LCHM Summer 2018 - 16

FEATURE

Lyme Disease
in Pennsylvania

BY ALYSSA BUCZYNSKI
Communicable Disease Investigator, Allentown Health Bureau

P

ennsylvania has been the nation's top erythema migrans (EM). Erythema migrans
state in regards to confirmed cases of is the "common clinical marker" for Lyme
Lyme disease for the past three years. In disease, occurring in 60%-80% of patients.
2010, there were 3,805 cases of Lyme The skin lesion must reach greater than or
investigated. In 2016, there were 11,443 cases equal to 5cm in size across its largest diameter
investigated, almost tripling the numbers for it to qualify as EM. Other acute symptoms
reported in 2010. All residents of PA are that may accompany the lesion include
at risk for contracting Lyme disease due to fatigue, fever, headache, mild nuchal rigidity,
the Blacklegged tick, vector of Lyme, being arthralgia, or myalgia. Late manifestations
present in all 67 counties of Pennsylvania. include musculoskeletal system complicaBlacklegged ticks, formerly known as the deer tions (not including myalgia or arthralgia),
tick, are included in the top four species of nervous system complications (not including
ticks that make up 90% of Pennsylvania's headache, fatigue, paresthesia, or stiff neck),
tick population.
and cardiovascular system complications (not
including palpitations, bradycardia, bundle
Lyme disease is caused by the bacterium branch block, or myocarditis).
Borrelia burgdorferi, which is transmitted
by the bite of an infected blacklegged tick.
Early detection is key with Lyme disease;
According to the CDC's newest case defini- if detected early enough Lyme disease can
tion, laboratory evidence of B. burgdorferi be treated with antibiotics. If the disease
is only required if the patient is exposed in is not detected early enough, it can spread
a low-incidence state, which Pennsylvania throughout the body, targeting the heart,
is not, or if the patient is exhibiting at least joints and nervous system.
one late manifestation symptom with no

CDC's recommended

treatment for Lyme disease

Sources:
Centers for Disease Control and Prevention. (2017). Lyme
Disease (Borrelia burgdorferi) 2017 Case Definition.
Retrieved from https://wwwn.cdc.gov/nndss/conditions/
lyme-disease/case-definition/2017/
Jacobs, S. (2012, July). Four common ticks in Pennsylvania.
Retrieved from http://ento.psu.edu/extension/factsheets/ticks
Pennsylvania Department of Health. (n.d.). Lyme Disease.
Retrieved from http://www.health.pa.gov/my health/diseases
and conditions/i-l/pages/lyme-disease-.aspx#.WusScIgvyM8

Doxycycline
100 mg, twice per day orally

Cefuroxime axetil
500 mg, twice daily orally

*Recent publications suggest the efficacy of shorter courses of treatment for early Lyme disease. Source: CDC
16 Lehigh County Health & Medicine | SUMMER 2018


https://wwwn.cdc.gov/nndss/conditions/ http://ento.psu.edu/extension/factsheets/ticks http://www.health.pa.gov/my

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