Disease Reporting And Case Definitions
The Centers for Disease Control and Prevention maintains a list of nationally notifiable diseases . RSMo 192.139, Communicable Disease Reporting, Guidelines for Department, stipulates that communicable disease reporting requirements established by the Missouri Department of Health and Senior Services shall be in accordance with guidelines, funding requirements, or recommendations established by CDC. DHSS has incorporated CDC-mandated diseases as well as selected other diseases for which there are established diagnostic tests into 19 CSR 20-20.020, Reporting Communicable, Environmental and Occupational Diseases . Local public health agencies and/or DHSS are notified by physicians, laboratories, and other reporters when diseases/conditions listed in 19 CSR 20-20.020 are confirmed or suspected. DHSS, in turn, reports cases to CDC.
The usefulness of public health surveillance data depends on its uniformity, simplicity, and timeliness. CDCs case definitions establish uniform criteria for disease reporting and should not be used as the sole criteria for establishing clinical diagnoses, determining the standard of care necessary for a particular patient, setting guidelines for quality assurance, or providing standards for reimbursement. Use of additional clinical, epidemiologic, and laboratory data may enable a physician to diagnose a disease even though the formal surveillance case definition may not be met.
Resources For Maine Residents
Public Law, Chapter 340, LD 597, 126th Maine State Legislature: An Act to Inform Persons of the Options for the Treatment of Lyme Disease
- Acknowledges difficulty in diagnosing and treating Lyme disease
- Information on risks of long term antibiotic therapy
Public Law, Chapter 235, LD 422, 127th Maine State Legislature: An Act to Improve Access to Treatments for Lyme Disease
- Allows licensed physicians to prescribe long-term antibiotic therapy to eliminate infection or to control a patients symptoms
What Is Chronic Lyme Disease
Chronic Lyme disease is initially introduced to the body by different strains and species of Borrelia bacteria, most often, Borrelia burgdorferi. It is often named, The Great Imitator, because its symptoms have been known to mimic hundreds of other illnesses.
Due to the wide variety of symptoms that it can cause, many doctors dismiss chronic, ongoing Lyme as a true disease. At the Biologix Center, this is never the case. The reality is that every system in the body can become damaged as a result of Lyme disease and therefore every system must be addressed before health can be restored. We recognize that our patients symptoms are very real, which is why we commit to using everything available to us to promote true healing.
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Not Everyone With Lyme Disease Develops A Bulls
Medically reviewed in February 2022
Lyme disease affects an estimated 476,000 people in the United States each year. Despite its increasing prevalence, there are many lingering myths about this tick-borne illness.
Also known as the great imitator, Lyme disease often affects more than one system in the body and can trigger a wide range of symptoms that mimic other conditions. These symptoms include fatigue, mental fog, joint and muscle pain, severe headache, poor sleep, tingling extremities, and mood changes. They may be confused with diseases such as chronic fatigue syndrome, rheumatoid arthritis, multiple sclerosis, depression, and even Alzheimers disease.
But the confusion doesnt stop there. There are nearly 900 species of ticks around the world, yet many people may not realize that only two species of blacklegged ticks spread Lyme disease in the United States. And contrary to popular belief, chronic Lyme disease isnt a recognized medical diagnosis, according to Danial Kaswan, MD, an infectious disease specialist affiliated with Aventura Hospital and Medical Center in Aventura, Florida.
We spoke to Dr. Kaswan about these and other misconceptions about Lyme disease. Heres what he had to say.
infections
How Is Lyme Disease Diagnosed
It can be difficult to diagnose Lyme disease. The ticks that carry it are very small and the bites dont hurt. Many patients dont remember being bitten. In addition, most of the symptoms are common with other illnesses.
If you find a tick in your skin, use tweezers to remove it immediately. Then wait a few days to see if you develop any symptoms. If you do, call your family doctor. Your doctor will ask you about your symptoms. He or she will look at the bite and check for a rash. They may order a blood test. But those arent always necessary to make the diagnosis. They can often give false results, especially in early-stage Lyme disease.
