Common Tickborne Illnesses Scott Cohen, M.D., M.B.A., Medical - PowerPoint PPT Presentation

Chenango County Department of Public Health Spring Fever March h 6, 2020 Common Tickborne Illnesses Scott Cohen, M.D., M.B.A., Medical Director Chenango County Health Department

Tickborne Illnesses Goals/Objectives • To review the most common tickborne illnesses (admittedly only a small fraction arthropod borne diseases) • Typical presentation • Geographic distribution • Etiologic agent “The bug” • Treatment • We will leave time at the end for related questions AND discussion of other contemporary issues such as CoVID19 if there are concerns. 2

• Lyme disease ( Borrelia burgdorferi ) Leading Tickborne • Rocky Mountain spotted fever ( Rickettsia Diseases in the U.S. rickettsii ) Ehrlichiosis( Ehrlichiachaffeensis, others) • • Anaplasmosis( Anaplasmaphagocytophilum ) • Babesiosis( Babesiamicroti ) 3

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Distribution of Key Tickborne Diseases, 2014 Diseases are reported to CDC by county of residence. Each dot represents one case. The county where the disease was diagnosed is not necessarily the county where the disease was acquired. 5

3 Main Ticks of Public Health Concern Lone Star Tick Blackl cklegg egged ed (Deer) er) Tick American ican Dog (Wood) ood) Tick Ehrlichiosis Lyme disease Rocky Mountain Spotted Fever Tularemia Anaplasmosis Tularemia Heartland virus disease Babesiosis Bourbon virus disease Ehrlichiosis Southern Tick-Associated Rash Illness Powassan virus disease (STARI) Borrelia miyamotoi disease

Selected Tick Vectors Transmit pathogens that cause the following diseases: • Lyme disease • Anaplasmosis • Babesiosis • Powassan virus disease Borrelia miyamotoi disease • • Ehrlichiosis • Tularemia ’ • Rocky Mtn. Spotted Fever • Tularemia 7

Tick Life Stages

Blacklegged Tick Life Cycle

Blacklegged Tick Life Stages Nymph Larva Adult

Engorged Adult Female Blacklegged Tick

Questing What blackleg klegged ged ticks ks do do: • Search for a host from the tips of low-growing vegetation • Sense body chemicals and other cues from potential hosts • Climb onto a person or animal near ground level as they walk by What blackleg klegged ged ticks ks don’t do : • Jump • Fly • Fall from treetops • See

Other Tick Prevention Methods • Tumble dry clothing on high for ≥ 6 (dry) - 60 (wet) minutes • Keep lawn and trails mowed short • Remove leaf litter and brush • Create a barrier between your yard and woods • Talk with your vet about tick preventatives for your pets Image courtesy of Kirby Stafford, Connecticut Agricultural Experiment Station, New Haven

How to Remove a Tick

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Lyme Disease  Caused by spirochete Borrelia burgdorferi (and newly discovered Borrelia mayonii )  Occurs in areas of North America, Europe, and Asia. Approx 30,000 cased reported annually in US  Transmitted in US by blacklegged ticks 16 16

Erythema Migrans (EM) • 70-80% of cases •~7 -14 days after tick bite •Expands over days •Rarely painful •Distinguish from allergic reaction ADD A FOOTER 17 17

Atypical EM Presentations ADD A FOOTER 18 18

Disseminated and Late Lyme Disease Facial palsy Summer months May be bilateral Meningitis Arthritis Intermittent Oligoarticular Late-stage neurologic Peripheral neuropathy 19 19

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Questions? Tick Borne illess? Others i.e. Coronavirus COVID19? 36 36

THANK YOU! Scott Cohen, M.D., M.B.A. Chenango County Health Department Phone 607-337-1660 Email Scott.cohen@bassett.org