Parental Surveillance Guide to Lyme’s Disease

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Agenda

• Establish objectives for this seminar• Define Lyme’s disease• Discuss warning signs• Know your options for treatment • Understand test results• Discuss long term affects• Share prevention strategies

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Objectives

• Gain awareness of disease in your area.

• Know how to identify symptoms.• Identify a step wise approach in

finding the diagnose. • Understand what your doctor is telling

you. • Apply prevention strategies.• Learn where to get help in the state of

Maryland.

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Lyme’s in your backyard?

• The Center for Disease Control and Prevention (CDC, 2011) listed the top 8 states with the highest number of reported Lyme’s disease cases.

• Pennsylvania • New York• New Jersey • Massachusetts• Connecticut • Wisconsin • Rhode Island • Maryland • Minnesota

Lyme’s disease on the rise

• Reports in Maryland has more than doubled in the last 10 years.

• The number of reported cases in Maryland increased from 691 to 1,235, during 2003 to 2005 (CDC, 2011a).

• The number peaked in 2007 at 2,576 cases and the last report in 2009 revealed 1,466 cases (CDC, 2011a).

• Most common among boys ages 5-9 years old • The true incidence of Lyme’s disease in not know.

– See link for further readinghttp://www.accessmedicine.com

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What is Lyme’s Disease?

• Tick borne infection• B.burgdorferi.

• Transmitted by Ixodes Tick• Ixodes Scapularus: Most common East Coast• Reservoir deer, rodents

• Tick cycle• Feed once during each three stages

» Larvae late summer

» Nymph following spring-early summer

» Adult late fall

Red Flag Warning Signs

Bulls eye lesion

Fatigue

Flu-like symptoms

– Not having the energy to play with friends

– Wanting to go to bed

– Continually expressing their legs are sore

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Figure 1.Pictures of erythema migrans. From “American Lyme’s disease foundaton,” 1993, Journal of Science, (260), p. 1610-1616. Reprinted with permission.

Figure 2. Classic erythema migrans. From” eMedicine,” 2008. Image reprinted with permission.

There is no one form of erythema migrams

First remove the TIC

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What to expect

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Lingering Lyme’s Disease

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Lab Results

• Conclusive Results

• (+) ELISA• (+) Western Blot• (-) Symptoms after

treatment

• Inconclusive Results

• (-) ELISA• (-) Western Blot• (+) Symptoms after

treatment

• Things to consider• PCR test• Juvenile arthritis

symptoms may persist • Antibiotics are not the

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Where to bring your child

No insurance

• Try to avoid the emergency room

• Refer to Clinical List for Maryland Doctors

• http://www.needymeds.org/free_clinics.taf?_function=list&state=md

Insurance

• Go to your pediatrician

• Rheumatologist in Maryland

• http://www.hopkinschildrens.org/staffDetail.aspx?id=3112

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Prevention Strategies

• Check your children• Must check for specific rashes

• Avoid tick-infected areas• High season in your area• Does bug spray help with ticks?

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Patient Education Material

• Pediatric Information – http://www.uptodate.com/contents/patient-information-lyme-di

sease-the-basics?source=search_result&search=lyme%27s+disease&selectedTitle=21%7E150

• Lyme’s Disease Specialists• Holtorf Medical Group

» http://aitrk3.holtorfmed.com/lyme-disease.html?aitrk=HM3&teng=go&geng=lyme&aeng=lyme3&keng=lyme%20disease&meng=p

• Lyme’s Disease: Supplements and More• The Healing Arts Partnership

» http://www.treatlyme.net/• American Lyme’s Disease Foundation

» http://www.aldf.com/lyme.shtml

Reference

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1. Center for Disease Control and Prevention. Morbidity and mortality weekly report. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5623a1.htm

2. McPhee, S., Maxine, A., & Radow, M. (2011). Current medical diagnosis and treatment. Retrieved from http://www.accessmedicine.com/content.aspx?aID=18802&searchStr=lyme+disease

3. Shapiro, E. (2011). Lyme disease: Clinical manifestations in children. Retrieved on October 16th 2011 from http://www.uptodate.com/contents/lyme-disease-clinical-manifestations-in-children?source=search_result&search=lyme%27s+disease&selectedTitle=1%7E150

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Questions and answers