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Lyme Disease Cases Continue to Increase Throughout Region

Sunday, May 12, 2019 @ 12:05 AM

Posted by Aly Delp

Erythema migrans (EM) or bull's-eye rash. Courtesy CDCCLARION CO., Pa. (EYT) – With the highest number of cases in the nation since 2000, the continuing rise in Lyme Disease is a serious concern in Pennsylvania.

(Photo courtesy Centers for Disease Control and Prevention)

According to data from the Pennsylvania State Department of Health, Lyme Disease continues to be a growing problem through much of Pennsylvania.

As of the most recent statistics gathered, from 2017, Clarion County has one of the highest incidence rates in the region at a rate of 323.38 per 100,000 people. Locally, only Jefferson County has a higher rate, at 658.00 per 100,000.

A map provided by the State Department of Health shows that Clarion County sits in the middle of an area of some of the highest incidence rates in the state.

Lyme-Disease-Incidence-in-PA

According to the Centers for Disease Control and Prevention, vector-borne diseases in the U.S. increased more than 300% from 2004 to 2016, and 76 percent of those cases are tick-borne pathogens, primarily Lyme disease.

With the continuing increases and such high incidence rates in the area, Lyme disease is a growing concern.

The bacterium that causes Lyme Disease, Borrelia burgdorferi, is spread through the bite of infected black-legged ticks (also known as deer ticks).

Blacklegged tick. Photo courtesy Centers for Disease Control and Prevention.

Black-legged tick. Photo courtesy Centers for Disease Control and Prevention.

According to Dr. Mark Posnick, a Clarion Hospital Family Medicine Resident Physician, one of the things many people don’t realize is that a tick that is attached for less than 24 hours is unlikely to transmit Lyme Disease.

“A tick usually has to be attached for more like 36 to 48 hours, but the CDC cutoff is 24 hours. If it isn’t attached that long, you’re much less likely to get Lyme disease,” Dr. Posnick told exploreClarion.com.

“These ticks can be as small as two millimeters up to one centimeter in size, and it’s typically the adult females feeding and transmitting Lyme disease.”

One of the first symptoms of Lyme disease is a circular rash called erythema migrans, more commonly known as “bullseye” rash, which can begin as small as two inches and can gradually reach up to 12 inches. The rash usually appears anywhere from three days to a month after being bitten.

Dr. Posnick noted that diagnosis for Lyme Disease is primarily clinical, based on symptoms, as the current screening tests aren’t always able to identify the disease immediately.

“If you have the rash, we consider that grounds for treatment,” he said.

Other symptoms can include fever, fatigue, headaches, muscle aches, and joint pain.

The treatment for Lyme disease is antibiotics, most often doxycycline, though other options include amoxicillin or cefuroxime axetil. People treated in the early stages of Lyme disease usually recover completely; although in some cases, symptoms such as fatigue and muscle aches can last for over six months.

The National Institutes of Health (NIH) has funded a number of studies on Lyme Disease and the treatments, including clinical research efforts addressing multiple aspects of the disease and “Post Treatment Lyme Disease Syndrome” (PTLDS), in which the patients’ symptoms persist after treatment.

Nevertheless, while the treatment for Lyme Disease is generally effective, avoiding infection in the first place is always preferable.

“Prevention is the best treatment,” Dr. Posnick noted.

The Pennsylvania Department of Health recommends treating clothing and gear with products containing 0.5% permethrin and using Environmental Protection Agency (EPA)-registered insect repellents containing DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-Undecanone.

After being outdoors, particularly in grassy, brushy, or wooded areas, always check your clothing, gear, and pets for ticks and shower within two hours, taking time to check your entire body for ticks and immediately removing any that you find.

If you do find a tick, it can be removed using fine-tipped tweezers. The tick should be grasped as close to the surface of the skin as possible and pulled straight up with steady pressure. Never jerk or twist when removing a tick as it can cause the mouth-parts to break off and remain in the skin. After removal, the bite should be cleaned with soap and water or rubbing alcohol.

Dr. Posnick noted that if the tick is still alive, it can be placed in a plastic bag with alcohol. He recommends photographing the tick to help identify it later, if necessary.

According to the CDC, vector-borne diseases in the U.S. increased more than 300% from 2004 to 2016, and 76 percent of those cases are tick-borne pathogens, primarily Lyme disease.

Locally, every county in our region has seen an increase in incidence rates in recent years as shown below.

Regional Incidence Rates Per County from 2011 to 2017:

– Armstrong County: 212.93 per 100,000 in 2011 to 323.38 per 100,000 in 2017;
– Butler County: 123.34 per 100,000 in 2011 to 352.16 per 100,000 in 2017;
– Clarion County: 94.97 per 100,000 in 2011 to 514.11 per 100,000 in 2017;
– Forest County: 65.88 per 100,000 in 2011 to 400.76 per 100,000 in 2017;
– Jefferson County: 240.13 per 100,000 in 2011 up to 658.00 per 100,000 in 2017; and
– Venango County: 16.46 per 100,000 in 2011 up to 279.56 per 100,000 in 2017.

As the statistics indicate, Clarion County’s Lyme Disease incidence rate rocketed in a short time span making it a serious health concern for the area.

While the NIH, the DCD, and the Pennsylvania Department of Health are concerned with the increases in Lyme Disease, the reasons for the increases are complicated.

According to the CDC, increases in Lyme disease have been linked to changes in land use patterns, including reforestation and suburban development. Changes in climate patterns can also have effects on the natural environment and ecological relationships, which in turn can affect vector-borne diseases like Lyme Disease.


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