TickTick--borne Diseases at Navy borne Diseases at Navy

and Marine Corps Bases and Marine Corps Bases

LCDR Brian F. PrendergastLCDR Brian F. Prendergast

Laura N. HorneLaura N. Horne

Navy and Marine Corps Public Health Center, Portsmouth, VANavy and Marine Corps Public Health Center, Portsmouth, VA

LCDR Craig StoopsLCDR Craig Stoops

Navy Entomology Center of Excellence, Jacksonville, FLNavy Entomology Center of Excellence, Jacksonville, FL

Melissa MillerMelissa Miller

US Army Center for Health Promotion and Preventive Medicine US Army Center for Health Promotion and Preventive Medicine –– North, Fort Meade, MDNorth, Fort Meade, MD

�� Opinions expressed do not necessarily reflect the official Opinions expressed do not necessarily reflect the official position of the Department of Defense or the Military position of the Department of Defense or the Military Services.Services.

TickTick--borne Disease Surveillanceborne Disease Surveillance

Tick-borne Diseases in the U.S. Navy

0

20

40

60

80

100

120

1996

1997

1998

1999

2000

2001

2002

2003

2004

2005

2006

2007

Lyme Disease

Rocky Mountain Spotted

Fever

�Currently reviewing several disease databases to get a more accurate view of morbidity

•Lab data

•Ambulatory data

•Navy Disease Reporting System

�Passive disease surveillance difficult

•under reporting

•mis-diagnoses/over reporting

Data from Navy Disease Reporting Data from Navy Disease Reporting

SystemSystem�� Most cases in Groton among nonMost cases in Groton among non--active dutyactive duty

�� Most cases in Camp LeJeune among Active DutyMost cases in Camp LeJeune among Active DutyFigure 1. Lyme Disease Case Reports for AD

Personnel by Reporting UIC, 1996-June 2007

51

43%

9

8%

8

7%

5

4%

44

38%

Camp Lejeune

Groton

Quantico

Jacksonville

All Other*

Figure 2. Lyme Disease Case Reports for non-AD

beneficiaries by Reporting UIC, 1996-June 2007

46

39%

20

17%

11

9%

10

8%

6

5%

5

4%

21

18%

Groton

Camp Lejeune

Bethesda

NEPMU2

Portsmouth

New port

All other*

Electronic Disease ReportingElectronic Disease Reporting

Reports of Lyme Disease in Active Duty Navy and MC

members, 2004-2008

0

10

20

30

40

50

60

2004 2005 2006 2007 2008

Number of Cases

Year

First year of NDSRi

SeasonalitySeasonality

Counts of Positive Lyme Disease Labs among Active Duty

Navy and MC at selected locations, 2004-2008

0

2

4

6

8

10

12

Janu

aryFeb

ruar

y

Mar

ch

Apr

il

May

June

July

Aug

ust

Septe

mbe

rO

ctobe

rNove

mbe

rD

ecem

ber

Month

# P

osit

ive P

ati

en

ts

Northern

Lejeune

Reports of Lyme Disease in Active Duty Navy and MC service

members, 2004-2008, by location

0

2

4

6

8

10

12

Janu

aryFeb

ruar

y

Mar

ch

Apr

il

May

June

July

Aug

ust

Sep

tem

ber

Oct

ober

Nove

mbe

rD

ecem

ber

MonthN

um

ber

of

Rep

ort

s

Lejeune

Northern

All others

What is the disease What is the disease

agent?agent?

Borrelia burgdorferi or B. lonestari

Ixodes scapularis

Amblyomma americannumOR

Tick CollectionTick Collection

and Analysesand Analyses

Tick Collection and AnalysesTick Collection and Analyses� Camp LeJeune

•• 1841 ticks collected1841 ticks collected

•• 17 17 Ixodes Ixodes scapularisscapularis

− 5 (35%) positive for Borrelia burgdorferi (Lyme disease)

•• 8 8 DermacenterDermacenter variabilisvariabilis− Zero positive for Rickettsia rickettsii (Rocky mountain spotted

fever)

•• 1816 1816 AAmblyommamblyomma americanumamericanum− MIR 0.66 % Borrelia lonestari

− CDC has new evidence that Borrelia lonestari is NOT a human pathogen

− >40 % pos Rickettsia amblyommii

� Parris Island• 10 total collected on June 08 and Aug 08

� MCRD Beaufort• 1806 total Aug 08

Conclusion:Conclusion:

� Vector for Lyme disease at CL is relatively rare, the infection rates are high. Classic Lyme disease cannot be ruled out as a source of morbidity at CL in summer months.

� The highest morbidity at CL is in the summer months. Morbidity is lower when the Lyme disease vector is more common.

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