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Lymes on the rise. The Increase of Lymes in Minnesota A local family physician inquiring about Lymes disease. Physician noted an increase of patients

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  • Slide 1
  • Lymes on the rise
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  • The Increase of Lymes in Minnesota A local family physician inquiring about Lymes disease. Physician noted an increase of patients experiencing ring shaped rashes, headaches, and fever chills which point to Lymes. Rigid diagnosis was not made as conformation requires an diagnostic assay. The physician expressed concern that the Minnesota Department of Natural Resources maybe inaccurate. Duluth area people might need to be better informed before planning outdoor activities.
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  • symptomology
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  • Contracting Lymes Disease The bite of an infected nymph or adult tick can only transmit Lyme disease after it attaches to the host for 36 48 hours the generation time of B. Burgdorferi: ~ 12 hours Spirochetes waiting in the mid-gut of the tick begin to multiply as the tick starts its blood meal then migrate to the salivary glands where they are discharged into the host with the tick's saliva. It takes several hours before a large enough infectious dose of spirochetes can penetrate the new host. Most incidences of Lyme disease occur from May through September because the nymphal stage of the tick is responsible for most cases They are too small to be easily detectable Their bites cause much milder pain than an adult tick.
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  • Lymes Disease
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  • Symptomology of Lymes Disease Lyme is a multisystem inflammatory disease affects the skin in the early stage and then spreads to the joints, nervous system and may eventually affect the organ systems. The symptoms are divided into three stages, each stage being more advanced than the previous.
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  • Symptomology Stage 1 Early localized infection Skin Rash Around Tick Bite (75%) Mild Illness Flu-like Symptoms Fevers Chills Swollen Lymph Nodes Headache Stiff Neck Muscle Fatigue Initial sign and symptoms of Lyme disease include an appearance of a rash, which has the appearance of being solid red or bulls eye rash with flu like symptoms. These symptoms may appear up to a month after infection.
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  • Symptomology Stage 2 Early Disseminated Infection Neurological Problems Meningitis Encephalitis Within weeks of stage one symptoms, the bacterium may spread to other parts of the body through the bloodstream. infected individuals may start having acute neurological problems such as Bell's Palsy. *15% of untreated patients progress to this stage. Meningitis, as well as mild Encephalitis is common at this stage, leading to memory loss, sleep disturbances, or changes in mood or affect.
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  • Symptomology Stage 3 Late Persistent Infection Polyneuropathy Pain and Numbness Cognitive Impairment Arthritis Acrodermatitis chronica atrophicans (primarily in Europe) The third and the most severe stage may occur months to years after initial infection. Symptoms at this stage are primarily rheumatologic and neurologic, and mostly untreatable.
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  • Resources: http://www.nature.com/nrmicro/journal/v3/n2/full/nrmicro1086.html
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  • 3 stages of Lyme Disease
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  • Stage 1: Early Localized (previous slides) Stage 2: Early Disseminated Weeks to Months Affects skin, joints, nervous system, heart Stage 3: Late Persistent Months to Years Damage to joints, nerves, brain
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  • Stage 3 Also Known as: Post-Lyme Disease Syndrome Chronic Lyme Disease Occurs 6 months after treatment
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  • Possible Cause If antibiotics are not received quickly, then the body may build up antibodies to B. b. These antibodies may later attack healthy tissues. Multiple studies hint at the autoimmune process behind Lyme Disease but nothing is known.
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  • Diagnosis Clinical Evidence Enzyme Linked Immunosorbent Assay Western Blotting Indirect Immunofluorescence Detect antibodies Lack s sensitivity and specificity PCR
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  • Treatment Short Term Treatment Amoxicillin Probenecid Ceftriaxone Doxycycline Tetracycline Chronic Antibiotics Penicillin Erythromycin Tetracyline
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  • Our tick collection methods Materials: Light-colored bed sheet Hand held GPS devices Sealable plastic containers Materials: Light-colored bed sheet Hand held GPS devices Sealable plastic containers Methods: We began by stopping at the banks of pre-selected locations listed in the GPS. We separated into groups of about two and while holding the sheet open, we swept the ground. After dragging for 100 yards we examined the sheet in hopes of finding black-legged ticks. Methods: We began by stopping at the banks of pre-selected locations listed in the GPS. We separated into groups of about two and while holding the sheet open, we swept the ground. After dragging for 100 yards we examined the sheet in hopes of finding black-legged ticks.
