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Disease Name: Lyme disease


Quick Links

Please review the Idaho Reportable Disease Rules (IDAPA 16.02.10) for the most up-to-date information.

Lyme Disease: http://www.cdc.gov/lyme/index.html


Overview / Case Definition

A systemic, tick-borne disease with protean manifestations, including dermatologic, rheumatologic, neurologic, and cardiac abnormalities. The most common clinical marker for the disease is erythema migrans (EM), the initial skin lesion that occurs in 60%-80% of patients.

For purposes of surveillance, EM is defined as a skin lesion that typically begins as a red macule or papule and expands over a period of days to weeks to form a large round lesion, often with partial central clearing. A single primary lesion must reach greater than or equal to 5 cm in size across its largest diameter. Secondary lesions also may occur. Annular erythematous lesions occurring within several hours of a tick bite represent hypersensitivity reactions and do not qualify as EM. For most patients, the expanding EM lesion is accompanied by other acute symptoms, particularly fatigue, fever, headache, mildly stiff neck, arthralgia, or myalgia. These symptoms are typically intermittent. The diagnosis of EM must be made by a physician. Laboratory confirmation is recommended for persons with no known exposure.

For purposes of surveillance, late manifestations include any of the following when an alternate explanation is not found:


Restrictions

None


Reporting

Within 3 working days

Reportable by Healthcare and Labs:

Reportable by Food Service Facility:

Suspect Reportable:

Reporting Timeframe: Within 3 working days



Diagnosis / Testing

Laboratory testing and criteria for confirmation

  1. Positive Culture for B. burgdorferi, or
  2. Two-tier testing, the same blood sample can be used for both tests. 

Tier 1: EIA (Enzyme Immunoassay)

This test measures a person's antibody (or immune response) to B. burgdorferi. If negative, no further testing required.  Other pathogens may cross-react in this test, so any ‘positive’ or ‘equivocal’ results should be verified by a Western blot.

Tier 2: Immunoblot (Western Blot)

Note: CDC does not recommend skipping the first test and just doing the Western blot. Doing so will increase the frequency of false positive results and may lead to misdiagnosis and improper treatment.


Treatment


Additional Information

Lyme Disease: http://www.cdc.gov/lyme/index.html


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