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Lyme  Disease Paul Mead, MD, MPH Division of Vector-borne Diseases Centers for Disease Control and Prevention
Lyme disease cause and discovery ,[object Object],[object Object],[object Object],Photo credit: Jay Carroll
Common human-biting ticks in the U.S. Transmit Lyme disease
Lyme disease transmission cycle Risk of human infection greatest in late spring and summer
Signs and symptoms of Lyme disease in humans
Erythema migrans (EM) ,[object Object],[object Object],[object Object],[object Object],[object Object]
Other presentations of EM From: Nadelman RB, Wormser GP. Management of tick bites and early Lyme disease,  Lyme disease . 1998; Philadelphia: American College of Physicians. 49-75
Later stages of Lyme disease Arthritis Facial palsy
Lyme disease cases reported to CDC, United States, 1992-2008 Increase in reports due to more complete surveillance, plus expansion in some areas
Reported Lyme disease cases, United States, 2008
Reported Lyme disease cases, Northeastern United States, 2008
Lyme disease incidence by age and sex, United States, 1992-2006
Reported Lyme disease cases by onset month, United States, 1992-2006
Clinical features of reported Lyme disease cases, United States, 1992-2006 N = 150,829
Diagnosis ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Laboratory testing for Lyme disease  ,[object Object],[object Object],[object Object],[object Object]
2 step process recommended ,[object Object],[object Object],[object Object],[object Object],[object Object],ELISA / EIA negative positive or indeterminate  IgM Immunoblot Stop IgG
How good is 2-tier testing? Bacon et al. JID 2003; 187:1187–99 ,[object Object],[object Object],Lyme Disease Stage Patients who test positive Acute EM  38% Arthritis  97% Late neurological 100%
Alternative tests ,[object Object],[object Object],[object Object],[object Object]
Treatment and outcome ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Symptoms after treatment for  Lyme disease Long term follow up of 96 patients with culture-confirmed EM in 1991-4 Nowakowski et al.  Am J Med 2003; 115:91-96
“ Post Lyme disease syndrome”  and “Chronic Lyme disease” ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]
Principles of prevention ,[object Object],2.  Environmental management 3.  Community intervention
1.  Personal protection ,[object Object],[object Object],[object Object],[object Object]
1.  Personal protection ,[object Object],[object Object],[object Object]
1.  Personal protection ,[object Object],[object Object],[object Object],[object Object]
Tick Removal  ,[object Object],[object Object],[object Object],[object Object],[object Object]
1.  Personal protection ,[object Object],[object Object],[object Object],[object Object]
2. Environmental management ,[object Object],[object Object],[object Object],[object Object],[object Object],From: Kirby Stafford, Tick Control Handbook, Connecticut Agricultural Experiment Station
2. Environmental management ,[object Object],[object Object],From: Kirby Stafford, Tick Control Handbook, Connecticut Agricultural Experiment Station
3. Community prevention ,[object Object],[object Object]
 
Thank You! The findings and conclusions in this report have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy

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Lyme Disease Town Meeting Dr. Mead, CDCP

  • 1. Lyme Disease Paul Mead, MD, MPH Division of Vector-borne Diseases Centers for Disease Control and Prevention
  • 2.
  • 3. Common human-biting ticks in the U.S. Transmit Lyme disease
  • 4. Lyme disease transmission cycle Risk of human infection greatest in late spring and summer
  • 5. Signs and symptoms of Lyme disease in humans
  • 6.
  • 7. Other presentations of EM From: Nadelman RB, Wormser GP. Management of tick bites and early Lyme disease, Lyme disease . 1998; Philadelphia: American College of Physicians. 49-75
  • 8. Later stages of Lyme disease Arthritis Facial palsy
  • 9. Lyme disease cases reported to CDC, United States, 1992-2008 Increase in reports due to more complete surveillance, plus expansion in some areas
  • 10. Reported Lyme disease cases, United States, 2008
  • 11. Reported Lyme disease cases, Northeastern United States, 2008
  • 12. Lyme disease incidence by age and sex, United States, 1992-2006
  • 13. Reported Lyme disease cases by onset month, United States, 1992-2006
  • 14. Clinical features of reported Lyme disease cases, United States, 1992-2006 N = 150,829
  • 15.
  • 16.
  • 17.
  • 18.
  • 19.
  • 20.
  • 21. Symptoms after treatment for Lyme disease Long term follow up of 96 patients with culture-confirmed EM in 1991-4 Nowakowski et al. Am J Med 2003; 115:91-96
  • 22.
  • 23.
  • 24.
  • 25.
  • 26.
  • 27.
  • 28.
  • 29.
  • 30.
  • 31.
  • 32.  
  • 33. Thank You! The findings and conclusions in this report have not been formally disseminated by the Centers for Disease Control and Prevention and should not be construed to represent any agency determination or policy