Tick-Associated Diseases: Symptoms, Treatment and Prevention

By Anderson, Alice; Chaney, Elizabeth | American Journal of Health Education, May-June 2009 | Go to article overview

Tick-Associated Diseases: Symptoms, Treatment and Prevention


Anderson, Alice, Chaney, Elizabeth, American Journal of Health Education


ABSTRACT

According to the Centers for Disease Control and Prevention (CDC), there are eleven tick-associated diseases prevalent in the United States. Most commonly diagnosed are Lyme disease, anaplasmosis (ehrlichiosis) and babeisois, with Lyme disease being the most common vector-borne disease in the country. In southeastern states, studies have shown the prevalence of southern tick-associated rash illness (STARI), which is similar to Lyme disease. Healthy People 2010's 14-8 objective is to reduce Lyme disease, with a "44 percent improvement" by the year 2010. A key component for success of this objective is to provide the public with important information that can yield early detection or prevention against tick-associated disease, such as Lyme disease. Additionally, awareness of signs, symptoms and how to protect oneself from tick-borne illnesses is critical for individuals living in regions where these diseases are most prevalent. Therefore, the purpose of this paper is twofold: (1) to convey the signs, symptoms, and clinical tests for early detection of Lyme disease and STARI, and (2) to provide guidelines and discussion of some treatment controversies for health educators to utilize in educating the public on personal protection against tick-associated illnesses.

INTRODUCTION

According to the Centers for Disease Control and Prevention (CDC), (1) there are 11 tick-associated diseases prevalent in the United States. The most commonly diagnosed diseases are Lyme disease, anaplasmosis (ehrlichiosis) and babeisois, with Lyme disease being the most common vector-borne disease in the country. In 2007, 27,444 cases of Lyme disease were reported, which resulted in a national average of 9.1 cases per 100,000 persons. The states with the most reported cases are Connecticut (incidence rate = 87.3), Delaware (incidence rate = 82.7), New Hampshire (incidence rate = 68.1), Massachusetts (incidence rate = 46.3) and Maryland (incidence rate = 45.8). (2) Approximately 20,000 new cases are reported every year, and the northeastern, north central, and Mid-Atlantic states continue to exceed the average reported number. (3) In the southeastern states, studies have shown the prevalence of a condition known as southern tick-associated rash illness (STARI), which is similar to Lyme disease. (4) Additionally, recent reports have shown an increasing number of Ixodid ticks in the Midwest and in extreme northeastern states. (5) Although these states are most notably the ones with the higher incidence rates of Lyme disease and STARI, individuals residing in all states should be aware of and know how to protect themselves from these diseases.

Bloodstream infections, such as Lyme disease and other tick-borne illnesses, significantly impact the direct and indirect costs of health care. According to cost data presented by Healthy People 2010, these infections add approximately $3,517 to hospital bills for the infected patient. For Lyme disease cases, if the illness is diagnosed in the early stages, it amounts to about $174 in direct costs for medical treatment. However, with a delayed diagnosis of the illness, costs incurred can range from $2,228 to $6,724 per patient, in the first year of treatment. (6) Clearly, an early diagnosis is essential, for many reasons, but in a time when health care costs are soaring for most Americans, it is critical for individuals to understand how to recognize the signs and symptoms of these tick-associated diseases.

Lyme disease is a multisystem disorder, "caused by the spirochete Borrelia burgdorferi and is transmitted to humans by the bite of infected blacldegged ticks." (3(p.573)) Symptoms of the disease can range from fever to sustained heart and nervous system problems. STARI, on the other hand, is similar to Lyme disease, and has been linked to bites from Amblyomma americanum (lone star) ticks living in southeastern states, but researchers have failed to provide evidence that STARI is more than a self-limiting skin condition. …

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