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June 08 Lyme Disease DuPage County Health Department CD REVIEW Volume 4, No. 6 June 2008 The purpose of this two-page surveillance update is to promote the control and prevention of communicable disease (CD) by providing clinically relevant information and resources to healthcare professionals in DuPage County. 111 North County Farm Road For questions or to report a suspect or Wheaton, IL 60187 known case of Lyme disease, please call the (630) 682-7400 Under the Microscope DuPage County Health Department at www.dupagehealth.org Lyme Disease (630) 682-7400, ext. 7553. Linda Kurzawa Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted to humans by the bite of an infected black-legged President, Board of Health tick (Ixodes scapularis, also known as the deer tick).1 The first clinical marker for the disease is usually a circular skin lesion (i.e., erythema migrans [EM]) that occurs in 70%-80% of patients at the site of a tick bite after an incubation period of 3-30 days.1 Maureen McHugh Typical symptoms include fever, headache, Executive Director fatigue, and EM. If left untreated, late manifes- Reported Cases of Lyme Disease by Month of Illness Onset tations can occur involving the joints (e.g., in DuPage County , 2003 - 2007 (n = 55) Rashmi Chugh, MD, MPH arthritis in one or a few joints), heart (e.g., acute 35 Medical Officer onset of atrioventricular conduction defects), 31 and nervous system (e.g., facial palsy).1 30 25 With approximately 20,000 new cases reported 20 Contact Information in the United States each year, Lyme disease is the most common vector-borne disease in the 15 9 Communicable Disease United States.2 Cases peak during summer 10 7 months, reflecting transmission by nymphal Number of Cases (630) 682-7400, ext. 7553 5 2 2 1 vector ticks during May and June.2 0 0 1 1 0 1 0 Environmental Health In a continuing effort to assess and monitor Jan. Feb Mar. Apr. May Jun. Jul. Aug. Sep. Oct Nov. Dec. (630) 682-7400, ext. 7046 Lyme disease risk in Illinois, public health Reported Month of Illness Onset officials have identified infected black-legged Immunizations ticks in several counties throughout Illinois, including DuPage County. The incidence of Lyme disease has overall increased (630) 682-7400 significantly over the past five years in Illinois, with a number of cases recently acquiring the infection within Illinois (without a history of travel to regions previously known to be endemic, e.g., Wisconsin).3 Sexually Lyme disease is diagnosed based on symptoms, objective physical findings (e.g., EM > 5 cm, facial palsy, or arthritis), and the Transmitted Diseases possibility of exposure to infected ticks (having been in wooded, brushy, or grassy areas, i.e., potential tick habitats, less than or equal (630) 682-7400, ext. 7575 to 30 days before onset of EM).1 Not all patients Reported Cases of Lyme Disease Reported Cases of Lyme Disease HIV/AIDS with Lyme disease will by Clinical Presentation by Late Manifestation (630) 682-7400, ext. 7310 develop the characteristic