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Lyme Disease Prevention Program
                             Kathleen F Kirby, RN




Special thanks to Barbara Wright
for creating this slide presentation

                                       1
What are Tick Borne Diseases?
  Several diseases can be acquired from an infected tick’s bite
  during it’s blood meal.

Lyme Disease

Babesiosis

Ehrlichoiosis




                                2
What is Lyme Disease?
Lyme Disease is a bacterial infection
that is caused by the spirochete
Borreliaburgdorferi.
This organism attacks various organ
systems in the body.
  Nervous System: Bell’s
  Palsy, meningitis (stiff neck), and
  severe headaches
  Skeletal System: Swelling at joints
  (particularly the knee joint), migratory
  joint pain, and arthritis.
  Circulatory System: Heart Block and
  arrhythmias
                                  3
Lyme Disease Symptoms
Symptoms typically appear 2-3 days after the bite of a tick.
Early symptoms may include one or more of the following:


 Expanding      Fatigue
 “bull’s eye”   Headaches
 rash           Muscle
 Flu-like       aches
 symptoms       Joint pain
 Fever
 Malaise

                             4
Examples of the characteristic Bull’s Eye Rashes




                        5
Lyme Disease Symptoms
          Late Symptoms of Lyme may include:

Nerve damage: Bell’s Palsy
Encephalopathy: Brain
Damage
Meningitis: neck
stiffness, headache
Heart abnormalities:
arrhythmia, heart block
Joints: severe joint pain or
swelling
                               6
Lyme Disease in the United States




                7
8
Lyme Disease
            in New Jersey

2010 New Jersey Reportable Communicable
          Disease Report shows
        3712 cases of Lyme Disease
      January 1, 2010- January 1, 2011




                                   9
Lyme Disease is on the Rise




             10
What is Babesiosis?


A malaria like illness
caused by the parasite
genus, babesia, that
attacks red blood cells. It
can be passed by a tick
bite with other tick-borne
infections, including
borrelia, the bacteria that
is the cause of Lyme
disease.
                              11
Babesiosis Symptoms
Nonspecific “flu-like” symptoms such as:

  Fever                         Loss of appetite
  Chills                        Nausea
  Drenching night sweats        Fatigue
  Body Aches                    Headache

Symptoms can occur one to six weeks after a tick bite.
Babesiosis is less common than Lyme disease.


                           12
What is Erlichiosis?


Erlichiosis is a disease
caused by several
bacterial species of the
genus Erlichia.Erlichia
attacks the white blood
cells in the body.




                           13
Types of Erlichiosis


There are 2 types of Erlichiosis described in the United
States.

  1) Human MonocyticErlichiosis (HME): transmitted by the
  Lone Star tick.

  2) Human Granulocytic Erlichiosis (HGE): transmitted by
  the black legged tick and the western black legged tick.
  HGE is now referred to as Anaplasmosis.
                           14
Erlichiosis (Anaplasmosis) Sypmtoms


  Severe headaches
  Sudden high fever
  Fatigue
  Muscle aches
  Nausea
  Rash



                      15
Erlichiosis (Anaplasmosis) Sypmtoms
               (cont’d.)
   Severe cases of Anaplasmosis may result in:
     Low white blood cells
     Low platelet counts
     Kidney failure
     Death

 Symptoms usually appear 3 – 16 days after a tick bite.
 Anaplasmosis is less common than lyme disease.


                             16
Erlichiosis in the United States




               17
Are There Any Vaccines?


There was a vaccine for lyme disease several years
ago but it is no longer available

If you have been vaccinated for lyme disease, you are
no longer protected.

There are no vaccines presently available for any of
the tick borne illnesses so prevention is the key.

                          18
What Do Ticks Look Like?




           19
                Black Legged Tick
Deer Tick
    also known as Black Legged Tick

Adult Female: reddish
brown, size of a sesame
seed
Adult Male: slightly small
than female, completely
dark brown
Nymph: size comparable to
a poppy seed
Larva: size smaller than a
pin head
Larva cannot transmit lyme
disease
                             20
American Dog Tick

Reddish brown coloring

Silver-gray markings on
back
                                    female

Move around vigorously

May cause Rocky Mountain
Fever but it is not known to
carry the lyme disease
bacteria


                               21            male
Lone Star Tick

Conspicuous white
marking on back
Reddish-brown color
More circular in shape
Elongated mouth parts
May transmit erlichiosis
or STARI (Souther Tick-
Associated Rash Illness)


                           22
Engorged versus
non-engorged lone star tick




             23
Engorged deer tick




        24
Life Cycle of Tick




        25
When am I most likely to get a tick
         borne illness?




                 26
Where do ticks live




         27
Tick removal
How to remove a tick

Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible.

