Lyme disease is a tick-borne illness caused by the Borrelia burgdorferi bacteria. It is transmitted through the bite of infected blacklegged ticks, which must be attached for over 36 hours to transmit the disease. Typical symptoms include a characteristic bullseye rash called erythema migrans, as well as fatigue, fever, headache and joint and muscle aches. If left untreated, the infection can spread to the joints, heart or nervous system. While most cases are treated successfully with antibiotics, testing may be inaccurate during early stages and the disease is most common in the Northeast, Midwest and Northern California.

1. Lyme Disease 2015
March 9, 2015
Daniel M. Sullivan MD FACP
Medicine Institute

2. What is it?
• Lyme Disease is a tick borne illness
• The tick transmits a bacteria into our
skin
• Borrelia Burgdorferei in the United
States
- Blacklegged ticks are the source

3. Ticks need 36 hours of
attachment to transmit disease
• The ticks are often in the nymph stage
• 2 mm in size

4. Blacklegged Ticks (Ixodes scapularis)
http://www.cdc.gov/lyme/transmission/blacklegged.html

5. Typical Symptoms
• Fever
• Headache
• Fatigue
• Rash

6. Erythema Migrans
• Rash is called Erythema Migrans
• Looks like a red bulls eye with a white
center
http://www.cdc.gov/ticks/symptoms.html

7. If Untreated
• Spreads to Joints
• Heart
• Nervous System

8. Diagnosis is Based on
Symptoms
Red expanding rash
Fatigue, Chills, Fever
Headache, Muscle, and Joint Aches
Swollen Lymph Nodes

9. Lab Testing
• Should be done if exposed to
blacklegged ticks and have symptoms

10. Treatment
• Most cases resolve with a few weeks of
antibiotics

11. Prevention
• Insect repellent
• Remove the tick promptly
• Reducing Tick Habitat
http://www2.epa.gov/insect-repellents

12. Prevention
http://www.bayexco.com/blog/wp-content/uploads/2014/07/Tick_Removal-300x195.jpg

13. Where is the Highest Risk
• Northeast and Mid-Atlantic
• Wisconsin and Minnesota
• Northern California

14. Reported Lyme disease cases in the United
States from 1990-2013
http://module.lymediseaseassociation.net/Maps/

15. Can the Blood Test be Wrong
• Often the test is negative during the
rash stage of the illness in the first few
weeks

16. If the Blood test is still
positive is infection still
present?
• The blood test measures antibodies
and stays positive for years.

17. Standard Treatment
• Early disease is treated with
doxycycline or amoxicillin
• Later disease in the nervous system
may need intravenous antibiotics

18. Reported cases of Lyme disease by year in
the United States 1995-2013
The graph displays the number of reported cases of Lyme disease from 1995 through
2013. The number of confirmed cases ranged from a low of 11,700 in 1995 to high of
29,959 in 2009.
http://www.cdc.gov/lyme/stats/chartstables/casesbyyear.html

19. Reported cases of Lyme disease in the
United Stated, 1991-2012
This figure shows the annual incidence of Lyme disease, which is calculated as the number
of new cases per 100,000 people. The graph is based on cases that local and state health
departments report to CDC's national disease tracking system.
http://www.epa.gov/climatechange/science/indicators/health-society/lyme.html

20. Confirmed Lyme disease cases by age and
sex in the United States, 2001-2010
Reported cases of Lyme disease are most common among boys aged 5-9.
http://www.cdc.gov/lyme/stats/chartstables/incidencebyagesex.html

21. Reported cases of Lyme disease, United
States, 2013
Though Lyme disease cases have been reported in nearly every state, cases are reported
from the infected person’s county of residence, not they place where they were infected.
http://www.cdc.gov/lyme/resources/brochure/lymediseasebrochure.pdf