Reports of multiple tick-borne diseases to Maine Center for Disease Control are indicating an increase in all tick-borne diseases, according to the Aug. 18 newsletter from that state agency. Physicians have already reported more anaplasmosis cases so far this year than all of last year, and babesiosis and Lyme numbers are steadily increasing as well.

Providers should be aware of the risk and prevalence of these diseases and consider them in their diagnoses, the CDC said, in its newsletter.

Anaplasmosis
228 cases reported to date in 2016, compared to 186 in all of 2015
116 cases reported from the Midcoast region (Knox 49, Lincoln 43, Sagadahoc 18 and Waldo six)

Babesiosis
49 cases have been reported to date in 2016, compared to 55 in all of 2015
13 cases reported from York county, 10 cases from Knox County

Lyme disease
Lyme disease cases take several months to be entered and classified, so current numbers are not available at this time

Powassan
No cases have been reported to date in 2016, compared to one in all of 2015

Co-infections
Because all of these diseases are carried by the same tick (Ixodes scapularis), a person may be infected with more than one disease.

To date, 11 co-infections have been reported: four co-infections with anaplasmosis and Lyme disease, two co-infections with babesiosis and Lyme disease and five co-infections with anaplasmosis and babesiosis.

In 2015, 22 co-infections were reported: 10 co-infections of Lyme disease and anaplasmosis; eight co-infections of Lyme disease and babesiosis; one co-infection of anaplasmosis and babesiosis; one co-infection of Lyme disease, anaplasmosis and babesiosis; one co-infection of Lyme disease and ehrlichiosis; and one co-infection of babesiosis and ehrlichiosis.

Recommendations for Providers
Consider tick-borne illnesses in your differential, particularly for individuals with "summer flu" symptoms

Submit samples for testing

Treat patients appropriately – recommendations for treatment are available from http://www.idsociety.org/uploadedfiles/idsa/guidelines-patient_care/pdf_library/lyme%20disease.pdf

Report cases. All tick-borne illnesses are reportable in Maine, including the erythema migrans rash which is confirmatory. All cases should be reported by phone to 1-800-821-5821 or by fax to 1-800-293-7534.

For more information
Maine CDC vectorborne webpages: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/index.shtml
Maine Physician's Reference Guide: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/documents/tick-reference-guide.pdf
Lyme forms for providers: http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/lyme/index.shtml#resourcephysicians
Guidance on treatment: http://www.idsociety.org/uploadedfiles/idsa/guidelines-patient_care/pdf_library/lyme%20disease.pdf
Lyme disease data: https://data.mainepublichealth.gov/tracking/home

During Lyme Disease Awareness Month, Maine CDC held many events to raise awareness of the disease and increase knowledge about prevention. One of the highlights is the annual poster design contest for students in kindergarten through eighth grade.

This year's theme was Tick Watch, with an emphasis on the awareness of ticks and prevention of tick bites. Students were asked to illustrate at least one of the prevention methods from the 'No Ticks 4 ME' educational campaign:

Using EPA-approved repellant

Wearing protective clothing

Performing daily tick checks

Using caution in tick infested area

Maine CDC received many  submissions for the 2016 contest, and one poster winner was selected from each of the three participating age groups: K-3; 4-5; 6-8. They are:

Reid Robishaw, Kindergarten, Gilford Butler School

Elizabeth Grondin, Grade 4, Jay Elementary School

Vanessa Luce, Grade 6, Warren Community School

The winning posters are viewable at www.maine.gov/lyme. Each winner received a Maine State Parks family day pass, a certificate and tick removal kits for their entire classroom.

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