People who have joint swelling or nervous system problems may need to have special tests. Your doctor may need to take some fluid from the swollen joint or the spine to check for clues to your condition.
If you have been sick for 4 weeks or more, call your doctor. He or she can give you a blood test at this stage. It will tell you if you have Lyme disease.
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There Is Currently No Available Vaccine For Lyme Disease The Tick
For more crisp and insightful business and economic news, subscribe to The Daily Upside newsletter. It’s completely free and we guarantee you’ll learn something new every day.
There is currently no available vaccine for Lyme disease, the tick-borne infection that, while rarely fatal, can leave patients with debilitating side effects for months. But now that’s a matter of a ticking clock.
On Monday, Pfizer took a $95 million, 8.1% stake in French vaccine developer Valneva to reset the terms of an alliance to develop the first Lyme disease shot in two decades.
History Of Lyme Disease
Lyme disease gets its name from a small coastal town in Connecticut called Lyme. In 1975, a woman brought to the attention of Yale researchers an unusual cluster of more than 51 cases of mostly pediatric arthritis. In 1977, Dr. Allen Steere and Yale colleagues identified and named the 51 clusters Lyme arthritis.” In 1979, the name was changed to “Lyme disease,” when Steere and colleague Dr. Steven Malawista discovered additional symptoms linked to the disease such as possible neurological problems and severe fatigue. In 1982 the cause of the disease was discovered by Dr. Willy Burgdorfer. Dr. Burgdorfer published a paper on the infectious agent of Lyme disease and earned the right to have his name placed on the Lyme disease spirochete now known as Borrelia burgdorferi.
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Who Is At Risk For Lyme Disease
Anyone can get a tick bite. But people who spend lots of time outdoors in wooded, grassy areas are at a higher risk. This includes campers, hikers, and people who work in gardens and parks.
Most tick bites happen in the summer months when ticks are most active and people spend more time outdoors. But you can get bitten in the warmer months of early fall, or even late winter if temperatures are unusually high. And if there is a mild winter, ticks may come out earlier than usual.
Stage : Late Disseminated Lyme Disease
Late disseminated Lyme disease occurs when the infection hasnt been treated in stages 1 and 2. Stage 3 can occur months or years after the tick bite.
This stage is characterized by:
- arthritis of one or more large joints
- brain disorders, such as encephalopathy, which can cause short-term memory loss, difficulty concentrating, mental fogginess, problems with following conversations and sleep disturbance
- numbness in the arms, legs, hands, or feet
Also Check: What Kind Of Ticks Give You Lyme Disease
What Are The Treatments For Lyme Disease
Lyme disease is treated with antibiotics. The earlier you are treated, the better it gives you the best chance of fully recovering quickly.
After treatment, some patients may still have pain, fatigue, or difficulty thinking that lasts more than 6 months. This is called post-treatment Lyme disease syndrome . Researchers don’t know why some people have PTLDS. There is no proven treatment for PTLDS long-term antibiotics have not been shown to help. However, there are ways to help with the symptoms of PTLDS. If you have been treated for Lyme disease and still feel unwell, contact your health care provider about how to manage your symptoms. Most people do get better with time. But it can take several months before you feel all better.
What Do You Do If There’s A Tick Under Your Skin
Use a pair of fine-tipped tweezers to remove it as soon as possible. Pull upward with steady pressure. If parts of the tick are still in your skin, try to get those with the tweezers, too. After everything is out, clean the bite area with rubbing alcohol or soap and water.
You probably wonât get infected if you remove the tick within 36 to 48 hours.
How do you throw away a tick?
Put it in soapy water or alcohol, stick it to a piece of tape, or flush it down the toilet.
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What Are The Symptoms Of Chronic Lyme Disease
Lyme disease does not affect any two people in the exact same way. Even when a person is living a seemingly symptom-free, healthy life, there are always underlying issues and weaknesses that are made worse by physical and emotional challenges in life. These weaknesses are what dictate which symptoms are manifested in each unique patients body. Some patients may experience one severe symptom, while others may experience over fifty major symptoms, even when both groups test highly positive for LD on blood tests.
