Experts fear bad tick season amid coronavirus pandemic
by: Nexstar Media Wire
Posted:
FILE – This March 2002 file photo shows a deer tick under a microscope in the entomology lab at the University of Rhode Island in South Kingstown, R.I. On Wednesday, Nov. 14, 2018, the Centers for Disease Control and Prevention said a record number of tick-borne diseases _ more than 59,000 _ were reported in 2017. It’s a 22 percent increase from the number reported the year before. (AP Photo/Victoria Arocho, File)
DALLAS (NEXSTAR) — As if there wasn’t enough to worry about in 2020, experts are warning about a potentially bad tick season.
Medical experts fear that many people who’ve been stuck inside due to coronavirus may “let their guard down” once they’re able to venture outdoors and not pay attention to tick bite prevention.
Some symptoms of Lyme disease are very similar to the symptoms of COVID-19,according to medical professionals. Ticks can carry Lyme and other dangerous diseases that can be severe if not treated properly. (See link for story)
The article states that Pennsylvania has seen an increase in ER visits related to tick bites. I pray they are immediately treating these people prophylactically. Everyone admits that early diagnosis and treatment is essential, yet so many still take a “wait and see” approach.
Trust me when I say you don’t want this to develop into a chronic condition. The risks of using antibiotics for a short time are nothing compared to a potential life-time of pain and expense.
Ticks are obligate hematophagous arthropods and act as vectors for a great variety of pathogens, including viruses, bacteria, protozoa, and helminths. Some tick-borne viruses, such as Powassan virus and tick-borne encephalitis virus, are transmissible within 15-60 min after tick attachment. However, a minimum of 3-24 h of tick attachment is necessary to effectively transmit bacterial agents such as Ehrlichia spp., Anaplasma spp., and Rickettsia spp. to a new host. Longer transmission periods were reported for Borrelia spp. and protozoans such as Babesia spp., which require a minimum duration of 24-48 h of tick attachment for maturation and migration of the pathogen.
Laboratory observations indicate that the probability of transmission of tick-borne pathogens increases with the duration an infected tick is allowed to remain attached to the host. However, the transmission time may be shortened when partially fed infected ticks detach from their initial host and reattach to a new host, on which they complete their engorgement.
For example, early transmission of tick-borne pathogens (e.g., Rickettsiarickettsii, Borreliaburgdorferi, and Brucellacanis) and a significantly shorter transmission time were demonstrated in laboratory experiments by interrupted blood feeding.
The relevance of such situations under field conditions remains poorly documented.
In this review, we explore parameters of, and causes leading to, spontaneous interrupted feeding in nature, as well as the effects of this behavior on the minimum time required for transmission of tick-borne pathogens.
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**Comment**
Partial feeding is not rare and needs to be taken into account. Unfortunately, authorities have followed a tightly controlled narrative when it comes to transmission times – which has only served to hurt patients for decades.
Bob Giguere of IGeneX states a case by Dr. Jones of a little girl who went outside to play about 8:30a.m. and came inside at 10:30 with an attached tick above her right eye. By 2 o’clock, she had developed the facial palsy. At the hospital she was told it couldn’t be Lyme as the tick hadn’t been attached long enough. They offered a neuro-consult…..
By 4pm she couldn’t walk or talk.
Do not believe what the “experts” tell you about transmission times!
Dangerous tick-borne bacterium extremely rare in New Jersey
The mystery behind the rise in spotted fever cases continues
Date: June 25, 2020
Source: Rutgers University
Summary:
There’s some good news in New Jersey about a potentially deadly tick-borne bacterium. Researchers examined more than 3,000 ticks in the Garden State and found only one carrying Rickettsia rickettsii, the bacterium that causes Rocky Mountain spotted fever. But cases of tick-borne spotted fevers have increased east of the Mississippi River, and more research is needed to understand why. (See link for article)
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**Comment**
Important quote:
“CDC researchers recently found that the invasive Asian longhorned tick, like the American dog tick and lone star tick, is an efficient vector of Rickettsia rickettsii in the lab,” said senior author Dina M. Fonseca.
I’m surprised they didn’t mention that the brown dog tick has outbreaks in Mexico.
Lyme disease symptoms could be mistaken for COVID-19, with serious consequences
May 27, 2020
Jory Brinkerhoff, Associate Professor of Biology, University of Richmond
Summer is field season for ecologists like me, a time when my colleagues, students and I go out into fields and woods in search of ticks to study the patterns and processes that allow disease-causing microbes – primarily bacteria and viruses – to spread among wildlife and humans.
That field work means we’re also at risk of getting the very diseases we study. I always remind my crew members to pay close attention to their health. If they get a fever or any other signs of sickness, they should seek medical treatment immediately and tell their doctor that they may have been exposed to ticks.
When summer flu-like illnesses develop in anyone who spends time outdoors in areas where ticks are common, tick-transmitted diseases like Lyme disease should be considered a likely culprit.
