Are You Checking for Ticks?

” . . . cases of tick-borne diseases [in the U.S.] increased more than twofold between 2004 and 2017. . . .Tick-borne diseases now make up more than three-quarters of all vector-borne disease reports.”

I live in a small town dotted with grassy and wooded areas, brush, and plenty of mammalian wildlife, so the possibility of contact with ticks is present even on a walk to the compost bin or train station.

I’ve become really good at tick identification and removal, but I can’t claim any special expertise in recognizing the early signs of tick-borne diseases.

CDC warns of tick-borne rickettsial disease increase.

For that information, we have help this month from Centers for Disease Control and Prevention (CDC) staff, who steer readers to new resources in the Update from the CDC column in AJN’s July issue, “Increase in Reports of Tick-Borne Rickettsial Diseases in the United States.”

Alison Binder and Paige Armstrong tell us about the CDC’s new online training toolkit and learning module, both designed to raise awareness about tick-borne rickettsial diseases. […]

2019-07-08T09:03:50-04:00July 8th, 2019|environmental health, infectious diseases, Nursing, Public health|2 Comments
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Measles Outbreaks, and an Unexpected Vulnerability

The second-greatest number of cases since ‘elimination.’

3D graphical representation of spherical-shaped, measles virus particle studded with glycoprotein tubercles. CDC/ Allison M. Maiuri, MPH, CHES

Last month, a state of emergency—which has now been halted by state court—was declared in nearby Rockland County, New York, barring children who hadn’t been vaccinated against measles from public places. The unprecedented step made worldwide news and highlights the public health measures being taken to stem the six currently ongoing measles outbreaks in the United States.

Measles was eliminated in the United States in 2000, but outbreaks have occurred since, increasingly so in recent years. The CDC reported this week that almost 400 cases of measles have been confirmed in 15 states during the first three months of this year alone. This is the second-greatest number of reported cases since eradication of the disease. The most—667 cases—occurred in 2014.

Public health authorities are clear about the cause of these outbreaks: people contract measles abroad and bring it back to the United States, where groups of people who are unvaccinated are particularly susceptible to developing and spreading this highly contagious disease. Up to 90% of unvaccinated […]

2019-04-08T07:55:37-04:00April 8th, 2019|infectious diseases, Nursing, Public health|3 Comments
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Acute Flaccid Myelitis: The Investigation Continues

The headlines of the past several weeks about kids with a polio-like illness have been pretty scary. The idea that a healthy child could suddenly be sidelined with extreme muscle weakness is a nightmare scenario for the parents of young children. While frustratingly little is known about acute flaccid myelitis (AFM), the good news is that it remains quite rare, affecting less than one in a million people in the U.S. each year.

According to the CDC, there have been a total of 404 confirmed cases of AFM in the U.S. since 2014, with a median age of eight years. The epidemiologic curve of cases indicates that the illness is seasonal, peaking in late summer and early fall. Oddly, the number of cases spiked in 2014, 2016, and 2018, while there were fewer cases during 2015 and 2017.

Signs and symptoms of AFM.

AFM often follows a respiratory illness or fever. Limb weakness (often unilateral) then occurs suddenly, progressing rapidly within hours or a few days. There may be facial muscle weakness, problems with eye movement, or speech or swallowing difficulties, but mental status generally is not affected. One death has been reported.

No clear cause.

Poliovirus, non-polio enteroviruses, adenoviruses, and West Nile virus are known to (rarely) […]

2018-11-12T08:25:04-05:00November 12th, 2018|infectious diseases, Public health|0 Comments
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It’s Spring. Time to Think about Lyme Disease

Ticks Ixodes pacificus (shown here in CDC image) and Ixodes scapularis are known vectors of Borrelia burgdorferi (Lyme disease)

National data confirm that diagnoses of Lyme disease begin to rise each year during the month of April, then rapidly reach their peak in June and July. Just in time for “Lyme season,” readers can learn more about the disease in “Lyme Disease: Diagnosis, Treatment, and Prevention” in this month’s AJN.

Lyme disease was first recognized in 1975 in Lyme, Connecticut. From 492 confirmed cases in 1982 (the first year in which Lyme was a reportable disease) to more than 35,000 confirmed and probable cases in 2016, the causative organism, Borrelia burgdorferi, has continued to expand its geographic reach. The CE article notes that these numbers may be undercounts and cites analysis of laboratory and medical claims data from 2008 suggesting that the true number of annual diagnoses may actually be between 240,000 to 444,000.  […]

2018-04-04T09:11:38-04:00April 4th, 2018|climate change, infectious diseases, Nursing, Public health|0 Comments
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The 1918 Influenza Epidemic’s Long Reach in Time

“It would be impossible to relate all the sad and terrible scenes . . . all night long . . . witnessing death scenes, seeing weeping relatives and trying to take care of emergencies . . . “

A mother’s death remembered.

Litter carriers at Red Cross Emergency Ambulance Station in Washington, D.C., during influenza pandemic of 1918.

When my grandfather was six years old, his mother went to sleep one night and never woke up. She was one of the nearly 700,000 Americans who died during the 1918–1919 influenza pandemic, which killed an estimated 50 million people worldwide. The rest of her young family—my grandfather and his twin brother, their seven-year-old sister, and my great-grandfather—survived. The shock of losing his mother so suddenly was still evident when my grandfather talked about her 70 years later. She was 29 years old and healthy, and then she was gone.

High mortality, even among healthy young adults.

My family was not alone as it mourned. The CDC estimates that one-third of the world’s population was infected by what’s become known as the “Spanish flu.” (The origin of this name is unclear: some sources suggest it’s due to a misunderstanding about […]

2018-03-07T09:08:45-05:00March 7th, 2018|infectious diseases, Nursing, Public health|1 Comment
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