in DuPage County , 2003 - 2007 (n = 55) in DuPage County , 2003 - 2007 (n = 55) bull’s eye rash, and many Tuberculosis may not recall a tick bite; Nervous System history of a tick bite is (630) 682-7522 and Musculoskeletal not required.1 Validated 1 No EM laboratory tests can be No Late School Health 13 (2%) very helpful but are not Manifestation (630) 682-7400, ext. 7300 (24 %) Musculo- generally recommended skeletal 36 1,4 (65%) when a patient has EM. Travel Clinic 11 Laboratory testing is EM (630) 682-7400 (20%) not recommended for 42 persons who do not have (76%) Animal Care & Control Nervous System symptoms of Lyme 7 disease.1 (630) 407-2800 (13%) Most cases of Lyme disease can be treated successfully with a course of appropriate antimicrobial therapy.3,5 The peak months for tickborne diseases are during spring and early summer. Steps to prevent Lyme disease include using insect repellent containing DEET, light-colored, protective clothing, removing ticks promptly and Please contact appropriately, proper groundskeeping, and trimming vegetation.6 The ticks that transmit Lyme disease can occasionally transmit other Peggy Iverson, BS at tick-borne diseases as well (e.g., anaplasmosis).1 (630) 682-7400, ext. 7534 or [email protected] References: to send suggestions 1. www.cdc.gov/ncidod/dvbid/lyme/index.htm 4. www.cdc.gov/mmwr/preview/mmwrhtml/mm5405a6.htm or to be added to the 2. www.cdc.gov/mmwr/PDF/wk/mm5623.pdf 5. www.journals.uchicago.edu/doi/pdf/10.1086/508667 distribution list. 3. www.idph.state.il.us/health/infect/LymeDiseaseHlthProviderInfo.pdf 6. www.idph.state.il.us/public/hb/hblyme.htm “We promote health, prevent illness, and provide quality service.” www.dupagehealth.org DUPAGE COUNTY HEALTH DEPARTMENT CD REVIEW CASES1 OF REPORTABLE DISEASES* Volume 4, No. 6 June 2008 * Last updated by the Illinois Department of Public Health in March 2008 2008 2007 2006 2005 2004 Median DuPage County healthcare Report Jan - Jan - Jan - Jan - Jan - Jan - ('04- providers and hospitals Vaccine Preventable Diseases Within May May May Total May Total May Total May Total May '07) must Chickenpox (varicella) 24 hrs 25 108 108 177 139 252 156 232 197 286 139 242 report any suspected or Diphtheria 24 hrs 0 0 0 0 0 0 0 0 0 0 0 0 confirmed case of these Haemophilus influenzae, invasive 24 hrs 0 1 1 4 4 7 5 10 2 6 2 7 Hepatitis A 24 hrs 1 9 10 23 5 9 1 9 11 27 5 16 diseases to the local health Hepatitis B 7 days 0 0 3 6 1 5 2 6 6 8 2 6 authorities within the number of Hepatitis B (carriers) 7 days 6 57 70 156 71 139 52 147 69 146 69 147 hours or days indicated. Influenza, deaths in < 18 yrs old 7 days 0 0 NR NR NR NR NR NR NR NR -- -- Measles (rubeola) 24 hrs 10 10 0 0 0 0 0 0 0 0 0 0 Mumps 24 hrs 0 1 10 13 14 129 0 0 1 1 1 7 REPORTING NUMBERS: Neisseria meningitidis, invasive 24 hrs 0 2 0 1 2 2 2 4 1 1 1 2 Pertussis (whooping cough) 24 hrs 0 1 7 9 14 26 12 29 8 126 8 28 Poliomyelitis 24 hrs 0 0 0 0 0 0 0 0 0 0 0 0 Communicable Diseases Rubella 24 hrs 0 0 0 0 0 0 0 0 0 0 0 0 (630) 682-7400, ext. 7553 Streptococcus pneumoniae, invasive 