Lyme Disease in Hispanics, United States, 2000–2013

Nelson, Christina; Starr, John; Kugeler, Kiersten J.; Mead, Paul S.

doi:10.3201/eid2203.151273

Cited by 10 publications

(14 citation statements)

References 4 publications

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“…This practice continued until 2008, when the National Surveillance Case Definition changed [50]. The current practice to confirm a LD case in an already endemic area is with the presence of EM or known exposure; otherwise, a positive laboratory testing is required in a non-endemic area for the confirmation of LD [50,51].…”

Section: Skinmentioning

confidence: 99%

Missed Diagnosis and the Development of Acute and Late Lyme Disease in Dark Skinned Populations of Appalachia

Palmieri¹

2019

BJSTR

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Background: Lyme Disease (LD) is the most commonly reported vector-borne disease in the United States, affecting over 300,000 people in the United States each year. If early LD goes undetected or is inadequately treated, the causative spirochete bacteria, Borrelia burgdorferi, can disseminate throughout the body and cause chronic symptoms that will characterize a patient with late LD. The incidence of LD is generally reported at a higher rate in light-skinned patients as compared to dark-skinned patients.Aim: To assess the rate and causative factors of late Lyme Disease in dark-skinned individuals within the Appalachian region and encourage research into the need for early clinical evaluation and testing for at-risk patients.Discussion: Healthcare providers are at risk of missing the diagnosis of acute Borrelia infection in dark-skinned patients based on historically lower reporting frequency and non-traditional early symptoms and clinical presentation. Misdiagnosis, or delayed diagnosis, adversely affects the health outcomes of people of color and risks progression of the infection from early to late LD. Recommendations:We defined the characteristics of darker skin tones as a quantitative score to identify the risk for non-traditional presentation of the early signs of Borrelia infection. Using this score, we recommend determining the association between dark skin color and undiagnosed LD based upon a systematic study on the correlation of patient skin color and positive LD testing. This data should be combined with other risks of exposure. The results of the recommended research would determine whether physicians in Appalachia should incorporate comprehensive treatment plans for LD in dark-skinned patients as preventive medical practice. Lyme Disease DefinedAccording to the Centers for Disease Control and Prevention (CDC) presently, Lyme Disease (LD) is the most commonly reported vector-borne disease in the United States, affecting over 300,000 people in the United States each year [1]. LD is not only of nationwide concern, but also infects people in more than 80 countries worldwide [2]. LD is commonly transmitted by the blacklegged tick, Ixodes scapularis, infected with the spirochete bacteria, Borrelia burgdorferi [1]. However, LD spirochetes are also transmitted globally through minor Borrelia species such as B.

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Section: Skinmentioning

confidence: 99%

Missed Diagnosis and the Development of Acute and Late Lyme Disease in Dark Skinned Populations of Appalachia

Palmieri¹

2019

BJSTR

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“…A recent study of US LD surveillance data found that Hispanics were more likely to have disseminated LD compared with non‐Hispanics (Nelson, Starr, Kugeler, & Mead, ). Potential reasons for the increased risk of disseminated infection include lack of health insurance among much of the population leading to delayed care, language barriers when accessing health care and lack of awareness of early LD symptoms (Nelson et al, ). In 2016, Hispanics had the highest uninsured rate (16%) of any race/ethnicity group in the USA (Barnett & Berchick, ), leaving this population at a substantial disadvantage in receiving care and treatment for LD and other conditions.…”

Section: Introductionmentioning

confidence: 99%

Knowledge and prevention of tickborne diseases among Hispanic and non‐Hispanic residents of Maryland and Virginia