Pull upward with steady, even pressure.

Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain
in the skin. If this happens, remove the mouth-parts with tweezers.




                                          28
Follow up care

After removing the tick, thoroughly clean the
bite area and your hands with rubbing alcohol,
an iodine scrub, or soap and water.
Record where on your body the bite occurred
and the date of the tick bite.

If you develop a rash or fever within several
weeks of removing a tick, see your doctor. Tell
the doctor the area where you think you picked
up the tick.           29
Tick removal don’ts



Don’t squeeze or rupture tick
Don’t pour kerosene or nail polish remover on
tick
Don’t cover the tick with petroleum jelly
Don’t use a smoldering match or cigarette butt
to remove tick
Don’t use anything else that might traumatize
the tick
                         30
How do you avoid getting a tick bite




                 31
BLAST Program Foundation



The BLAST     acronym is based on
the most effective prevention
practices found in recent research.



                 32
BL A S T
Bathe or
shower
soon after
you come
indoors.

                33
B LAST

Look
for ticks
and
rashes.



              34
BL AST

Apply
repellents




               35
BLA T  s
Spray the edges
of your yard.
A single
perimeter spray
for tick control
once in the
Spring can
reduce the
number of ticks
by 80% to 90%
                     36
BLAS        T
•Treat your pets.
•Check your pets for
ticks after coming
indoors.
•Ask your vet what
you can use to repel
ticks.
•Don’t sleep with you
pets. Ticks on your pet
may crawl onto you.
                          37
Quiz Time!

     38
B           Bathe
L           Look
    Great
A   Job!
            Apply
S           Spray
T           Treat
            39
Follow these directions and you
may lower your chances of being
  infected with Lyme Disease.




               40
Works Cited

     Centers for Disease Control and Prevention
             www.cdc.gov/lyme/pre/in_the_yard
     Food and Drug Administration, June 20, 2011
      Sanjai Kuman, chief of laboratory of emerging pathogens
 Lyme Disease Association, August 9, 2009
      www.lymediseaseassociation.org
     National Institute of Health, 2010




                             41
Works Cited continued

     New Jersey Department of Health and Senior Services
www.state.nj.us/health/cd/documents

       National Pesticide Information Center
        npic.orst.edu/pest/tick/lyme
       Ridgefield, Ct Health Department,
        Jennifer Reid, Community Program Coordinator
               www.ridgefieldct.org
 tickinfo.com

