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.
What’s The Treatment For Later
There are a few options to treat the joint pain and swelling associated with Lyme disease. Pain-relievers and anti-inflammatories â such as ibuprofen â can help relieve symptoms. An in-office procedure called arthrocentesis can be used to withdraw fluid from swollen joints. Rarely, arthritis persists after antibiotic treatment. Some scientists believe that chronic joint inflammation can be triggered by the infection even after the successful elimination of Lyme bacteria.
Can Lymes Disease Affect Your Spine
Picture source: hamptonpt.com
Yes, Lyme disease can affect your spine. Lyme disease is caused by a bacteria called Borrelia burgdorferi, and it is transmitted to humans through the bite of an infected tick. Lyme disease can cause a number of symptoms, including joint pain, weakness, and paralysis. If Lyme disease is not treated, it can cause serious problems, including problems with the nervous system. Lyme disease can affect the spine by causing inflammation of the spinal cord or by causing the bones of the spine to deteriorate.
The disease causes neck pain in approximately 30% of patients. Babesia and Bartonella, as well as other co-infections, are frequently found in addition to Lyme disease. One of the first symptoms that some patients with Lyme disease experience is a stiff neck. When Lyme disease strikes, it can cause meningitis, an inflammation of the protective tissues covering the brain and spinal cord. Antibiotics are usually effective in treating Lyme disease and its co-infections, but serious symptoms may develop and become chronic. Long-term treatment of Lyme disease, Bartonella, and other infections is not well understood by the medical community.
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What Happens At Your Appointment
The GP will ask about your symptoms and consider any rash or recent tick bites you know about.
Lyme disease can be difficult to diagnose. It has similar symptoms to other conditions and there’s not always an obvious rash.
2 types of blood test are available to help confirm or rule out Lyme disease. But these tests are not always accurate in the early stages of the disease.
You may need to be retested if you still have Lyme disease symptoms after a negative result.
In Order To Correctly Diagnose An Em Rash The Following Characteristics Are Key Considerations:
- An EM rash typically appears after the third day of infection and according to information on the NHS website, can take up to three months to appear .
- An EM rash will most often appear at the site of the bite and will grow outwards as it progresses. We always advise to draw around the rash with a biro each day to monitor the changing size.
- An EM rash isnt usually hot, itchy or raised but some patients have reported experiencing these things.
- An EM rash wont normally respond to antihistamines or antifungal cream.
- Its not unheard of to present with multiple EM rashes across the body, even if you were only bitten once.
- An EM rash wont always have a central clearing, and may have a central blister.
- An EM rash is often circular or oval, but may also appear blotchy.
- An EM rash can be red, blue and/or purple, and sometimes a yellowing colour can appear, though this may not be the case for people with darker skin tones. Read this blog from Dr Z Husain Skin Colour, Medical Education and Erythema Migrans Room for Improvement for more information about skin colour and the EM rash.
The following images and information are available to download from the NICE Lyme disease tools and resources section and detail ten different types of the EM rash. Click on the images to enlarge them.
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Rocky Mountain Spotted Fever Rash
Lyme disease and STARI arent the only tick-borne infections that can cause a rash. For example, Rocky Mountain spotted fever causes some type of rash in about 90% of infected people. Although less than 50% of people display a rash during the first three days post-infection, sometimes making diagnosis difficult.
A typical early RMSF rash involves small, pink, flat lesions on the ankles, forearms, wrists, and occasionally on the soles of feet and the palms of the hands. In severe cases, a petechial rash may develop around days 5-6 of the illness. This rash is more widespread with red to purple spots. Those infected should take all possible steps to prevent the progression of the disease from reaching this stage.
RMSF can cause serious long-term side effects and is potentially fatal, and its vital to know other potential symptoms, including nausea and vomiting, a loss of appetite, and headache.
Telehealth Rash Consultation Services
Tick bite and Lyme disease rash consultation* is available by telemedicine appointment at the Johns Hopkins Lyme Disease Research Center. A telehealth visit requires the ability to digitally photograph the patients skin rash for the evaluation and to meet certain State insurance parameters.
* Only available currently to patients in Maryland, Pennsylvania, Virginia, and Delaware.
If you are experiencing flu-like symptoms, please seek the advice of a healthcare practitioner.
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Signs And Symptoms Of Untreated Lyme Disease
Seek medical attention if you observe any of these symptoms and have had a tick bite, live in an area known for Lyme disease, or have recently traveled to an area where Lyme disease occurs.
Untreated Lyme disease can produce a wide range of symptoms, depending on the stage of infection. These include fever, rash, facial paralysis, and arthritis.
The appearance of the erythema migrans rash can vary widely.
- Fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes may occur in the absence of rash
- Erythema migrans rash :
- Occurs in approximately 70 to 80 percent of infected persons
- Begins at the site of a tick bite after a delay of 3 to 30 days
- Expands gradually over several days reaching up to 12 inches or more across
- May feel warm to the touch but is rarely itchy or painful
- Sometimes clears as it enlarges, resulting in a target or bulls-eye appearance
- May appear on any area of the body
- Does not always appear as a classic erythema migrans rash
Swollen Knee
- Severe headaches and neck stiffness
- Additional EM rashes on other areas of the body
- Arthritis with severe joint pain and swelling, particularly the knees and other large joints.
- Intermittent pain in tendons, muscles, joints, and bones
- Heart palpitations or an irregular heart beat
- Episodes of dizziness or shortness of breath
- Inflammation of the brain and spinal cord
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Diagnosis Of Lyme Disease
Diagnosis is currently based on clinical findings supported by several types of laboratory tests. One type of test seeks to isolate the actual organism from the EM skin lesion, blood, joints, and cerebrospinal fluid. Other types of tests attempt to detect antibodies formed by the patients immune system against the organism. Currently, serology tests are poorly standardized and physicians must interpret them with caution. They are insensitive during the first several weeks of infection and may remain negative in people treated early with antibiotics. Test sensitivity increases when patients progress to later stages of the disease, but a small proportion of Lyme disease patients never develop a positive blood test result. Another complicating factor is that there can be a cross-reaction in the blood test, giving a false positive result for Lyme disease in persons who really have conditions such as syphilis, Rocky Mountain spotted fever, human immunodeficiency virus infection, infectious mononucleosis, lupus or rheumatoid arthritis. Although present diagnostics are not perfect, great strides have been made in the past twenty years. More sensitive and specific tests for Lyme disease are being developed.
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What Causes Erythema Migrans
Erythema Migrans is often the first sign of Lyme disease. Lyme disease is caused by the bacteria Borrelia burgdorferi. The bacteria are transmitted to humans through infected deer ticks. Dog ticks and wood ticks don’t transmit Lyme disease. The Centers for Disease Control and Prevention estimates that there are 300,000 cases of Lyme disease each year, though the actual number reported is much lower.
Can Lyme Disease Affect Your Spine
Lyme disease is a bacterial infection that is transmitted to humans through the bite of an infected tick. Lyme disease can affect many different parts of the body, including the spine. Lyme disease can cause a wide range of symptoms, including severe joint pain, muscle weakness, and paralysis. Lyme disease can be difficult to diagnose, and it can be difficult to treat. Lyme disease is a serious infection, and it can be fatal if it is not treated properly.
This condition, also known as spinal cord dysfunction, is sometimes accompanied by elevated levels of blood immunoglobulins and IgM antibodies against Borrelia burgdorferi in the cerebrospinal fluid . It is possible to recover completely by treating the patient with antibiotics and steroids early in the treatment process. It is located in the southern state of New Mexico. I wrote this article to present the results of an acute transverse myelitis study in a child with Lyme disease and to review literature. In Pediatr Neurol, Erol I, Klarslan B, Saygi S, and Demir S. The article appears in the April 2013 issue of The Journal of Agriculture. Chhabda S., Malik P. Reddy N., Muthusamy K. Mirsky D. Sudhakar S., Mankad K., and others were cited.
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How To Prevent Lyme Disease
The deer ticks that carry the bacteria that transmit Lyme disease are most prevalent in New England, the mid-Atlantic states, and the upper Midwest of the United States. They live in moist and woody environments. If you’re going to be in an area like this, use an insect repellent that contains DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. You should also:
- Check your body for ticks after being outside.
- Check your clothing and pets for ticks.
- Place clothes in a dryer on high heat to kill ticks.
- Remove attached ticks with tweezers as soon as you notice them.
- Watch for symptoms of Lyme disease after you remove a tick.
- Contact your healthcare provider if you develop a fever or rash, even if you don’t remember being bitten.
- Treat your animals using veterinarian-prescribed tick prevention products to keep them from bringing ticks into your house.
- Discourage deer from coming into your yard by removing plants that attract them and putting up fences.
- Create a tick-safe zone in your yard by using chemical control agents and keeping the area clean of yard debris.
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How Is Lyme Disease Treated
Antibiotics, usually doxycycline or amoxicillin, are effective treatments for Lyme disease. How long your treatment lasts depends on the stage of infection. In general, its true that the sooner youre treated, the quicker and more complete the recovery.
Pregnant people should receive treatment for Lyme disease as well. There is, however, no evidence that a fetus can get the infection from its parent. Theres also no strong evidence that miscarriages are more likely after Lyme disease.
What should I do if a tick bites me?
If a tick bites you, the best way to remove it is by taking the following steps:
- Tug gently but firmly with blunt tweezers near the “head” of the tick at the level of your skin until it releases its hold on your skin.
- Avoid crushing the tick’s body or handling the tick with bare fingers because you could expose yourself to the bacteria in the tick.
