Tickborne Diseases
Continuing Education Credits
Tickborne infections are the most important of vectorborne diseases in the United States (US). Because tickborne diseases are so difficult to diagnose, deaths and morbidity occur. This course will review the life cycle, geographical ranges, and identification of ticks involved in human diseases. The organisms that cause tickborne diseases will be discussed, to include Lyme disease, Rocky Mountain spotted fever, human monotropic ehrlichiosis and granulotropic anaplasmosis, tularemia, babesiosis, southern tick-associated rash illness, tickborne relapsing fever, Colorado tick fever, and other rare and emerging tickborne diseases. Numerous case studies about tickborne diseases are also presented.
Objectives
- Review the life cycle, geographical ranges, and identification of ticks involved in human diseases.
- Identify the organisms that cause tickborne diseases, to include Lyme disease, Rocky Mountain spotted fever, human monotropic ehrlichiosis and granulotropic anaplasmosis, tularemia, babesiosis, southern tick-associated rash illness, tickborne relapsing fever, Colorado tick fever, and rare and emerging tickborne diseases.
- Recognize the symptoms, pathogenesis, and laboratory diagnosis of the discussed tickborne diseases.
- Analyze and solve case studies about the tickborne diseases presented.
Course Outline
- Introduction
- Introduction
- Tick Phylogeny and Life Cycle
- How Ticks Cause Disease
- Tickborne Diseases
- Lyme Disease
- Lyme Disease: Epidemiology
- Lyme Disease Stage 1: Localized Infection
- Lyme Disease Stage 2: Early Disseminated Disease
- Lyme Disease Stage 3: Late Disease
- Lyme Disease: Diagnosis
- According to the Centers for Disease Control and Prevention (CDC), what is the most sensitive and best method for the laboratory diagnosis of Lyme disease?
- Southern Tick-Associated Rash Illness
- Southern Tick-Associated Rash Illness
- STARI: Clinical Manifestations
- STARI: When Should it be Suspected?
- Rocky Mountain Spotted Fever
- Rocky Mountain Spotted Fever: Epidemiology
- RMSF: Clinical Presentation
- RMSF: Laboratory Diagnosis
- What is the fastest laboratory method for diagnosing Rocky Mountain spotted fever (RMSF)?
- Ehrlichiosis
- Ehrlichiosis: Epidemiology
- Ehrlichiosis: Clinical Manifestations
- Ehrlichiosis: Laboratory Diagnosis
- Anaplasmosis
- Anaplasmosis: Epidemiology
- Anaplasmosis: Clinical Manifestations
- Anaplasmosis: Laboratory Diagnosis
- Tularemia
- Tularemia: Epidemiology
- Tularemia: Clinical Manifestations
- Tularemia: Laboratory Diagnosis
- Babesiosis
- Babesiosis: Epidemiology
- Babesiosis: Tickborne and Congenital Infections
- Babesiosis: Laboratory Diagnosis
- Tickborne Relapsing Fever
- Tickborne Relapsing Fever: Epidemiology
- Tickborne Relapsing Fever: Clinical Manifestations
- Tickborne Relapsing Fever: Laboratory Diagnosis
- Colorado Tick Fever
- Colorado Tick Fever: Epidemiology
- Colorado Tick Fever: Clinical Manifestations
- Colorado Tick Fever: Laboratory Diagnosis
- Case Studies
- Case Study 1 A 12-year-old female from Santa Cruz, California, presented with a swollen, painful right knee and hip. She reported recurrent knee swelling and pain lasting several days every four to five months. Her parents chose to treat her with herbs instead of antimicrobials when she was first seen with knee pain.On this occasion, her WBC count was 7,000/mL, hematocrit was 33%, and erythrocyte
- Case Study 2A 5-year-old female who lives in Missouri was taken to the emergency department (ED) in June. She had a three-day history of intermittent headache, nausea, and a sore throat. Her temperature was 105°F (40.6°C), and she had a maculopapular rash on her wrists, hands, legs, and the soles of her feet. Laboratory tests were performed. Results of laboratory studies include:8.8
- Case Study 2, continuedTo narrow the diagnosis, more information is required. Health care personnel should determine the following points:How long has the rash been there? She developed the rash on the day of admission to the ED.Where did the rash appear before the onset of fever? Her rash appeared on the arms and legs and then spread to her palms and the soles of her feet.Was she taking any medic
- Case Study 3 A healthy 20-year-old female from southeast Missouri presented with a fever of 104°F, vomiting, and diarrhea. She had a red, maculopapular rash that began on her face and blanched when touched. Laboratory findings include:WBC: 4.9 × 109/mLHgb: 10.9 g/dLPlatelets: 102 × 109/mLHyponatremiaMildly elevated liver enzymesAdditionally, inclusion bodies were seen in the cytopla
- Case Study 4An 81-year-old woman taking prednisone and methotrexate for rheumatoid arthritis fell and fractured her hip. She received two units of leukocyte-reduced RBCs. Nine days later, she presented with fever, myalgia, and pancytopenia. She developed disseminated intravascular coagulopathy with multiorgan failure. The peripheral blood smear revealed intracytoplasmic inclusions in neutrophils,
- Case Study 4, continued
- Case Study 5In June, a woman attempted to take a dead rabbit from her dog. She already had a splinter in her finger, and it became infected. A lesion developed at the site of the splinter, similar to the wound shown in the image. Within seven days, the lesion ulcerated, and she became ill with a fever of 104°F. She reported no tick bites. What is the most likely pathogen?
