SEASONAL It’s Tick Season

It’s Tick Season

By Dr. Ned Ketyer :

Originally posted at www.ThePediaBlog.com :

The Pennsylvania Department of Health issued an email advisory to health providers last week regarding the rising number of tick bite-related emergency department visits and tickborne illnesses in the state:

The Pennsylvania Department of Health (PADOH) has identified recent sustained increases in tick bite-related emergency department visits in nearly all regions of the state. This trend is expected, as tick exposures in Pennsylvania generally increase during spring and summer months and serves as an important reminder that tickborne diseases occur annually in Pennsylvania.

In addition, due to the stay at home orders, residents may be spending more time outdoors. Seeking medical care for tickborne illness should not be delayed due to the COVID-19 pandemic.

From April through September, health care providers should have a heightened clinical suspicion for tickborne diseases.

Reported Cases of Lyme Disease — United States, 2018 (CDC)

As seen in the map above, the range of Ixodes scapularis (the blacklegged tick) extends from northeastern and mid-Atlantic states through Pennsylvania to the upper midwest. The best-known illness it transmits by biting people (and dogs too) is Lyme disease, which is caused by the bacterium Borrelia burgdorferi. Anaplasmosis, babesiosis, and Powassan disease are much rarer diseases transmitted by blacklegged ticks (also called deer ticks). The Pennsylvania Department of Environmental Protection has collected blacklegged ticks and documented Lyme disease in every one of Pennsylvania’s 67 counties.

Other species of ticks can cause other diseases in humans. For example, a bite from either the American dog tick, the brown dog tick, or the Rocky Mountain wood tick can cause Rocky Mountain Spotted Fever (a very serious infection in which the greatest June 11, 2020 numbers are seen in North Carolina, Oklahoma, Arkansas, Tennessee, and Missouri — states far away from the Rocky Mountains).

The lone star tick (Amblyomma americanum) causes ehrlichiosis, tularemia, STARI, the Heartland and Bourbon viruses, and the sudden onset of a life-threatening (anaphylactic) beef allergy. (The irony of this unusual malady should not be missed: Cows belch methane which contributes to climate change, which in turn is believed to be responsible for expanding the tick’s range beyond the U.S. Southwest and the Lone Star State, Texas.)

In Pennsylvania, Lyme disease is the most commonly reported tickborne infection. Pennsylvania ranks fourth nationally in Lyme disease incidence (79.7 per 100,000) and number one in total cases (10,208) in 2018. Transmission via tick bites occurs more frequently during the summer, from May through September. (Year-long transmission is possible where blacklegged ticks are present in areas that don’t receive subfreezing temperatures and snowfall in winter — don’t have a season.)

another consequence of climate change. In such places ticks really Previously on The PediaBlog, we’ve examined the clinical symptoms and treatment of Lyme disease…

Typical symptoms are not specific: fever, headache, muscle aches, and fatigue. The rash that can accompany a tick bite — erythema migrans or bullseye rash — is not present in all cases. If the diagnosis is made at this early stage, treatment with antibiotics (amoxicillin or cefuroxime under eight years old and doxycycline for those who are older) for 2-4 weeks is usually curative. If this early stage of Lyme disease is not identified and treated, the bacteria can spread to the joints (arthritis), the nervous system (meningitis, bell’s palsy), heart (arrhythmias), and cause severe symptoms of debilitating and chronic fatigue and muscle pain. In people with these symptoms, treatment options and recovery without residual health problems are variable, less than certain, and frequently a simple matter of opinion. This can be frustrating for people who suffer as well as doctors who treat them.

… and strategies to prevent tick bites:

Ticks live in areas that are grassy, bushy, leafy, or wooded. Spending time outdoors walking in tall grass, gardening in the yard, hiking, camping or hunting in the woods invites ticks to latch onto your clothing and skin. Pretreating clothing and gear