{"id":10189,"date":"2025-03-01T14:03:03","date_gmt":"2025-03-01T19:03:03","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan226\/"},"modified":"2025-03-02T00:49:23","modified_gmt":"2025-03-02T05:49:23","slug":"dhan226","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan226\/","title":{"rendered":"php\/alerts\/dhan226 ~  Division of Public Health &#8211; &#8211; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan226.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->226 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->April 20, 2010 2:21 pm <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; Wellness<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthyhomes.html\">Healthy Homes<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/healthywp.html\">Healthy Workplaces<\/a><\/li>\n        <li><a href=\"\/dph\/lab\/labs.html\">Laboratory<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/feir.html\">Restaurant Inspections<\/a><\/li>\n        <li><a href=\"\/dph\/screen.html\">Screening and Testing<\/a><\/li>\n        <li><a href=\"\/dph\/chca\/dphwichominf01.html\">WIC<\/a><\/li>\n        <li><a href=\"\/dph\/servicesadd.html\">Additional Services<\/a><\/li><li>\n      <\/li><\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#InformationMenu\"><h2>Information <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n        <ul class=\"panel-collapse collapse\" id=\"InformationMenu\">\n        <li><a href=\"\/dph\/factsheetsaz.html\">A-Z Fact Sheets<\/a><\/li>\n        <li><a href=\"\/dph\/pubreportsaz.html\">A-Z Publications &#038; Reports<\/a><\/li>\n        <li><a href=\"\/dph\/diseasesandconditions.html\">Diseases &#038; Conditions<\/a><\/li>\n        <li><a href=\"\/dph\/faq.html\">FAQ&#8217;s<\/a><\/li>\n        <li><a href=\"\/dph\/php\/alerts.html\">Health Alerts<\/a><\/li>\n        <li><a href=\"\/dph\/healthylifestyles.html\">Healthy Lifestyles<\/a><\/li>\n        <li><a href=\"\/dph\/hipaa.html\">HIPAA<\/a><\/li>\n        <li><a href=\"\/dph\/regs.html\">Regulations<\/a><\/li>\n        <li><a href=\"\/dph\/forms.html\">Request Forms<\/a><\/li>\n        <li><a href=\"\/dph\/links.html\">Links &#038; Resources<\/a><\/li>\n        <li><a href=\"http:\/\/delaware.gov\/help\/foia_request.shtml\">FOIA Request Form<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li><a id=\"SocialMenuHeader\"><h2>Connect <i class=\"fa fa-thumbs-o-up fa-fw\"><\/i><\/h2><\/a>\n      <ul id=\"SocialMenu\">\n        <li class=\"facebook\"><a href=\"https:\/\/www.facebook.com\/DEPublicHealth\" target=\"_blank\" title=\"Division of Public Health Facebook Page\"><i class=\"fa fa-facebook-square fa-lg\"><\/i> Facebook<\/a><\/li>\n        <li class=\"twitter\"><a href=\"https:\/\/twitter.com\/Delaware_DHSS\" target=\"_blank\" title=\"Delaware Health and Social Services Twitter Account\"><i class=\"fa fa-twitter-square fa-lg\"><\/i> Twitter<\/a><\/li>\n        <!-- <li class=\"googleplus\"><a href=\"#\"><i class=\"fa fa-google-plus-square fa-lg\"><\/i> Google +<\/a><\/li>\n        <li class=\"flickr\"><a href=\"#\"><i class=\"fa fa-flickr fa-lg\"><\/i> Flickr<\/a><\/li>\n        <li class=\"youtube\"><a href=\"#\"><i class=\"fa fa-youtube-square fa-lg\"><\/i> Youtube<\/a><\/li>\n        <li class=\"instagram\"><a href=\"#\"><i class=\"fa fa-instagram fa-lg\"><\/i> Instagram<\/a><\/li>\n        <li class=\"linkedin\"><a href=\"#\"><i class=\"fa fa-linkedin-square fa-lg\"><\/i> Linkedin<\/a><\/li>\n        <li class=\"pinterest\"><a href=\"#\"><i class=\"fa fa-pinterest-square fa-lg\"><\/i> Pinterest<\/a><\/li> -->\n      <\/ul>\n    <\/li>\n  <\/ul>\n\n              <\/div>\n\n            <\/div>\n\n          <\/div>\n\n        <\/div><br>\n\n      <\/div>\n\n\n\n      <div class=\"col-md-9\" id=\"main_content\"> \n\n  \n\n<h2 class=\"center\">Health\n\n<!--[type=EDIT name=\"DHANType\"]-->\n\n\n\n   Advisory<!--[END]-->\n\n<br>\n\n<!--[type=EDIT name=\"DHAN Heading\"]-->\n\n\n\nLYME DISEASE: SURVEILLANCE AND REPORTING IN DELAWARE<!--[END]-->\n\n<\/h2>\n\n\n\n<!--[type=HTMLEDIT name=\"Content\"]-->\n\n\n\n<p>\n\n\n  With the summer season quickly approaching, Delaware\u2019s Division of Public Health (DPH) provides this reminder about surveillance\n\n\n  and reporting Lyme Disease (LD)\n\n\n<\/p>\n\n\n<h3>\n\n\n  Background\n\n\n<\/h3>\n\n\n<p>\n\n\n  LD is the most common vector-borne disease in the United States. According to the Centers for Disease Control and Prevention (CDC),\n\n\n  350,198 confirmed and probable cases were reported in 2008 yielding a national average of 9.4 cases per 100,000 persons. In the 10 states\n\n\n  where LD is most common, the average was 56.0 cases per 100,000 persons.\n\n\n<\/p>\n\n\n<p>\n\n\n  In recent years, the implementation of electronic reporting, and increased awareness and testing by the medical community, have resulted\n\n\n  in a significant increase in the number of reported cases of LD in Delaware. From 2004 \u2013 2008 Delaware had the highest or second\n\n\n  highest incidence rate of LD in the U.S. In 2008, New Castle County had the highest rate in Delaware (98.1 cases per 100,000 persons),\n\n\n  followed by Kent (90.3), and Sussex Counties (58.4).