- Case Study 6 A one-month-old infant from Massachusetts was fussy, pale, had warm skin, and was vomiting. His temperature was 101.5°F (38.6°C), and he had tachycardia, poor perfusion, splenomegaly, and pulmonary edema.Laboratory studies revealed hemolytic anemia and thrombocytopenia. His ALT was increased, but his other chemistry studies were normal. His urine was dark red and cloudy with
- Case Study 7 A 60-year-old male from Boise, Idaho, had a 1-month history of intermittent fevers and headaches. He reported a fever of 105°F with a headache for three days. A second fever presented 13 days later that lasted two days. He finally sought medical attention when he had his third fever 26 days after the first symptoms. His history was remarkable for having camped in a cabin in the B
- Case Study 8 A healthy 49-year-old male from Manhattan, New York, presented with a fever and malaise three days after returning from a horseback riding trip on the Western slope of the Rocky Mountains. He removed four ticks from his body and reported chills, fever, and severe myalgia. His symptoms resolved, only to recur two days later. He had a fever of 100.6°F (38.1°C), conjunctivitis,
- Emerging and Rare Tickborne Diseases
- Emerging and Rare Tickborne Diseases
- Rickettsia parkeri
- Rickettsia parkeri
- Rickettsia species 364D
- Rickettsia species 364D
- Borrelia miyamotoi
- Borrelia miyamotoi
- Other Ehrlichia Organisms
- Other Ehrlichia Species
- Heartland Virus
- Heartland Virus
- Powassan Virus
- Powassan Virus
- Prevention of Tickborne Diseases
- Prevention of Tick Bites
- Correctly Remove Ticks
- What is the best method for removing a tick that has bitten you?
- Table Summary of Major Tickborne Diseases
- Summary of Major Tickborne Diseases
- References
- References
Additional Information
Level of Instruction: Intermediate
Intended Audience: Medical laboratory scientists, medical
laboratory technicians, laboratory supervisors, and laboratory managers. This
course is also appropriate for MLS and MLT students and pathology residents.
Author Information: Lynda Britton, PhD, MLS(ASCP)CMSM, received her BS degree in medical technology from the University of Texas at Arlington and her doctorate from Louisiana State University in Baton Rouge, LA. She began her career as a bench microbiologist and worked in several states. Lynda is the Clinical Coordinator for the Medical Laboratory Sciences Program at LSU Health Sciences Center in Shreveport, LA. She is a professor and teaches microbiology and molecular diagnosis.
Reviewer Information: Margaret Reinhart, MS, MLS(ASCP) is a Senior Lecturer emerita in Biological Sciences at the University of the Sciences in Philadelphia, PA, where she taught hematology, clinical immunology, parasitology, and other related courses, as well as directed the MLS program for over 30 years. She is currently an adjunct instructor in Hematology at Pennsylvania Hospital, Philadelphia, PA. She holds a Masters Degree in Biology and in Health Care Administration.
Course Description: Tickborne infections are the most important vector-borne diseases in the United States. Because tickborne diseases are so difficult to diagnose, deaths and morbidity occur. This course will review the life cycle, geographical ranges, and identification of ticks involved in human diseases.