May 18, 2014

Waterboro search update: FSAR stand down

Update from the MASAR Facebook page:

It is with heavy heart and great sadness that we share this story. Our condolences and prayers are with Jaden's family, friends and the entire community. Thanks again for the untiring dedication of our Maine Warden Service and the many trained and untrained searchers that jumped in to help. Good teamwork and perseverance brought closure to everyone.

Link to press story:

http://wgme.com/news/features/top-stories/stories/family-jaden-dremsas-body-found-22425.shtml#.U3iK3VhdV8u

May 11, 2014

May 2, 2014

Spring 2014, Maine Deer Tick, Lyme Disease Update

Unfortunately, despite our harsh Winter, ticks were not fazed.
 
2014 Lyme Disease Information from the Maine CDC



Lyme disease is the most common vector-borne disease in Maine. Ticks are already out and we expect

the number of Lyme disease cases to increase as the weather continues to get warmer. May is Lyme

Disease Awareness Month in Maine.

 Provide general information regarding ticks and Lyme disease

 Remind providers to report cases of Lyme disease, including those diagnosed by erythema

 Provide resources on diagnosis and treatment of Lyme disease

 Remind providers that Anaplasma, Babesia and other tick borne diseases are also increasing in

Lyme disease is a bacterial infection that is carried by Ixodes scapularis (the deer tick). Cases have

been increasing each year in Maine, and occur in all 16 counties. Over 1,375 cases of Lyme disease

were reported statewide in 2013, a record high for Maine. Lyme disease is most common among school

age children and mature adults over the age of 65. Most infections occur during the summer months, and

as the weather continues to warm up, more ticks will be out in the open, and we are likely to see more

cases of Lyme disease. Cases have already been reported in 2014, and the number will rise as we enter

The most common early symptom of Lyme disease is an expanding red rash (erythema migrans) that

occurs 3-30 days after being bitten. Fever, joint and muscle pains may also occur. Untreated infections

can lead to clinical findings in skeletal, cardiac, and nervous systems. Disseminated manifestations of

disease include: arthritis characterized by recurrent, brief attacks of joint swelling; lymphocytic

meningitis; cranial neuritis (such as Bell’s palsy); encephalitis; and second or third degree

atrioventricular block. Lyme disease is treatable, and the majority of patients recover after receiving

 Remove the tick properly, ideally using tweezers or a tick spoon.

 Identify the tick and the engorgement level, or length in time of attachment. Tick identification

for a fee is available through the University of Maine Cooperative Extension and more

information can be found at http://extension.umaine.edu/ipm/tickid/

 Clean the area around the bite, and instruct the patient to watch for signs and symptoms for 30

 Testing of the tick is not routinely recommended because even if the tick tests positive for Lyme,

that does not mean it was attached long enough to transmit the disease, and even if the tick tests

negative that does not mean that was a patient’s only exposure, and that does not eliminate the

possibility of Anaplasmosis or Babesiosis.

 Prophylaxis after a tick bite is not routinely recommended, but can be considered under specific

o Tick has been identified as an engorged deer tick that has been attached for over 24 hours

o Exposure occurred in an area where there is a high rate of infected ticks. Areas south of

Bangor have the highest rate of infected ticks in the state. There is limited data from the

more northern counties on the rate of infection among ticks.

Maine Center for Disease Control and Prevention (Maine CDC)


o Prophylaxis can be started with 72 hours. Even if prophylaxis is used, monitoring for

symptoms for 30 days is recommended.

 There is no data showing if prophylaxis is effective in preventing Anaplasmosis, and a single

dose of doxycycline will not have an effect on Babesiosis. As such, even if prophylaxis is used,

monitoring for symptoms for 30 days is recommended.

 Preferred laboratory testing is a two tier method, with an EIA or IFA test followed by Western

 IgM is only considered reliable in the first month after exposure

 IDSA guidelines for assessment, treatment, and prevention of Lyme disease are available at

http://cid.oxfordjournals.org/content/43/9/1089.full

Lyme disease is a reportable condition in the state of Maine. Report all diagnosed erythema migrans

rashes and all positive lab diagnoses. Cases can be reported by fax at 1-800-293-7534 or by phone at 1-

Other diseases that are carried by ticks in Maine include Anaplasmosis, Babesiosis and Powassan.

Symptoms of Anaplasma include: fever, headache, malaise and body aches. Symptoms of Babesia

include: extreme fatigue, aches, fever, chills, sweating, dark urine, and possibly anemia. Symptoms of

Powassan include: fever, headache, vomiting, weakness, confusion, loss of coordination, speech

difficulties, seizures, and encephalitis and meningitis. Preferred testing for both Babesiosis and

Anaplasmosis is by PCR. Most reference labs offer a tick borne disease panel by PCR. Powassan

testing is by ELISA or MIA and samples should be sent to HETL to be forwarded to federal CDC.

In 2013, providers reported 94 cases of Anaplasmosis, 36 cases of Babesiosis, and 1 case of Powassan.

Five anaplasmosis cases and two babesiosis cases have already been reported in 2014. Anaplasmosis,

Babesiosis, Ehrlichiosis, Powassan, and Rocky Mountain Spotted Fever are all reportable in Maine.

A Physician’s Reference Guide is available and describes the most common tick borne diseases in

Maine. This guide can be found on our website at: http://www.maine.gov/dhhs/mecdc/infectious-
disease/epi/vector-borne/index.shtml under Resources. Paper copies can be requested through

 Lyme disease data is available on Maine CDC’s website at www.maine.gov/idepi and then

navigating to Maine Tracking Network: Lyme disease on the left navigation pane.

 For more information on tick borne diseases including Lyme:

http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/index.shtml

 For IDSA Lyme disease treatment guidelines:

http://cid.oxfordjournals.org/content/43/9/1089.full

 To order Lyme educational materials: http://www.maine.gov/dhhs/mecdc/infectious-
disease/epi/order-form-wn.shtmlDisease consultation and reporting available through Maine

Maine Center for Disease Control and Prevention (Maine CDC)