260162 Promoting prevention and wellness: The case of tick-borne illnesses in an endemic area

Wednesday, October 31, 2012 : 12:50 PM - 1:10 PM

Sara Weiner, BS , Medical Student, University of Massachusetts Medical School, Worcester, MA
Suzanne Cashman, ScD , Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA
Dan Wemple, BS , Medical Student, University of Massachusetts Medical School, Worcester, MA
Meghan King, BS , Graduate School of Nursing, University of Massachusetts Worcester, Worcester, MA
Sebastian Ramos, BS , Medical Student, University of Massachusetts Medical School, Worcester, MA
Rebecca Rozin, BA , Graduate School of Nursing, University of Massachusetts Worcester, Worcester, MA
Caitliin Cronin, BS , Pharmacy, Mass College of Pharmacy and Health Sciences, Worcester, MA
Parag Kunte, MPH , Center for Health Policy and Research, University of Massachusetts Medical School, Shrewsbury, MA
Michael Loberg, PhD , Board of Health, Vineyard Haven, MA, Vineyard Haven, MA
To address the long-standing problem of endemic tick-borne illness (TBI) on the island of Martha's Vineyard, MA, in 2011, the six towns' boards of health collaborated to develop a Program to Reduce the Incidence and Severity of Tick-Borne Illness. In the fall 2011, six health professions students conducted an island wide survey that included local clinicians, residents, and visitors. Survey results indicate that island caregivers are shifting to a “Better safe than sorry” attitude re treatment and to TBI panels instead of Lyme only titer. Providers expressed high concern for visitors who may seek care for emerging Lyme symptoms upon returning to non-endemic areas. Exploration of the DPH/CDC TBI Incidence reporting system uncovered provider misconceptions regarding requirements for reporting, lack of time for paperwork and follow-up, and a wide range of opinions regarding the importance of reporting. Providers indicated diagnosing and treating many more cases of Lyme than reported. Recommendations regarding how the Incidence reporting system could be improved include clarifying DPH/CDC reporting guidelines for provider education to correct misconceptions. Survey results also highlighted the issue of pharmacists possibly dispensing prophylactic treatment without a written prescription within 72 hours of confirmed tick bite. In 2010, island pharmacists filled an estimated 1,200 prescriptions for doxycycline. They estimated that 1,079 of these 1,200 prescriptions were for new cases of Lyme disease. Each of the eight pharmacists interviewed believe in dispensing doxycycline 200 mg by mouth, as a single dose for prophylactic treatment of tick-borne diseases in asymptomatic patients with a tick bite.

Learning Areas:
Administration, management, leadership
Assessment of individual and community needs for health education
Clinical medicine applied in public health
Planning of health education strategies, interventions, and programs
Public health administration or related administration
Public health or related organizational policy, standards, or other guidelines

Learning Objectives:
Explain reasons for prophylactic treatment of tick-borne illnesses Describe CDC’s incidence reporting system and discuss how it might be improved Identify two reasons that providers in an area endemic for tick-borne illnesses and with limited resources suggest using prophylactic treatment

Keywords: CDC Guidelines, Health Promotion

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I collected the data, contributed to analyzing it, and to developing the ppt presentation.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.