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Why This Tick Season Worries Health Officials

May 03, 2018

The United States is ill-prepared for a looming public health threat, says the Center for Disease Control and Prevention, as it released a report this week that found illnesses caused by mosquito, tick and flea bites tripled nationwide from 2004 to 2016.

More than 640,000 cases were reported in that 13-year period, says the CDC, as reported cases of Lyme disease, West Nile, Zika and Rocky Mountain spotted fever increased to 96,000 nationwide in 2016 from 27,388 in 2004. In Connecticut, where  Lyme disease disease originated in 1975 when a group of adults and children from Lyme reported unusual arthritic-like symptoms, another warm winter promises a healthy tick population and increased threat of the disease.

The blacklegged tick, commonly known as the deer tick, loves the warmer winters. The more temperate conditions — and the growing deer population — have contributed to a sharp increase in deer ticks in Connecticut that carry Lyme disease, says the Connecticut Agriculture Experiment Station. In its most recent testing of close to 5,577 ticks in 2017, 32 percent of the 4,458 bites identified as deer tick carried Lyme disease. (In a typical year, it tests about 3,000 tests submitted by the public.)

“We are seeing increasing number of tick borne illness in the past few years,” says Dr. Michael Rajkumar, an infectious disease specialist at Backus Hospital.  “There are several instances where there were dual or triple infections which led to patients getting admitted to the hospital. They are usually elderly or immune-compromised patients. These folks do poorly especially if they get more than one infection.”

The number of people infected with Lyme disease remains uncertain because it’s difficult to diagnose and often unreported. Some people test positive when they actually have a different bacterial illness. Some with Lyme disease test negative. Symptoms of chronic Lyme disease also often mimic chronic fatigue syndrome, fibromyalgia and juvenile idiopathic arthritis.

“If it’s not treated within the initial course of the illness,” says Dr. Maurice Defina of the Hartford HealthCare Medical Group, “it can progress to others things like arthritis, septic arthritis. It can even cause meningitis. And there have been reports of potentially chronic illnesses as well.”

For a town-by-town breakdown of Lyme disease cases reported to the state Department of Public Health in 2017, click here.

Ticks can also carry babesiosis, a Malaria-like parasitic disease.

“Many people infected with babesiosis don’t even know they’re infected,” says Dr. Virginia Bieluch, an infectious disease specialist at The Hospital of Central Connecticut. “They may have no illness or a mild illness and they will resolve it on their own without any treatment.”

A 55-year-old New Milford man died in August 2017 from liver and kidney failure attributed to babesiosis, microscopic parasites transmitted by ticks that infect red blood cells. He had experienced stomach issues for weeks before his death, but by the time he visited a doctor the disease was irreversible.

Others develop flu-like symptoms that include fever, sweats, chills, body aches, headache, fatigue, nausea and loss of appetite. Hemolytic anemia, the breakdown of red blood cells, is also possible.

Babesiosis is particularly life-threatening, says the CDC, in people who:

• Don’t have a spleen.
• Have a weak immune system because of cancer, lymphoma, AIDS or other reason.
• Have a serious health condition, such as liver or kidney disease.
• Are elderly.

Like Lyme disease, with its Connecticut origins, babesiosis is a New England-born disease, with the first case reported on Nantucket in 1969. The disease has spread since the late 1980s to the New England mainland, throughout the Northeast and into the Midwest.

Doctors can confirm babesia, the malaria-like parasite, with a blood sample examined under a microscope, but only within two weeks of infection. Patients with symptoms are typically treated with anti-malarial drugs and antibiotics. Those with compromised immune systems can require hospitalization.

What it takes to get infected: It’s not so much a tick bite as a long-term tick residency on your skin. An infected tick attached to your skin for less than 36 to 48 hours is unlikely to transmit Lyme disease. Surprised? Your  mother was right: “Check yourself for ticks!”

What to look for: A rash that appears from three to 30 days after the bite, expanding up to 12 inches. It may or may not develop into a bull’s-eye pattern. But be careful: Up to 30 percent of people infected with Lyme disease do not get a rash. Other symptoms might resemble the flu: Fever, chills, headache and body aches. Check with your doctor as soon as possible.

Testing: A two-step laboratory blood test checks for signs of antibodies against Lyme disease bacteria. The first step, enzyme immunoassay (EIA), determines if the second step, immunoblot (or Western blot), is required. Both results must be positive for  a Lyme disease diagnosis.

Prevention: Wear long pants, long sleeves and light-colored clothing, which makes it easier to detect ticks. Spray exposed skin with a repellant that contains up to 30 percent DEET. A permethrin (0.5 percent) spray works best on clothing, shoes, sneakers and other gear.

Ticks attached to clothing can survive machine washing. To kill any ticks, tumble-dry clothes on high heat for 10 minutes. If the clothes must be washed first, use hot water.

How to remove a tick: The CDC recommends fine-tipped tweezers.

• Grasp the tick close to the skin.
• Pull steadily, with even pressure. A twist or other sudden movement could cause the tick’s mouth parts to break off and remain in the skin.
• After removal, clean the area thoroughly with rubbing alcohol, iodine or soap and water.

“Early recognition and treatment is vital to avoid long-term effects from Lyme disease,” says Dr. Rajkumar.

If you’re concerned about a possible tick bite, visit your nearest Hartford HealthCare-GoHealth Urgent Care, 8 a.m. to 8 p.m. and Saturday and Sunday from 9 a.m. to 5 p.m. To make an appointment, call 860.698.4303 or check in online by clicking here.