Starr

Gharpure

et al. 2019

Zoonoses and Public Health

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Tickborne diseases (TBDs) such as Lyme disease (LD), babesiosis, ehrlichiosis and Rocky Mountain spotted fever cause substantial morbidity and even mortality in the USA. Data indicate that Hispanic populations may be at greater risk for occupational exposure to ticks and disseminated LD; however, information on knowledge and practices of Hispanic populations regarding TBDs is limited. We surveyed 153 Hispanic and 153 non‐Hispanic residents of Maryland and Virginia to assess awareness of TBDs, prevention practices and risk of tick encounters. Hispanic respondents were less likely than non‐Hispanics to report familiarity with LD symptoms (21% vs. 53%, p < 0.001) and correctly identify ticks as vectors of LD (40% vs. 85%, p < 0.001). Although there was no significant difference in overall proportion of respondents who routinely take one or more preventive measures to prevent tick bites (59% vs. 61%, p = 0.65), Hispanics were more likely to report showering after coming indoors (36% vs. 25%, p = 0.04) but less likely to conduct daily tick checks compared with non‐Hispanics (17% vs. 35%, p < 0.001). History of tick bite or finding a tick crawling on oneself or a household member in the past year did not significantly differ between Hispanics and non‐Hispanics (19% vs. 24%, p = 0.26). Notably, after controlling for Hispanic/non‐Hispanic ethnicity, primary language (English vs. Spanish) was a significant predictor of whether an individual had knowledge of LD symptoms, correctly identified ticks as vectors for LD and performed daily tick checks. These results provide guidance for future development of more targeted and effective TBD prevention education for both Hispanic and non‐Hispanic communities.

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“…In the first phase skin lesions are seen that develop in 3 -30 days and that are known as EM. EM is found in 70% -80% of the cases [10]- [12]. In the second phase, there can be fever, adenopathy, cold, neurologic and cardiac findings, ambulant arthralgia and oligoarticular arthritis.…”

Section: Introductionmentioning

confidence: 99%

“…EM generally starts as a red macule or papule in the proximal parts of extremities or on the body. It generally expands enlarging from the center to the sides and its diameter can reach up to 50 cm [12]. Skin lesions generally disappear in 3 -4 weeks [10].…”

Section: Introductionmentioning

confidence: 99%

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Evaluation of Lyme Disease in a Health Worker, and Review of the Literature

Bilman¹,

Yetik²

2016

OALib

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Lyme disease (LD) is a multisystemic zoonotic infection disease that occurs in the consequence of contamination of Borrelia type of spirochetes that ticks carry after they have bitten. Typical clinic findings are on the skin and in joints. In this paper, the study on heavy joint pain having suddenly been added to the profile and on limitation of movement, and the process of getting the diagnosis of LD were probed in the patient with lesions on her skin that occurred three months ago. The case not having reported a history of being bitten by ticks and who was a health professional was female patient of 41 years of age. In her examination, a large number of lesions similar to fly bites were seen on the skin in the periphery of extremities, and the patient, whose routine hematologic and biochemical examinations were within normal limits, was determined to be Borrelia IgM positive and Borrelia IgG negative in the enzyme-linked immunosorbent assay (ELISA) tests performed from peripheric blood. Through these findings, cutaneous lesions and arthralgia were thought to be related to Borrelia infection that developed after the tick bite that took place months ago and was not realized. The patient was treated with doxycycline (100 mg/day, 30 days) and prednisolone (16 mg/day, 30 days, reducing the dose). As a supplementary treatment, vitamin D was administered by way of IM as a support. Arthralgia and joint involvement started to recover the second day. Lesions partly regresses in three days after the treatment started. LD cases must be considered in the differential diagnosis of infectious diseases that start with unexplained arthralgia at the beginning and suspicious lesions on the skin, and the case is probed by scanning literature over these concepts.

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Lyme Disease in Hispanics, United States, 2000–2013

Cited by 10 publications

References 4 publications

Missed Diagnosis and the Development of Acute and Late Lyme Disease in Dark Skinned Populations of Appalachia

Missed Diagnosis and the Development of Acute and Late Lyme Disease in Dark Skinned Populations of Appalachia

Knowledge and prevention of tickborne diseases among Hispanic and non‐Hispanic residents of Maryland and Virginia

Evaluation of Lyme Disease in a Health Worker, and Review of the Literature

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