LYME DISEASE - USA (03): (NEW YORK) INCREASED INCIDENCE *******************************************************
A ProMED-mail post
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International Society for Infectious Diseases
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Date: Sun 27 Jul 2014
Source: New York Post [edited] <http://nypost.com/2014/07/27/campaign-to-battle-lyme-disease-mounts-as-hamptons-epidemic-grows/>


It's the Hamptons' [Suffolk County, Long Island, New York] dirty
little secret: dozens of children and adults are being diagnosed with
Lyme disease each day as officials mount a campaign to battle ticks.
The problem has gotten so bad that Southampton Hospital launched the
Tick-Borne Disease Resource Center to help residents bugging out over
the tiny blood-suckers.

One physician, Dr Blake Kerr, told The Post he treats 100 patients a
week for Lyme disease. "It's an epidemic," said Kerr, who runs
Wainscott Walk-In Medical Center and last summer contracted Lyme and 2
other tick-borne illnesses simultaneously. Pediatrician Dr Nadia
Persheff of Hampton Pediatrics in Southampton sees as many as 4
children a day for Lyme disease and 20 for tick bites -- including one 3-week-old baby who came in with 4 ticks on his back. "You have to
check every kid and every baby," Persheff said. "We're much busier
than last summer. I've never seen it like this."

Suffolk County was ground zero for Lyme disease in 2012, leading the
state [New York State] with 689 reported cases, data show. In 2013,
the number of reported cases dropped to 566, according to state data.

Still, locals believe the ticks -- and tick-related illnesses -- are
growing every year. The culprits are often deer ticks, which carry
Lyme or malaria-like diseases such as babesiosis and -- at the size of
a poppy seed -- are much smaller than common wood ticks.

Lyme disease, a bacterial illness with symptoms of skin rash,
headache, and fatigue can cause neurological damage and other serious
problems if left untreated. Early treatment typically includes a
single dose of antibiotics.

Brian Kelly, owner of East End Tick and Mosquito Control, said he has
fielded frantic calls from out-of-towners who want him to remove ticks
from their bodies. "People are realizing they're everywhere -- you
can't even go to the beach without getting a tick," Kelly said.

[Byline: Kate Briquelet]

--
Communicated by:
ProMED-mail from HealthMap Alerts
<promed@promedmail.org>

[In the USA, the prevalence of _Borrelia burgdorferi_-infected _Ixodes scapularis_ ticks, the vector of Lyme disease, commonly ranges between
20 and 40 percent in New England, the Mid-Atlantic States, and
Minnesota and Wisconsin, where Lyme disease is endemic (Wormser GP,
Dattwyler RJ, Shapiro ED, et al: The clinical assessment, treatment,
and prevention of Lyme disease, human granulocytic anaplasmosis, and babesiosis: clinical practice guidelines by the Infectious Diseases
Society of America. Clin Infect Dis. (2006) 43(9): 1089-134. doi: 10.1086/508667. Available at <http://cid.oxfordjournals.org/content/43/9/1089.full>).

However, at sites in Westchester and Suffolk Counties in New York
State (one of the Mid-Atlantic states), over 50 percent prevalence of
_I. scapularis_ ticks have been found to be infected with _B.
burgdorferi_, and over 20 percent of _B. burgdorferi_-infected ticks
were either co-infected with _Anaplasma phagocytophilum_ (the cause of
human granulocytic anaplasmosis or HGA) or _Babesia microti_ (the
cause of babesiosis); a lower percentage was co-infected with
_Borrelia miyamotoi_ (the cause of a relapsing-fever like illness) (<http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2883481/>).

In regions where the local rate of _B. burgdorferi_ infection in
_Ixodes_ ticks is at least 20 percent, the Infectious Diseases Society
of America (IDSA) recommends chemoprophylaxis with a single dose of
antibiotic after a tick bite, if (a) the attached tick can be reliably identified as an adult or nymphal _I. scapularis_ tick that is
estimated to have been attached for 36 hours or longer on the basis of
the degree of engorgement of the tick with blood or of certainty about
the time of exposure to the tick, (b) prophylaxis can be started
within 72 hours of the time that the tick was removed, and (c) there
is not contraindication for the antibiotic. Chemoprophylaxis can
consist of a single dose of doxycycline for adults (200 mg dose) and
children at least 8 years of age (4 mg/kg up to a maximum dose of 200
mg) after a recognized tick bite (<http://cid.oxfordjournals.org/content/43/9/1089.full>).

Treatment of adult patients with early localized or early disseminated
Lyme disease associated with erythema migrans, in the absence of
specific neurologic manifestations or advanced atrioventricular heart
block, is doxycycline (100 mg twice per day), amoxicillin (500 mg 3
times per day), or cefuroxime axetil (500 mg twice per day) for 14
days (range, 10-21 days for doxycycline and 14-21 days for amoxicillin
or cefuroxime axetil)
(<http://cid.oxfordjournals.org/content/43/9/1089.full>). Doxycycline
has the advantage of being effective for treatment of HGA (but not for babesiosis), which may occur simultaneously with early Lyme disease. Doxycycline is relatively contraindicated during pregnancy or
lactation and in children less than 8 years of age. Antibiotics
recommended for children are amoxicillin (50 mg/kg per day in 3
divided doses [maximum of 500 mg per dose]), cefuroxime axetil (30
mg/kg per day in 2 divided doses [maximum of 500 mg per dose]), or, if
the patient is 8 years of age or older, doxycycline (4 mg/kg per day
in 2 divided doses [maximum of 100 mg per dose]) (<http://cid.oxfordjournals.org/content/43/9/1089.full>).

The Hamptons, a popular summer seaside resort, is a group of villages
in the towns of Southampton and East Hampton, which form the South
Fork of Suffolk County, Long Island in New York State (<http://en.wikipedia.org/wiki/The_Hamptons>). Long Island may be
found on the interactive HealthMap/ProMED-mail map at <http://healthmap.org/promed/p/40685>. - Mod.ML]

[See Also:
Lyme disease - USA (02): (WI) increased incidence 20140319.2341237
Lyme disease - USA: (NY) cervid, human, control 20140214.2277111
2013
----
Lyme disease - USA (05): carditis, fatal 20131214.2115869
Lyme disease - USA (04): underreporting 20130822.1894924
Lyme disease - USA (03): (NY) increased incidence 20130513.1710851
Lyme disease - USA (02): increased incidence 20130417.1651205
Lyme disease - USA: (OR, WA) increased incidence 20130413.1642921
2012
----
Lyme disease - USA (02): (NY) increased incidence 20120506.1124721
Lyme disease - USA: (PA,NJ) increased incidence 20120423.1111304] .................................................sb/ml/mj/mpp

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