24 hours: (630) 682-7400 disease, in those < 5 yrs old 7 days 0 0 3 7 5 8 6 9 3 7 3 8 Tetanus 7 days 0 0 0 0 0 0 0 0 0 0 0 0 Other Communicable Diseases Tuberculosis 2 Anaplasmosis 7 days 0 0 NR NR NR NR NR NR NR NR -- -- (630) 682-7400, ext. 7522 Anthrax 3 hrs 0 0 0 0 0 0 0 0 0 0 0 0 Botulism, foodborne 3 hrs 0 0 0 0 0 0 0 0 0 0 0 0 Botulism, other 24 hrs 0 0 1 1 0 0 0 0 0 0 0 0 STDs Brucellosis 3 hrs 0 0 0 0 0 0 0 0 0 0 0 0 3 (630) 682-7400, ext. 7575 California encephalitis 7 days 0 0 NR NR NR NR NR NR NR NR -- -- Cholera 24 hrs 0 0 0 0 0 0 0 0 0 0 0 0 Creutzfeldt-Jakob disease 7 days 0 0 NR NR NR NR NR NR NR NR -- -- HIV/AIDS: Cryptosporidiosis 7 days 0 0 1 4 0 9 0 3 2 2 0 4 (630) 682-7400, ext. 7310 Cyclosporiasis 7 days 0 0 0 0 0 0 1 2 23 23 0 1 Ehrlichiosis2 7 days 0 0 1 1 0 2 0 0 0 0 0 1 1 Enteric E. coli infections4 24 hrs 0 3 4 10 1 11 9 17 0 11 1 11 Provisional cases, based on date of onset Giardiasis 7 days 3 16 35 62 13 43 24 47 20 64 20 55 2 Glomerulonephritis5 24 hrs 0 0 0 0 0 0 0 0 0 0 0 0 Listed in CD Rules and Regulations under Hantavirus pulmonary syndrome 24 hrs 0 0 0 0 0 0 0 0 0 0 0 0 "Tickborne Disease" Hemolytic uremic syndrome 24 hrs 0 0 0 0 0 0 0 0 0 0 0 0 Hepatitis C (cases & carriers) 7 days 6 91 122 207 122 239 101 238 87 189 101 223 3 Listed in CD Rules and Regulations under Hepatitis D 7 days 0 0 NR NR NR NR NR NR NR NR -- -- "Arboviral Infections" Histoplasmosis 7 days 0 0 3 4 0 1 0 0 2 6 0 3 Influenza A, novel virus 3 hrs 0 0 NR NR NR NR NR NR NR NR -- -- 4 O157:H7, STEC, EIEC, ETEC, EPEC Legionellosis 7 days 0 1 2 9 4 8 3 4 1 5 2 7 Leprosy 7 days 0 0 0 0 0 1 0 0 0 0 0 0 5 Listed in CD Rules and Regulations under Leptospirosis 7 days 0 0 0 1 0 0 1 1 0 0 0 1 "Streptococcal infections, group A invasive Listeriosis 7 days 0 0 0 1 1 6 0 2 0 2 0 2 disease sequelae" Lyme disease2 7 days 0 0 1 16 0 10 2 12 2 9 1 11 Malaria 7 days 1 2 4 7 2 6 3 5 0 8 2 7 6 Q fever case in 2004 not related to any Ophthalmia neonatorum 7 days 0 0 0 0 0 0 0 0 0 0 0 0 suspected bioterrorism threat or event Plague 3 hrs 0 0 0 0 0 0 0 0 0 0 0 0 Psittacosis 7 days 0 0 0 0 0 0 0 0 0 0 0 0 7 Two or more laboratory-confirmed cases of Q fever6 3 hrs 0 0 0 0 0 0 0 0 0 1 0 0 community onset MRSA infection during a Rabies, human case 24 hrs 0 0 0 0 0 0 0 0 0 0 0 0 14 day period Rabies, potential exposure 24 hrs 2 3 10 34 13 27 9 24 4 18 9 26 Reye syndrome 7 days 0 0 0 0 0 0 0 0 0 0 0 0 8 Includes streptococcal toxic shock Rheumatic fever5 24 hrs 0 0 0 0 1 1 1 1 0 0 0 1 syndrome and necrotizing fasciitis Rocky Mountain spotted fever2 7 days 0 0 0 0 1 1 0 0 0 1 0 1 Salmonellosis 7 days 13 38 48 129 30 98 35 120 26 107 30 114 9 Due to Staphylococcus aureus Severe Acute Respiratory Syndrome 3 hrs 0 0 NR NR NR NR NR NR NR NR -- -- Shigellosis 7 days 1 10 4 17 7 26 10 35 0 15 4 22 10 Smallpox 3 hrs 0 0 0 0 0 0 0 0 0 0 0 0 HIV/AIDS data are provided quarterly by Smallpox vaccination, complications 24 hrs 0 0 NR NR NR NR NR NR NR NR -- -- IDPH and are provisional, based on date of St.
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