Tick season: Practice vigilance in the fight against tick-borne illnesses
Warm weather means more time spent outdoors making memories. But if your adventures include time hiking in the woods or even in tall grass, you should be wary of ticks and their highly infectious bites, which can cause illnesses including Lyme disease, the most common vector-borne disease in the U.S.
Lyme disease cases exploded in the U.S. over the last two decades and experts warn that this year could shape up to be a bitter one in the battle against tick-borne diseases, which are often hard to diagnose and tough to treat. The Centers for Disease Control (CDC) estimates that the annual number of new diagnoses of Lyme disease in the U.S. currently exceeds 300,000, and that number is on the rise.
“As an osteopathic physician with a focus on prevention, I can’t stress enough the need to prevent tick bites to avoid debilitating illnesses,” says Dr. Tom Moorcroft, DO, a family medicine practitioner in Connecticut who treats Lyme patients.
The menace of ticks
A study published last year in the Journal of Medical Entomology found that blacklegged ticks and the rarer western blacklegged ticks, both of which carry the Lyme bacterium Borrelia burgdorferi, are now found in half of all U.S. counties, though transmission remains highest in the Northeast and Upper Midwest states.
“Most cases of Lyme (and related diseases) are reported over the summer. I saw near-summer levels of tick bites in the spring, so there’s potential for this year to be quite bad,” says Dr. Moorcroft.
Also on the rise this year are cases of Powassan virus, a very rare (with only 12 reported U.S. cases in 2016) but deadly tick-borne disease which scientists say takes less than 10 minutes to transmit from tick to human. This contrasts with the 24 to 48 hours it typically takes the Lyme bacterium to transmit.
Rocky Mountain spotted fever
Another potentially fatal tick-borne disease is Rocky Mountain spotted fever, suspected in the death of an Indiana toddler. RMSF is most commonly transmitted by the American dog tick in the eastern, central and Pacific coastal states, the Rocky Mountain wood tick in the western U.S. and the brown dog tick in parts of Arizona and along the U.S.-Mexico border, according to CDC tracking.
These ticks can be a particular threat for children who play with pets and often rub up against them.
Children are five times more likely than adults to die from RMSF, according to the CDC. Treatment for RMSF is most effective when started in the first 5 days of illness, with doxycycline as the treatment of choice for any age group. Misperceptions about the use of doxycycline for young children can prevent kids from getting lifesaving treatment, says the CDC.
While the CDC does not support the use of antibiotics as a preventive measure in treating suspected cases of tick-borne diseases, some doctors who regularly treat patients in tick-endemic regions disagree with that protocol.
“Untreated tick-borne infections can lead to long-term negative effects on your health and can sometimes be fatal,” says Dr. Moorcroft. “If a tick-borne infection is suspected, a prophylactic trial of treatment is generally safe and effective, and may prevent months or years of suffering. It could even save a life.”
Threat to children
Young children, particularly boys between the ages of 5 and 9 who often play outside, are most at risk for tick-borne diseases such as Lyme, the CDC reports.
For this reason, parents are urged to remain vigilant in checking for ticks, particularly with grade school-aged kids who are more self-sufficient than younger children and no longer require help bathing and going to the bathroom, which are ideal times to inspect for ticks.
Frequently, the symptoms of Lyme disease in children look quite different than in adults, according to Dr. Moorcroft. Adults may initially suffer from vague, flu-like symptoms ranging from fever, chills, headache, brain fog, and muscle and joint pain.
Children may develop sleep problems, including nightmares. Some children present with odd skin sensations and discomfort when touched. They may complain of debilitating headaches and gastrointestinal changes. Others may experience abrupt behavioral changes, outbursts of rage and problems with speech and motor skills.
“This makes the diagnosis of Lyme disease in children more challenging,” says Dr. Moorcroft, “as well as more crucial.”
Education and prevention
The confluence of vague and overlapping symptoms coupled with diagnostic difficulties make Lyme and other tick-borne diseases a particularly pesky public health threat.
According to the International Lyme and Associated Diseases Society (ILADS) guidelines for the management of Lyme disease “Early Lyme disease should … be considered in an evaluation of ‘off-season’ onset when flu-like symptoms, fever and chills occur in the summer and fall. Early recognition of atypical early Lyme disease presentation is most likely to occur when the patient has been educated on this topic.”
That is why it is important for the public to educate and advocate for themselves. If you have flu-like symptoms and spend time in areas endemic to ticks, be sure to share this vital information with your doctor.