The reality is that any underlying immune, endocrine, genetic/epigenetic, and other bioregulatory dysfunctions, as well as any unresolved physical, mental, or emotional issues will be manifested physically or psychologically as the body loses its ability to control overgrowth of the Borrelia and other co-infections associated with Lyme disease. These unique underlying dysfunctions, combined with the Borrelias ability to suppress the immune system even further, are the reasons why LD can create so many diverse symptoms. Some of the more common symptoms include:
- Rash most are solid pink to red uncommon: bulls-eye or other appearance
- Fever
- Fatigue
- Muscle and joint pain
The non-rash symptoms are often described as a summertime flu. Some people may notice areas of numbness or tingling.
Once the infection spreads beyond the skin, it can affect any system of the body, causing many symptoms including:
What Causes Lyme Disease
People get Lyme disease when they are bitten by an infected tick. Ticks live in areas with a lot of plant life, such as wooded areas or fields. They sit near the top of grassy plants and low bushes. They wait there for people or animals to brush up against them. Ticks can crawl on your clothes or body for up to several hours or more before attaching to the skin.
Ticks can attach to any part of your body. They are usually found in hard-to-see areas, including the armpits, groin, or scalp. An infected tick needs to be attached to your skin for 36 to 48 hours before it passes the bacteria on to you.
People who spend time in outdoor areas where ticks are common are at higher risk of getting tick-borne diseases.
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Promoting Collaborative Approaches To Understanding Lyme And Other Tickborne Diseases
Supporting coordinated research efforts through TickNET
CDCs TickNET program was established by CDC in 2007 to bring together expertise from state public health partners, CDC, and research scientists. TickNET fosters coordinated surveillance, education, and research on the prevention of tickborne diseases. For more information, see TickNETA collaborative public health approach to tickborne disease surveillance and research.
Funding state health departments to improve surveillance and prevention
CDC provides funds to state health departments for Lyme and tickborne disease surveillance through the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement. This money coupled with CDCs subject matter expertise helps state public health departments strengthen their ability to detect, respond to, control, and prevent Lyme and other tickborne diseases.
Supporting vector-borne disease Centers of Excellence
CDC has awarded nearly $50 million to five universities to establish regional Centers of Excellence to help effectively address emerging vector-borne diseases in the United States. Scientists and public health experts at the Northeastexternal icon and Midwestexternal icon Regional Centers of Excellence will have a strong research component involving the surveillance and control of disease-carrying ticks.
Supporting large-scale prevention research
Infection Prevention And Control
- Wear light coloured clothing to help spot ticks
- Use insect repellents that contain DEET or Icaridin. Always follow the manufacturers instructions.
- Do daily full body checks on yourself, your children and pets after coming in from the outdoors
- Cut your grass and dipope of leaf litter where ticks can live.
- Outdoor workers should shower or bathe within two hourrs of being in forested or long grass areas
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Can Lyme Disease Be Prevented
To prevent Lyme disease, you should lower your risk of getting a tick bite:
- Avoid areas where ticks live, such as grassy, brushy, or wooded areas. If you are hiking, walk in the center of the trail to avoid brush and grass.
- Use an insect repellent with DEET
- Treat your clothing and gear with a repellant containing 0.5% permethrin
- Wear light-colored protective clothing, so you can easily see any ticks that get on you
- Wear a long-sleeve shirt and long pants. Also tuck your shirt into your pants and your pant legs into your socks.
- Check yourself, your children, and your pets daily for ticks. Carefully remove any ticks you find.
- Take a shower and wash and dry your clothes at high temperatures after being outdoors
Centers for Disease Control and Prevention
Discovering New Tickborne Diseases
CDC is partnering with the Minnesota Department of Health, Mayo Clinic, Tennessee Department of Health, and Vanderbilt University to obtain up to 30,000 clinical specimens from patients with suspected tickborne illness over a 3-year period. CDC will use advanced molecular detection methods to identify tickborne bacteria that may be the cause of these patients illnesses. Already, investigators have used AMD to sequence the full genome of a newly discovered bacteria, Borrelia mayonii, which is another cause of Lyme disease in upper Midwestern states.
