Massachusetts, Maryland, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island and Wisconsin.

The highest incidence was among children 5-14years of age, 53% of the cases reported was among male. Center for

Disease Control, (2006).

Where do you find the vectorsIn the woodsAround deer.In homes closes to bushes.Leaves around the home.Piles of woods.Untrimmed trees around the home.

Control of transmission:Non human host-mice, deer, birds.Vectors: Deer tick (Ixodes scapularis). Vector controlling agents: insecticides, incent

repellants.

Steeve, Coburn & Glickstein, (2004 p 1100)

Tick management strategies for the control of Ixodes scapularis.Personal protection: prevention of tick bites, tick checks after

visiting the woods and bushes, and tick removal.Landscape management: cutting of the grasses, tick safe

landscape modification to make it unsuitable for ticks.Management of host abundance: fencing, host reduction and

destruction of the host habitats. Host targeted Acaricides: the treatment of the host like the white

footed mice, chipmunks or deer through passive tropical applications.

Biological or natural control: use of fungal pathogens and biopesticides to control tick.

Stafford, (2007)

Personal protection to prevent Lyme disease.

Wearing long sleeve and long pants in wooded areas.

Use of Insect repellants. Shower immediately coming out from the woodsSelf checks after visiting the woods. Call your doctor for check up for un-usual Rash.

Center for Disease Control, (2006).

Environmental prevention for Lyme disease.

Clearing the surroundings. Keeping the lawns mowed, and removing things from the edge of the lawn.

Removing brushes and leaves around stonewalls and wood piles.

Discouraging rodents activities.Keep dogs cats and other mammal pets away from the woods

to reduce them bringing tick back to the house.Fencing homes to exclude deer and planting plants that do not

attract Deer.Using pesticide :DEET or permethrin-based mosquito and tick

repellants should be used in the yard when working in the lawns.

American Academy of Pediatrician, (2000); Stafford, (2007)

Clinically treatment of Lyme disease.

You can treat Lyme disease clinically by the use of antibiotics after diagnosis through laboratory test. Antibiotics can also be used as a prophylaxes to prevent Lyme disease.

Wormser, et al. (2006)

Laws and policies about Lyme disease.

Lyme disease is a reportable disease. By this I mean that when you are infected by Lyme disease, the hospital where you are diagnosed with the disease will report the incidence to the health department and then this will be reported to center for Disease control.

Center for Disease Control, (2006).

More work is needed on better vaccines and insecticides to be used to prevent the disease and eradicate the vectors. The last vaccine that was in use for Lyme disease was discontinued in 2002 due to lack of demand for the vaccine.

Education and information is the key. Pass on information to your friends, colleagues and family members on the need to prevent tick bite especially the blacked legged tick and ways to prevent its spread.

Stafford, (2007)

Recommendations and conclusion

Reference:American Academy of Pediatricians, (2000) Prevention of Lyme disease. Pediatrics, 105, 142-147

http://pediatrics.aappublications.org/cgi/reprint/105/1/142

American Lyme Association , (2006) Lyme disease. Retrieved January 15, 2011 from

http://www.aldf.com/lyme.shtml

Center For Disease Control, (2010) reported cases of Lyme disease United States 2009. Retrieved January, 15 th from

http://www.cdc.gov/ncidod/dvbid/lyme/ld_Incidence.htm

Center For Disease Control, (2006) Lyme disease I Incidence. Retrieved January, 15 th from

Http://www.cdc.gov/ncidod/dvbid/lyme/ld_MeanAnnualIncidence.htm

Google Images, (2011) Images of tick and Erythema Migrans Retrieved January, 15 th 2011 from

http://www.google.com/images?hl=en&source=imghp&biw=1596&bih=695&q=lyme+disease&gbv=2&aq=0&aqi=g10&aql=&oq=Lyme

Reference cont.Minnesota Department of Health, (2010). Blacklegged tick . Retrieved February, 5 th 2011 from

http://www.health.state.mn.us/divs/idepc/dtopics/tickborne/ticks.html

Stafford, K. C. (2007). Tick management handbook. Produced by The Connecticutt Agricultural experimental station. Retrieved

February, 6th 2011 from: http://www.ct.gov/caes/lib/caes/documents/publications/bulletins/b1010.pdf

Steers, A., Coburn J., & Glickstein, L. (2004) The emergency of Lyme disease. The Journal of clinical investigation, 115(8),

1093-1101. Retrieved January, 15, 2011 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC385417/pdf/JCI0421681.pdf

Wormser, G. P., Dattwayler, R. J., Shapiro, E. D., Halperin, J. J., Steere, A. C., Klempner, M. S.,… Nadelman R.O., (2006) The

Clinical assessment, treatment, and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: Clinical

practice guidelines by the infectious disease society of America. Clinical Infectious Disease, 43, 1089-1134. Retrieved

January, 15, 2011 from http://cid.oxfordjournals.org/content/43/9/1089.full.pdf+html

Resources on Lyme disease from CDC

NEW Free Lyme Disease Continuing Medical Education for Clinicians Brochures and educational materials Protect Yourself from Tick-Borne Diseases.

( PDF - 1 page, 782KB) Lyme Disease: A Public Information Guide

( 16 pages, 4.94MB) Tickborne Diseases in Massachusetts, a physicians’ reference manual

(26 pages, 2MB) Tick Management Handbook: An integrated guide for homeowners, pest control

operators, and public health officials for the prevention of tick-associated diseases. ( 84 pages, 8,800KB) (From Connecticut Agricultural Experiment Station, New Haven CT)

Lyme Disease: The Facts, the Challenge (29 pages, 407KB) (From U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES National Institutes of Health)

Information about repellents: Insect repellent use and safety , Insect repellent protection times

More Resources From CDC Prevention How Can We Prevent Lyme Disease?

Edward B. Hayes, M.D., and Joseph Piesman, D.Sc.(Access granted courtesy of New England Journal of Medicine)

Ecology and transmission Surveillance for Lyme Disease --- United States, 1992--2006

MMWR,October 3, 2008 / 57(SS10);1-9 Lyme Disease --- United States, 2003--2005

June 15, 2007 / 56(23);573-576 Case definition and report forms Lyme Disease Surveillance Case Definition (revised Jan 2008) Lyme Disease Surveillance Case Report Form

-For Public Health Officials Use ( 2 pages, 737 KB)

Other helpful ResourcesAmerican Lyme disease foundation.

http://www.aldf.com/lyme.shtml

QuestionsANY QUESTION ??????