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Tickborne Disease EpidemiologyFairfax County
Fairfax County, VA, May 30, 2015
Shawn Kiernan District Epidemiologist
Fairfax County Health Department
All Public Health is Local
• Nearly 3,000 local health departments in the U.S.– Governmental entities of towns, cities, counties,
and/or districts
7%
11%
82%
cities
towns ortownships
county or county-relatedjurisdictions
Public Health Core Functions
• Protect against environmental hazards • Prevent injuries • Promote and encourage healthy behaviors• Assure the quality and accessibility of health
services • Respond to disasters and assist communities
in recovery • Prevent epidemics and the spread of disease
Surveillance
Over 70 diseases on the Virginia Reportable Disease List– Physicians and directors of medical care facilities – Laboratories – Other facilities (e.g. nursing homes, day cares)– Includes bioterrorism agents, suspected outbreaks
of any disease, and diseases of public health concern
Vector-borne Transmission• Vector-borne transmission is the term commonly used to describe an illness caused by an
infectious disease that is transmitted to people by blood-sucking arthropods. • The arthropods (insects or arachnids) that most commonly serve as vectors include:
mosquitoes, fleas, lice, biting flies and bugs, mites, and ticks. • Vectors typically become infected by a disease agent while feeding on infected
vertebrates (e.g., birds, rodents, other larger animals, or humans), and then pass on the microbe to a susceptible person or other animal.
• In almost all cases, an infectious microbe must infect and multiply inside the arthropod before the arthropod is able to transmit the disease through its salivary glands. The most common vector-borne diseases in Virginia are carried by mosquitoes and ticks.
Lyme Disease
• 1975- Mysterious cases of rheumatoid arthritis in children living in Lyme, CT
• Symptoms increased during summer, and the children lived and played in wooded areas– Children often recalled having a skin rash prior to arthritis– Researchers suspected deer ticks to be vector
• (1982) Dr. Willy Burgdorfer, a zoologist and microbiologist, discovers the bacterium that causes Lyme disease, Borrelia burgdorferi
Dr. Burgdorfer / Source: NIAID/RML
Reported cases of tickborne disease, Fairfax County 2004-2013
Disease 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013
5 year average (2008-2012)
Ehrlichiosis/Anaplasmosis 0 2 2 2 11 1 7 17 6 11 8.4
Lyme disease 1 10 102 208 191 260 256 146 149 260 200.4
Spotted fever rickettsiosis 7 8 11 5 9 6 11 20 26 23 14.4
Treatment and Outcome
• Lyme disease is treated with antibiotics
• Recommended regimens range from 2-4 weeks, by pill or intravenously, depending on stage of illness
• Most patients treated with antibiotics recover completely
• A few patients, particularly those diagnosed with later stages of disease may have persistent symptoms