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CZVBD : lyme-disease

Zoonotic Disease

Lyme disease is the most common tick-borne disease in Maryland and in the United States.

    Maryland Get Ticked Off
  • Lyme disease is caused by the bacterium Borrelia burgdorferi.
  • Lyme disease is transmitted by the bite of an infected black-legged tick (sometimes called a deer tick). The tick must be attached for at least 24 hours for transmission to occur.
  • From 3-30 days after a tick bite, a gradually expanding rash can occur at the site of the bite in 70-80% of infected people. The rash can expand over several days to up to 12 inches and may resemble a bull’s eye.
  • Other symptoms may include fever, headache and fatigue. If untreated, Lyme disease may progress to involve joints, the nervous system, and the cardiac system.
  • Contact your health care provider if you develop any of these symptoms after a tick bite or after being in tick habitat.
  • Most cases of tick-borne disease can be cured with antibiotics, especially when treatment is started early.
  • To prevent Lyme disease:

    • Look for ticks when they are most active in late spring through early fall.
    • Wear long pants and long sleeves, to help keep ticks off your body.
    • Tuck shirts into pants, and pants into socks, to keep ticks on the outside of clothing.
    • Wear light colored clothing to help spot ticks more easily.
    • Use insect repellent, such as DEET, according to the product label.
    • When hiking, walk in the center of the trail when in woods or high grass.  Stay away from brushy areas, high grass and leaf litter.
    • Check for ticks daily after being in tick habitat.
    • Talk to your veterinarian about tick control products for pets.

    To Treat Lyme Disease:

    • The Infectious Disease Society of America has published science-based guidelines for the treatment of Lyme.
    • In most cases, 2-4 weeks of antibiotic therapy cures an infection with the Lyme disease bacterium.
    • After being treated for Lyme disease, some patients still report non-specific symptoms and may be diagnosed with post-treatment Lyme disease syndrome.
    • Multiple controlled clinical trials have found no lasting benefit of prolonged antibiotic treatment for patients with chronic symptoms.
    • In addition, months of antibiotic use can cause serious - potentially fatal - side effects, and increase the risk of antibiotic-resistant infections.

    Click here for Lyme Disease Factsheet

    FOR HEALTHCARE AND PUBLIC HEALTH PROFESSIONALS

    Antibiotic Treatment

    Patients treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. In most cases, 2-4 weeks of antibiotic therapy cures an infection with the Lyme disease bacterium. Patients with certain manifestations, including neurological or cardiac forms of illness, may require intravenous antibiotic treatment.

    After being treated for Lyme disease, some patients still report non-specific symptoms, including persistent pain, fatigue, impaired cognitive function, or unexplained numbness. These patients often show no evidence of active infections and may be diagnosed with post-treatment Lyme disease syndrome (PLDS). In patients with PLDS, multiple controlled trials have shown that prolonged antibiotic therapy is not beneficial and the risks outweigh the benefits.

    The Infectious Disease Society of America has published science-based guidelines for the treatment of Lyme.

    Lyme Disease Continuing Medical Education for Clinicians

    As a service to clinicians, CDC has supported the development of an online CME Case Study Course on the Clinical Assessment, Treatment, and Prevention of Lyme Disease.  This free, interactive course consists of a series of case studies designed to educate clinicians regarding the proper diagnosis and treatment of Lyme disease. Each case is accredited for .25 CME credits, for a maximum of 1.5 CME. There is no cost for these credits.

    Reporting

    Click here to learn about reporting Lyme disease and other diseases 

    Case Definitions for Infectious Conditions

    Like other reportable communicable diseases listed in COMAR 10.06.01.03, health care providers, hospitals and laboratory directors are required to report diagnosed or suspected cases of Lyme disease to the health officer or commissioner in the county where the provider cares for that person.

    EDUCATIONAL MATERIALS

    Video Podcast

    DHMH and National Park Service Collaboration: Greenbelt Park Ticks and Lyme Disease Information

    Erythema Migrans Poster - Looking for a bull's eye rash? Look again - erythema migrans can take many forms

    Brochures

    Proper Removal of Ticks

    It is very important to remove ticks properly. Mark your calendar on the date when a tick is taken off your body.  This information will be useful to your doctor.

    Figure: Proper Removal of Ticks  
    [Courtesy of CDC]

    Remove a tick from your skin as soon as you notice it. Use fine-tipped tweezers to firmly grasp the tick very close to your skin. With a steady motion, pull the tick’s body away from your skin. Then clean your skin with soap and warm water. Throw the dead tick away with your household trash.

    Avoid crushing the tick’s body. Do not be alarmed if the tick’s mouthparts remain in the skin. Once the mouthparts are removed from the rest of the tick, it can no longer transmit the Lyme disease bacteria. If you accidentally crush the tick, clean your skin with soap and warm water or alcohol.Don’t use petroleum jelly, a hot match, nail polish, or other products to remove a tick.


    Pet Protection. Household pets may carry ticks inside the home.

    • Talk to your veterinarian about tick control products.
    • Try to prevent pets from going into areas infested with ticks (woods, fields).
    • Brush loose ticks off before letting pets into the house.
    • Remove all ticks in the same way you would from yourself.

    Healthy Pets Healthy People CDC Lyme Disease and Animals

    KidsHealth Lyme Disease for Kids page

    Residential Property Management If your home borders wooded, brushy areas, implement one or more of the following landscaping strategies to reduce tick density:

    • Keep the grass in your yard cut short.
    • Remove leaves and leaf litter.
    • Clear brush from the yard.
    • Create dessicating barriers by placing wood chips where lawns abut forest or dense vegetation.
    • Consider the use of acaricide (tick-killing chemicals, like carbaryl cyfluthrin or deltamethrin) in early May to reduce ticks around the property.  Consult a certified pest control professional.
    • Consider excluding or removing deer.

    Tick Management Handbook

    An integrated guide for homeowners, pest control operators, and public health officials for the prevention of tick-associated disease. Click here.

    "Tommy’s Tick Tips. Know the risks. Avoid the ticks.”

    DATA STATISTICS

    Reported cases of Lyme disease in Maryland:

    Lyme Disease Reports 2000-2012
    Lyme Disease Reports 1990-1999.pdf

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