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  • Our Results We continued collecting over two days for a total of eight stops. We found six ticks. Some observations were made about the general environment in which the ticks were found, however, very little information was recorded. All of the ticks found were in their nymph stage and were not much larger than the point of a pencil. Our sampling was done during the mid summer season rather than the late spring or fall, this may be why so few ticks were collected. We continued collecting over two days for a total of eight stops. We found six ticks. Some observations were made about the general environment in which the ticks were found, however, very little information was recorded. All of the ticks found were in their nymph stage and were not much larger than the point of a pencil. Our sampling was done during the mid summer season rather than the late spring or fall, this may be why so few ticks were collected.
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  • Project title Michael Cherry| Dr. Ben Clarke| Bridges and Pathways Program 2010
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  • Tick Collection What criteria and procedures should be used when collecting ticks in the wild?
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  • Project Overview Where ticks are located Survey techniques should be consistent Use of standardized equipment Integrity of Data Collection Criteria and methods of recording
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  • Where are ticks located in the midwest? Near or in deciduous forests Dry to mesic (moderate moisture) forests Alfisol-type soils of sandy or loam-sand textures overlying sedimentary rock Along ecotones (boundaries between varying ecosystems)
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  • Alfisol Soils Alfisols are a soil order in USDA soil taxonomy. Alfisols form in semiarid to humid areas, typically under a hardwood forest cover. They have a clay- enriched subsoil and relatively high native fertility. "Alf" refers to Aluminium (Al) and Iron (Fe).USDA soil taxonomyhardwood Alfisol from East Tennessee. http://www.uamont.edu/facultyweb/francis/soilprofiles/soilprofilepage.htm
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  • Where are ticks not located in the midwest? Near coniferous forests Grasslands Wet and very damp forests Acidic soils of low fertility and a clay soil texture Precambrian bedrock
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  • Construction of dragging equipment 70 x 90cm piece of light-colored corduroy 1cm diameter wooden dowel along leading edge Steel rod sewn into trailing edge for added weight Rope or wood handle to allow front edge of sheet to contact vegetation
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  • Collection Techniques from Schulze/jordan Same individual should perform the dragging for consistency Speed, height Collected hourly from 0600 2100 hours 100m long transects, collect every 10m to prevent ticks from falling off Ramdomize dragging order, direction of travel, location within each transect (left, right, center) to minimize repeated dragging of same areas Minimize dew collection by drying on running pickup truck hood To minimize effects of moisture on tick collection
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  • Statistics For each sampling event (each hour) (use of Weather Station): Ambient Temperature Ambient Humidity Place Weather Station in center of area, 1m above vegetation height Litter temperature and humidity (digital thermometer) At least 2.5cm below leaf litter surface but not into the soil
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  • Statistical analysis Use of repeated measures of analysis of variance Use of multiple linear regression to examine relationships Use separate regressions for each species Tolerance value of 0.1 is acceptable Calculate temp gradient: subtract hourly litter temp from ambient Calculate humidity gradient: subtract litter H from ambient H Use Pearson correlation and linear regression to determine relationships between calculated gradients and numbers of questing ticks
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  • Conclusion Consistency regarding the gathering of ticks and in measuring and recording statistics are critical to success
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  • Works Cited Meteorologically Mediated Diurnal Questing of Ixodes Scapularis and Amblyomma Americanum Nymphs Terry Schulze and Robert Jordan Journal of Medical Entomology (2003) Distribution of the Common Tick, Ixodes ricinus, in different vegetation types in Southern Sweden Anders Lindstrom and Thomas Jaenson, Journal of Medical Entomology (2003)
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  • Possible Outcomes o Lymes disease occurances have been on the rise in the US partially due to climate