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Lyme Disease

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Wendy Anderson

on 2 April 2013

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Transcript of Lyme Disease

Lyme Disease Stage 1 (days and weeks following infection):
Erythema migrans
Chills and fever
General malaise
Headaches and lightheadedness
Myalgia and stiffness Conclusion Stage 2 (weeks to months):
Facial muscle weakness/Bell's palsy or paralysis
Arthralgia in large joints
Cardiac abnormalities, palpitations How Can This Be Accomplished? Creating a new system that
will transform the future of Lyme disease practice guidelines Current Approach: What?
Availability of a vaccine
Benefits versus risks of the vaccine
Signs and symptoms of Lyme disease
Effects of chronic Lyme disease Plan This primary level of care consists of the integration of the
Lyme vaccine and patient education into current
practice, with a result in overall
better patient outcomes. Stage 3 (months to years):
Muscle weakness
Difficulty with speech
Irregular muscle movement
Neurologic symptoms What's the Big Deal? According to the CDC, the number of confirmed cases in Minnesota and Wisconsin increased more than 20% (2010). Lyme disease is an illness that can be reduced in large numbers if focus is placed on prevention strategies. Transformation Newly diagnosed patients are treated with antibiotic therapy Evidence-based Literature However, Even after treatment with antibiotics, approximately 10-20% of patients with Lyme disease will continue to experience symptoms that last months to years Post-treatment Lyme Disease Syndrome (PTLDS): The condition is thought to be caused by an autoimmune response, in which a person’s immune system continues to damage the body’s tissues even after the infection has been cleared. PTLDS can cause symptoms such as muscle and joint pains, cognitive defects, sleep disturbance, or fatigue (Centers for Disease Control and Prevention, 2013). Vaccination In 1998 the vaccine called LYMErixTM was made available to the public after the completion of a trial and approval of the FDA. Media coverage began to highlight stories of “vaccine victims,” and the public began to shy away from the vaccine. Eventually the pharmaceutical company withdrew the vaccination. It is important to note, “Even available postmarket surveillance failed to demonstrate convincing harm from the LYMErixTM vaccine. After review of available data, the FDA found insuffifficient evidence to support a causal relationship between the reported adverse effects and the vaccine and continued to permit use of the vaccine” (Nigrovic & Thompson, 2007, p. 5). Stage 1: Education! Where?
Medical conference
Family and pediatric clinics in high-risk areas, as well as hospitals. Stage 2: Persuasion to form an attitude Healthcare Providers
Involve public health
Have information published in a journal Patients
Pamphlets in waiting rooms of hospitals, clinics, wildlife centers, schools, daycares, etc.
Patient education in high risk areas at annual physical Stage 3: Adopt or Reject Idea Stage 4: Implementation Stage 5: Reinforce or Reverse the Innovation Adopt? Stage four will follow
Reject? Evaluation and reeducation Vaccination will be added to the immunization schedule as optional, starting at age 15
Offered at next appt or hospitalization
Vaccine only offered once patient, or guardian, is education on risks versus benefits Reinforce? Follow up will be done in 6 months, 18 months, and 5 years
Reverse? Evaluation, then begin at phase one again Successful implementation of this transformation
will result in a lower incidence of Lyme disease in endemic areas. SUCCESS References

A.D.A.M. Medical Encyclopedia. (2011, August 26). Lyme Disease. Retrieved from

Centers for Disease Control and Prevention. (2012, June 1). Summary of Notifiable Diseases, 2010. Morbidity and Mortality Weekly
Report, 59(53), 1-111. Retrieved from http://www.cdc.gov/mmwr/PDF/wk/mm5953.pdf

Centers for Disease Control and Prevention. (2013, January 11). Signs and Symptoms of Lyme Disease. Retrieved from

Centers for Disease Control and Prevention. (2013, January 25). Treatment. Retrieved from

Huber, D. L. (2010). Leadership and Nursing Care Management (Fourth ed.). Maryland Heights : Saunders Elsevier.

McGoff, C. (2011). Change Vs. Transformation. Retrieved from

Nigrovic, L. E., & Thompson, K. M. (2007, January). The Lyme vaccine: a cautionary tale. Epidemiology and Infection, 135(1), 1-8.

Steere, A. C., Sikand, V. K., Meurice, F., Parenti, D. L., Fikrig, E., Schoen, R. T., . . . Krause, D. S. (1998, July 23). Vaccination against Lyme
disease with recombinant Borrelia burgdorferi outer-surface lipoprotein A with adjuvant. The New England Journal of Medicine, 339(4), 209-215.
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