Using advanced molecular detection techniques, CDC researchers analyzed over 13,000 leftover samples for the presence of bacteria from patients who were suspected of having tickborne illness. Twelve tickborne species of bacteria that cause illness in people were detected, including two not previously associated with human illness. This large-scale study involving researchers from the Minnesota Department of Health, Mayo Clinic, Tennessee Department of Health, and Vanderbilt University, showed that a single advanced molecular detection test can be used to:
- Detect tickborne bacterial pathogens in clinical samples
- Discover bacteria not previously associated with human infection, that are likely transmitted to humans by tick bite
- Identify tick-transmitted bacterial co-infections
- Understand which bacterial infections can cause symptoms that may be confused with tickborne diseases
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Key Points To Remember
- Most Lyme disease tests are designed to detect antibodies made by the body in response to infection.
- Antibodies can take several weeks to develop, so patients may test negative if infected only recently.
- Antibodies normally persist in the blood for months or even years after the infection is gone therefore, the test cannot be used to determine cure.
- Infection with other diseases, including some tickborne diseases, or some viral, bacterial, or autoimmune diseases, can result in false positive test results.
- Some tests give results for two types of antibody, IgM and IgG. Positive IgM results should be disregarded if the patient has been ill for more than 30 days.
The Psychological Symptoms Of Lyme Disease Can Sometimes Mimic Mental Disorders Which Can Lead To Misdiagnosis
During her dozen years as a mental health counselor, Christine Hammonds patients have visited her with a litany of troubling psychological symptoms: severe depression, anxiety, paranoia, delusions, hallucinations and even brief psychotic episodes.
But for some of these patients, the cause of their seemingly textbook mental issues isnt from an anomaly of brain chemistry or function, but from Lyme disease the most common vector-borne disease in the U.S.
The Centers for Disease Control and Prevention records about 30,000 cases of Lyme disease annually. Although the true number of infections commonly caused by the Borrelia burgdorferi bacteria may affect upwards of 475,000 people each year.
This number is far more than diseases like West Nile Virus, Dengue fever, and malaria, all which blood-feeding arthropods like mosquitoes, ticks and fleas spread. Lyme is acquired through the bite of blacklegged ticks also called deer ticks which carry the infecting bacteria.
Although typically the disease consists of skin rashes, fatigue, headaches and fever which antibiotics can treat in a couple weeks some patients develop wide-ranging physical and psychological symptoms that cause chronic impairment of normal functioning, long after the infection should be gone.
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Can Lyme Disease Be Prevented Or Avoided
The best way to prevent Lyme disease is to avoid being bitten by ticks. When you are outdoors, follow these guidelines:
- Avoid areas that are wooded, brushy, or have tall grass.
- Walk in the center of trails.
- Use an insect repellent with at least 20% DEET. It can be put on clothing or sparingly on the skin. Dont apply it to the face or hands of children.
- Treat clothing, tents, or other gear with repellents containing 0.5% permethrin.
- Wear light-colored clothing. This makes it easier to see and remove ticks from your clothes.
- Wear a long-sleeved shirt and long pants. Tuck your pant legs into your socks or boots for added protection.
After you get home, check everything and everyone for ticks.
- Bathe or shower as soon as you can to wash off any ticks that have not attached to you.
- Check your entire body for ticks. Use a mirror for places you cant see. Check your children and your pets. Common tick locations include the back of the knees, groin area, underarms, ears, scalp, and the back of the neck.
- Check any gear you used, including coats, backpacks, or tents.
Tumble dry clothes or blankets on high heat in the dryer for 10 to 15 minutes. This should kill any ticks. If clothes are dirty, wash them in hot water and dry on high heat for 60 minutes.