                             42

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Lymes pp

  • 1. Lyme Disease Prevention Program Kathleen F Kirby, RN Special thanks to Barbara Wright for creating this slide presentation 1
  • 2. What are Tick Borne Diseases? Several diseases can be acquired from an infected tick’s bite during it’s blood meal. Lyme Disease Babesiosis Ehrlichoiosis 2
  • 3. What is Lyme Disease? Lyme Disease is a bacterial infection that is caused by the spirochete Borreliaburgdorferi. This organism attacks various organ systems in the body. Nervous System: Bell’s Palsy, meningitis (stiff neck), and severe headaches Skeletal System: Swelling at joints (particularly the knee joint), migratory joint pain, and arthritis. Circulatory System: Heart Block and arrhythmias 3
  • 4. Lyme Disease Symptoms Symptoms typically appear 2-3 days after the bite of a tick. Early symptoms may include one or more of the following: Expanding Fatigue “bull’s eye” Headaches rash Muscle Flu-like aches symptoms Joint pain Fever Malaise 4
  • 5. Examples of the characteristic Bull’s Eye Rashes 5
  • 6. Lyme Disease Symptoms Late Symptoms of Lyme may include: Nerve damage: Bell’s Palsy Encephalopathy: Brain Damage Meningitis: neck stiffness, headache Heart abnormalities: arrhythmia, heart block Joints: severe joint pain or swelling 6
  • 7. Lyme Disease in the United States 7
  • 8. 8
  • 9. Lyme Disease in New Jersey 2010 New Jersey Reportable Communicable Disease Report shows 3712 cases of Lyme Disease January 1, 2010- January 1, 2011 9
  • 10. Lyme Disease is on the Rise 10
  • 11. What is Babesiosis? A malaria like illness caused by the parasite genus, babesia, that attacks red blood cells. It can be passed by a tick bite with other tick-borne infections, including borrelia, the bacteria that is the cause of Lyme disease. 11
  • 12. Babesiosis Symptoms Nonspecific “flu-like” symptoms such as: Fever Loss of appetite Chills Nausea Drenching night sweats Fatigue Body Aches Headache Symptoms can occur one to six weeks after a tick bite. Babesiosis is less common than Lyme disease. 12
  • 13. What is Erlichiosis? Erlichiosis is a disease caused by several bacterial species of the genus Erlichia.Erlichia attacks the white blood cells in the body. 13
  • 14. Types of Erlichiosis There are 2 types of Erlichiosis described in the United States. 1) Human MonocyticErlichiosis (HME): transmitted by the Lone Star tick. 2) Human Granulocytic Erlichiosis (HGE): transmitted by the black legged tick and the western black legged tick. HGE is now referred to as Anaplasmosis. 14
  • 15. Erlichiosis (Anaplasmosis) Sypmtoms Severe headaches Sudden high fever Fatigue Muscle aches Nausea Rash 15
  • 16. Erlichiosis (Anaplasmosis) Sypmtoms (cont’d.) Severe cases of Anaplasmosis may result in: Low white blood cells Low platelet counts Kidney failure Death Symptoms usually appear 3 – 16 days after a tick bite. Anaplasmosis is less common than lyme disease. 16
  • 17. Erlichiosis in the United States 17
  • 18. Are There Any Vaccines? There was a vaccine for lyme disease several years ago but it is no longer available If you have been vaccinated for lyme disease, you are no longer protected. There are no vaccines presently available for any of the tick borne illnesses so prevention is the key. 18
  • 19. What Do Ticks Look Like? 19 Black Legged Tick
  • 20. Deer Tick also known as Black Legged Tick Adult Female: reddish brown, size of a sesame seed Adult Male: slightly small than female, completely dark brown Nymph: size comparable to a poppy seed Larva: size smaller than a pin head Larva cannot transmit lyme disease 20
  • 21. American Dog Tick Reddish brown coloring Silver-gray markings on back female Move around vigorously May cause Rocky Mountain Fever but it is not known to carry the lyme disease bacteria 21 male
  • 22. Lone Star Tick Conspicuous white marking on back Reddish-brown color More circular in shape Elongated mouth parts May transmit erlichiosis or STARI (Souther Tick- Associated Rash Illness) 22
  • 25. Life Cycle of Tick 25
  • 26. When am I most likely to get a tick borne illness? 26
  • 27. Where do ticks live 27
  • 28. Tick removal How to remove a tick Use fine-tipped tweezers to grasp the tick as close to the skin's surface as possible. Pull upward with steady, even pressure. Don't twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. 28
  • 29. Follow up care After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water. Record where on your body the bite occurred and the date of the tick bite. If you develop a rash or fever within several weeks of removing a tick, see your doctor. Tell the doctor the area where you think you picked up the tick. 29
  • 30. Tick removal don’ts Don’t squeeze or rupture tick Don’t pour kerosene or nail polish remover on tick Don’t cover the tick with petroleum jelly Don’t use a smoldering match or cigarette butt to remove tick Don’t use anything else that might traumatize the tick 30
  • 31. How do you avoid getting a tick bite 31
  • 32. BLAST Program Foundation The BLAST acronym is based on the most effective prevention practices found in recent research. 32
  • 33. BL A S T Bathe or shower soon after you come indoors. 33
  • 36. BLA T s Spray the edges of your yard. A single perimeter spray for tick control once in the Spring can reduce the number of ticks by 80% to 90% 36
  • 37. BLAS T •Treat your pets. •Check your pets for ticks after coming indoors. •Ask your vet what you can use to repel ticks. •Don’t sleep with you pets. Ticks on your pet may crawl onto you. 37
  • 39. B Bathe L Look Great A Job! Apply S Spray T Treat 39
  • 40. Follow these directions and you may lower your chances of being infected with Lyme Disease. 40
  • 41. Works Cited  Centers for Disease Control and Prevention www.cdc.gov/lyme/pre/in_the_yard  Food and Drug Administration, June 20, 2011 Sanjai Kuman, chief of laboratory of emerging pathogens  Lyme Disease Association, August 9, 2009 www.lymediseaseassociation.org  National Institute of Health, 2010 41
  • 42. Works Cited continued  New Jersey Department of Health and Senior Services www.state.nj.us/health/cd/documents  National Pesticide Information Center npic.orst.edu/pest/tick/lyme  Ridgefield, Ct Health Department, Jennifer Reid, Community Program Coordinator www.ridgefieldct.org  tickinfo.com 42

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  1. Source: http://www.cdc.gov/lyme/stats/maps/map2010.html
  2. 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 smallAnd may feed anywhere on the body so check thoroughly.
  3. If you choose to use a tick repellent on your skin, use a product that contains DEET at a concentration of at least 30% to 40%.Clothing: A permethrin based product is recommended.
  4. Hire a professional.7