- Wash the bite area thoroughly with soap and water.
- Don’t use kerosene, petroleum jelly or hot cigarette butts to remove the tick.
- Don’t squeeze the tick’s body with your fingers or tweezers.
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How Does Lyme Disease Affect The Body
The bacteria have a unique ability to evade the human immune system and can survive in the body even when aggressive treatment is used. This can lead to a systemic reaction called the Jarisch-Herxheimer reaction, where the patients immune system triggers an inflammatory response all over the body because of the antibiotic treatment. This can lead to the worsening of current symptoms and the development of new ones.
In some cases, patients may also get Lyme disease coinfections, which are becoming more common. Coinfection occurs when a person is infected with more than one infection at the same time. Symptoms of these infections can overlap with those of Lyme disease, complicating the diagnosis and treatment. Coinfection can result in more severe infection, more symptoms, and a longer recovery time.
Lyme disease can also affect the thyroid system, which is a well-known cause of alopecia, or hair loss. Alopecia areata is an autoimmune disorder that occurs when the immune system attacks hair follicles and causes hair loss. This can result in patchy hair loss on the scalp, beard area, eyebrows, and eyelashes, and may also affect other parts of the body. Hair loss may be confined to one side, and hair fall and growth may occur simultaneously in various parts of the body. It can affect anyone, regardless of age or gender.
The frequency of hair loss in patients with Lyme disease has not been well studied, but there are several theories.
What Are The Subtypes Of Lyme Disease
There are different types of Borrelia in each continent resulting in various forms of Lyme disease in North America and Europe.
In North America, the infection is due to the subspecies B. burgdorferi sensu stricto and most often presents as:
- Erythema migrans
In Europe, Lyme disease is due to the subspecies B. burgdorferi sensu stricto, B. afzelii and B. garinii, and most often presents as:
- Erythema migrans
- Acrodermatitis chronica atrophicans
- Lyme neuroborreliosis.
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Is There A Cure For Lyme Disease
Antibiotics can cure Lyme disease. Different stages of disease may be treated with different antibiotics. Treatment choices also depend on the areas of the body involved. Oral amoxicillin , cefuroxime axetil , and doxycycline are often used to treat the early stages of Lyme disease. A bull’s-eye skin rash after a tick bite is a reason to see the doctor urgently for treatment. The rash typically resolves in about 1 or 2 weeks with antibiotic treatment. Intravenous medications such as ceftriaxone may be necessary to treat later stages of Lyme disease.
Lyme Disease And Spinal Degeneration
Lyme disease is caused by a bacterium called Borrelia burgdorferi, and is transmitted to humans through the bite of an infected tick. Lyme disease can cause a wide range of symptoms, including fever, headache, fatigue, and a characteristic bullâs-eye rash. If left untreated, Lyme disease can spread to the joints, heart, and nervous system and cause more serious problems. Spinal degeneration is a condition in which the bones of the spine deteriorate and break down. This can lead to a number of problems, including pain, numbness, and weakness. Spinal degeneration is often caused by age, wear and tear, or injury.
This is a digitized version of a print article from The Timesâ archive, prior to its online debut in 1996. On February 15, 1995, Section C, Page 8 contains a corrected version of the article. A young woman is one of dozens of people who have reported psychiatric and neurological issues as a result of Lyme spirochete. It is a bacterium that can infect the brain and spinal cord, and it is similar to the organism that causes syphilis. Memory problems are one of the most common symptoms of a brain infection. People suffering from schizophrenia and other psychiatric disorders can develop hallucinations, paranoia, manic depression, seizures, and dementia as a result of Lyme disease. Dr. Brian Fallon, who wrote a paper for The American Journal of Psychiatry, looked at the neurological aspects of Lyme disease.
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Life Cycle Of B Burgdorferi
The primary vector of Lyme disease in the northeastern and north central United States is the deer tick, Ixodes scapularis. The primary vector in the Pacific coastal area of the country is I.pacificus. Ticks go through four stages in their development , and B. burgdorferi is maintained in ticks as they pass from one stage to the next. When an infected tick bites a human or certain animals , the infectious agent can be transmitted, resulting in disease. Wild rodents and deer are part of the natural life cycle of B. burgdorferi. Infected larval and nymphal ticks feed on small mammals while adult ticks feed on deer. The explosive repopulation of white-tailed deer in parts of the United States has been linked to the spread of Lyme disease. The majority of human Lyme disease cases result from bites by infected nymphs. At this stage the tick is small, less easily detected, and less likely to be promptly removed, which increases the possibility that it will transmit disease. Dogs, cattle, and horses develop disease that may include the joint and heart complications seen in humans. A vaccine is available for dogs, which in addition to protecting them, has a beneficial public health impact by decreasing the proximity of this disease to people. There is no evidence that Lyme disease has been transmitted directly from animal-to-animal, animal-to-human, or human-to-human.