\n\n\n<\/p>\n\n\n<h4>\n\n\n  2008 Case Definition:\n\n\n<\/h4>\n\n\n<ul>\n\n\n  <li>Physician diagnosed erythema migrans\u00a0 <strong>OR<\/strong>\n\n\n  <\/li>\n\n\n  <li>At least one late manifestation exhibited (musculoskeletal, cardiovascular or neurologic) <em>with<\/em> laboratory confirmation.\n\n\n    <ul>\n\n\n      <li>Laboratory confirmation consists of:\n\n\n        <ul>\n\n\n          <li>A positive culture for <em>B. Burgdorferi<\/em>\u00a0 <strong>OR<\/strong>\n\n\n          <\/li>\n\n\n          <li>Two-tiered testing of a positive enzyme immunoassay (EIA) or immunofluorescent assay (IFA) followed by a positive Western\n\n\n          immunoblot (IgM OR IgG)\u00a0 <strong>OR<\/strong>\n\n\n          <\/li>\n\n\n          <li>Single-tier positive IgG Western immunoblot\n\n\n          <\/li>\n\n\n        <\/ul>\n\n\n      <\/li>\n\n\n    <\/ul>\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p>\n\n\n  LD reports are not considered confirmed if the medical provider specifically states it is not a case of LD, or if the only symptom listed\n\n\n  is \u201ctick bite\u201d or \u201ctick exposure.\u201d\n\n\n<\/p>\n\n\n<h3>\n\n\n  Surveillance\/Reporting\n\n\n<\/h3>\n\n\n<p>\n\n\n  DPH receives electronic laboratory results that may be indicative of LD. However, we do not receive electronic notification for cases of\n\n\n  LD that are diagnosed clinically based on the presence of the characteristic bull\u2019s-eye rash, erythema migrans. For such cases,\n\n\n  which can be automatically confirmed in the absence of any laboratory testing, we rely on medical providers to report these cases\n\n\n  directly to us by phone, facsimile or mailed morbidity report.\n\n\n<\/p>\n\n\n<p>\n\n\n  Because laboratory reports lack necessary clinical information, case reports are instrumental for determining case status as well as\n\n\n  supplying DPH with important epidemiologic data. When DPH receives positive laboratory results or a report of possible LD from a hospital\n\n\n  or medical provider, a LD case report form and accompanying letter are sent to the practitioner. Practitioners are requested to complete\n\n\n  the form and return by facsimile or in the included postage paid envelope.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Treatment\n\n\n<\/h3>\n\n\n<p>\n\n\n  Patients treated with antibiotics in the early stages of the infection usually recover rapidly and completely. A few patients,\n\n\n  particularly those diagnosed with later stages of disease, may have persistent or recurrent symptoms. Antibiotics commonly used for oral\n\n\n  treatment include doxycycline, amoxicillin, or cefuroxime axetil. Patients with certain neurological or cardiac forms of illness may\n\n\n  require intravenous treatment with drugs such as ceftriaxone or penicillin.\n\n\n<\/p>\n\n\n<p>\n\n\n  Treatment guidelines for LD and other tick-borne diseases have been developed by the Infectious Diseases Society of America (IDSA) and\n\n\n  can be found at: <a href=\"http:\/\/www.journals.uchicago.edu\/doi\/full\/10.1086\/508667\">http:\/\/www.journals.uchicago.edu\/doi\/full\/10.1086\/508667<\/a>\n\n\n<\/p>\n\n\n<h3>\n\n\n  Further Information\n\n\n<\/h3>\n\n\n<ul>\n\n\n  <li>CDC &#8211; Lyme disease: <a href=\"http:\/\/www.cdc.gov\/ncidod\/dvbid\/lyme\/index.htm\">http:\/\/www.cdc.gov\/ncidod\/dvbid\/lyme\/index.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>CDC \u2013 Free Online Lyme disease CME for clinicians: <a href=\"http:\/\/www.cdc.gov\/ncidod\/dvbid\/lyme\/ld_clinicians.htm\">http:\/\/www.cdc.gov\/ncidod\/dvbid\/lyme\/ld_clinicians.htm<\/a>\n\n\n  <\/li>\n\n\n  <li>DPH \u2013 Lyme disease: <a href=\"\/dph\/epi\/lyme.html\">http:\/\/www.dhss.delaware.gov\/dph\/epi\/lyme.html<\/a>\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p>\n\n\n  Contact information for DPH, Bureau of Epidemiology:\n\n\n<\/p>\n\n\n<ul>\n\n\n  <li>Office \u2013 1-888-295-5156 or 302-744-1033\n\n\n  <\/li>\n\n\n  <li>Facsimile \u2013 1-302-223-1540\n\n\n  <\/li>\n\n\n  <li>Morbidity report &#8211; <a href=\"\/dph\/dpc\/rptdisease.html\">http:\/\/www.dhss.delaware.gov\/dph\/dpc\/rptdisease.html<\/a>\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<p>\n\n\n  ************************************\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this email because you are a registered member of the Delaware Health Alert Network. If you are not a member and would\n\n\n  like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a>\n\n\n<\/p><!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #226 April 20, 2010 2:21 pm Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10189","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10189","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10189"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10189\/revisions"}],"predecessor-version":[{"id":11365,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10189\/revisions\/11365"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10189"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}