Lyme disease and more: A follow-up

Last week’s story, “The many faces of Lyme disease,” received a lot of feedback from readers. They requested that we provide some more information this week on other diseases that can be transmitted by ticks, and ways to protect yourself, your family, and your pets from tick bites.

I also received a letter from a Chisholm resident, Gerry Wozniak, who was recently hospitalized for Human Anaplasmosis. “I really felt I was going to die,” he told me over the phone. His symptoms included weight loss, temperature of 104 degrees, nausea, muscle aches, chills and shaking, hallucinations, and ultimately loss of consciousness. It wasn’t until his third trip to the emergency room, that he was diagnosed with and treated for HA (with antibiotics). He spent three days in the Intensive Care Unit.

Gerry did not know he’d been bitten by a tick. His advice: “When you experience some or any of these symptoms, get to the emergency room fast – and be assertive. The first two times I was sent home with Tylenol and an antinausea drug. Luckily, on my third visit to the emergency room, Dr. Stan Bezek put it together and treated me appropriately.”

Remember, Lyme disease and its diagnosis and treatment are fraught with controversy. About the only thing that everyone agrees upon is that the numbers of cases continue to rise. If you are interested in learning more, I recommend research.

Following is information from the Minnesota Department of Health website: www.health.state.mn.us.

Diseases that can be transmitted by ticks

It is a good idea to recognize and watch for the early symptoms of some of the more commonly encountered tick-transmitted diseases.

Tick-borne diseases of concern in Minnesota include:

LYME DISEASE

Lyme disease is a potentially serious bacterial infection affecting both humans and animals. The incidence of Lyme disease in Minnesota has been increasing in recent years.

The signs and symptoms of Lyme disease vary among individuals. A person may not have all of these symptoms. People often feel like they have “the flu.”

Three to 30 days after a blacklegged tick bite, look for: • A distinctive rash • Fever • Chills • Headache • Muscle and joint pain • Fatigue

Days to weeks after onset of illness, one or more of these signs and symptoms may occur: • Multiple rashes • Facial paralysis on one side of the

face • Fever • Stiff neck • Headache • Weakness, numbness or pain in

arms or legs • Irregular heart beat • Dizziness, feeling lightheaded, or

heart palpitations • Persistent weakness and fatigue

Weeks to months after onset of illness, some of these signs or symptoms may appear: • Joint swelling from arthritis in one or

more joints, usually the knees • Problems with the nervous system • Persistent weakness and fatigue

HUMAN ANAPlASMOSIS (HA)

Human anaplasmosis, formerly known as human granulocytic ehrlichiosis (HGE) is a bacterial disease that was first recognized in Minnesota in the early 1990s. It is transmitted to people by deer ticks, the same ticks that transmit Lyme disease. HA is less common than Lyme disease, however.

The signs and symptoms of human anaplasmosis may include: • Fever (over 102°) • Severe headache • Muscle aches • Chills and shaking

Less frequent symptoms of human anaplasmosis include nausea, vomiting, loss of appetite, weight loss, abdominal pain, cough, diarrhea, aching joints and change in mental status.

Although people of any age can get human anaplasmosis, it tends to be most severe in the aging or immunecompromised. Severe complications can include respiratory failure, renal failure and secondary infections.

BAbESIOSIS

Babesiosis is a protozoan infection that occurs infrequently in Minnesota. Approximately 20% of patients diagnosed with Babesiosis also have Lyme disease from the same deer tick bite. Babesiosis is a protozoan infection.

Signs and symptoms may include: • High fever • Muscle aches • Chills • Fatigue • Headache • Loss of appetite

Signs and symptoms may go away without treatment, but some cases may be severe. People who are elderly or immune-compromised (including people without a spleen) are most likely to have a severe infection.

ROCKY MOUNTAIN SPOTTEd FEVEr (RMSF)

Rocky Mountain spotted fever is extremely rare in Minnesota, but isolated cases have been reported from the southern section of the state.

Signs and symptoms include an abrupt onset of fever, malaise, headache, myalgias, loss of appetite, nausea, and vomiting, and a rash. The typical rash first appears as spots on the wrists and ankles which then spread to the trunk and also sometimes the palms and soles. The rash often appears two to five days after onset of fever. RMSF can result in organ failure and death.

Preventing tick-borne disease

Preventing exposure to blacklegged ticks (also known as deer ticks or bear ticks) requires diligence. Campers, hikers, hunters, farmers and people in outdoor occupations may be at risk in the counties known to have blacklegged ticks. Some people have been exposed to blacklegged ticks in their yard, particularly when the yard has a lot of brush and leaf litter, and is adjacent to the woods.

Minimizing your risk

Use a good tick repellent. Products containing permethrin, which are used on clothing, are especially recommended for people who will be spending an extended period of time in possible tick habitat. Permethrin products are marketed under names like Permanone® and Duranon® and are available in stores that sell outdoor gear. Do not use permethrin on your skin.

Standard DEET-based products are another option. Use a product containing no more than 30 percent DEET for adults. Concentrations up to 30 percent DEET are also safe for children (according to reports from the American Academy of Pediatrics). Do not use DEET for infants under two months of age.

Products containing DEET will also protect you from mosquito bites and mosquito-transmitted diseases. Follow the manufacturer’s directions for all repellent applications.

Wear clothes that will help shield you from ticks. Wear long-sleeved shirts and long pants. Tuck your pants into the top of your socks or boots to create a “tick barrier.” Wear light colored clothes to make it easier to spot ticks.

Check frequently for ticks and remove them promptly. Ticks must remain attached for one to two days before they can transmit the Lyme disease bacteria. Some research suggests that human anaplasmosis may be transmitted more quickly. Check the hairline and behind the ears and points of clothing constriction (e.g. behind knees, waist line, and arm pits).

Tick removal. If you live near the woods in an area with blacklegged ticks: • Keep your lawn mowed short.

• Remove leaves and clear the brush around your house

and at the edges of the yard.

• Keep children’s play-sets or swing-sets in a sunny and dry

area of the yard.

• Make a landscape barrier (such as a three foot wide border

of wood chips) between your lawn and the woods.

Prevention for pets. A vaccine to prevent Lyme disease is available for dogs. However, the vaccine will not stop your dog from bringing ticks into the home. Check your dog or cat for ticks before allowing them inside. Topical tick repellants are available for pets.

Tick removal. If you find a tick on yourself, remove the tick promptly. Prompt tick removal is important.

If possible, use a pair of tweezers to grasp the tick by the head. Grasp the tick close to the skin. Pull the tick outward slowly, gently, and steadily. Do not squeeze the tick. Use an antiseptic on the bite.