This summer, however, the global emergence of the novel coronavirus and COVID-19 is presenting a whole new set of challenges for diagnosing Lyme disease and other tick-borne illnesses.
Anyone who mistakes Lyme disease for COVID-19 could unknowingly delay necessary medical treatment, and that can lead to severe, potentially debilitating symptoms.
Delaying medical treatment can be dangerous
As we move from spring into summer, and into the peak period of tick activity in much of the Northern Hemisphere, time spent outdoors will increase, as will risk of tick-transmitted disease.
In some cases, there are key symptoms of a tick-transmitted disease that can help with diagnosis. For example, early Lyme disease, which is caused by the bite of an infected black-legged tick, sometimes called the deer tick, is commonly associated with an expanding “bull’s-eye rash.” Seventy percent to 80% of patients have this symptom.
However, other symptoms of Lyme disease – fever, head and body aches and fatigue – are less distinctive and can be easily confused with other illnesses, including COVID-19. This can make it more difficult to diagnose a patient who did not notice a rash or was unaware that they ever had a tick bite. As a result, Lyme disease cases can be misdiagnosed. Nationally, Lyme disease may be undercounted to the point that only one in 10 cases is reported to the CDC.
If Lyme disease is identified and treated quickly, two to four weeks of antibiotics can usually knock out Borrelia burgdorferi, the species of spirochete bacteria that causes it.
Lyme disease is most common in the Northeast and North Central U.S., but that does not mean that people in areas without Lyme disease are free from worry about tick-transmitted disease. Ticks throughout North America can spread a wide range of diseases, many of which also present with flu-like symptoms, leading to the potential for misdiagnosis, especially when these diseases are not especially common in the general population.
Spotted fevers are another group of tick-transmitted diseases. The most severe of these is Rocky Mountain spotted fever, which can be fatal. Spotted fevers, as the name suggests, are typically associated with a rash. But the rash may not show until after fever and other flu-like symptoms, creating the same risk of being mistaken for COVID-19. Like Lyme disease, spotted fevers can be treated with anitibiotics, and early treatment can head off more severe infections, so quick, accurate diagnosis is critical.
Is COVID-19 increasing chances of tick bites?
Recent reports from across the nation and around the globe suggest that wildlife have become more bold this spring, wandering into suburbs and cities where human and vehicle traffic are reduced because of COVID-19.
Whether this phenomenon is being driven by changes in animal behavior or is simply an artifact of humans spending more time in their homes and becoming more aware of their surroundings is not clear, but changes in wildlife behavior and habitat use could affect tick-transmitted disease. For example, white-tailed deer are important hosts to multiple human-biting tick species in eastern North America, including black-legged ticks, and more deer around our homes and in our neighborhoods could lead to more ticks that have a chance to bite humans.
Ticks do not move very far by themselves – perhaps about a foot per day for some species – but can be dispersed dozens of miles or more while hitching a ride on a highly mobile host like a deer, coyote or bird. Thus, the wildlife we observe exploring our neighborhoods while we are encouraged to stay at home may be leaving behind ticks that are carrying pathogens, or that could acquire infection from the more common wildlife already near our homes.
As with COVID-19, mitigation efforts can substantially reduce the risk of tick-borne diseases. Wear long sleeves and long pants and use an EPA-registered repellent when you are in tick habitat, and check yourself thoroughly for ticks when you get home.
It is important to be aware of ticks when spending time outside, but fear of ticks should not stop people from enjoying nature.
Delays in treatment have been and continue to be a serious problem.
The author’s point that Lyme could be mistaken for COVID is important.
Lyme/MSIDS has been and continues to be mistaken for just about everything. Testing is abysmal (just like antibody and PCR testing for COVID) and shouldn’t be solely relied upon.
Rocky Mountain Spotted Fever Can Be Deadly: How to Prevent, Diagnose, and Treat the Tick-Borne Disease
by Jenny Lelwica Buttaccio
Posted 6/11/20
When it comes to tick-borne diseases (TBD), there are several other infections with the potential to make you sick beyond the best-known Borrelia burgdorferi, the bacteria that causes Lyme disease.
For starters, there are well-known Lyme disease coinfections like Bartonella and Babesia that may compound Lyme symptoms and add insult to injury for many people. Cases of these are on the rise as environmental and climate patterns continue to shift in such a way that supports tick populations, and as housing developments expand into wooded areas, bringing people, animals, and ticks in increasingly close proximity to one another.
Additionally, there’s an emerging threat of lesser-known pathogens that seem to garner media attention each year. One such infectious agent is Rickettsia rickettsii, a bacteria that causes Rocky Mountain spotted fever (RMSF).
“Rickettsia has a preference for infecting cells lining blood vessels, specifically endothelial cells — this makes for a much more virulent bacteria,” says Dr. Bill Rawls, MD, Medical Director of RawlsMD and Vital Plan.
RMSF is spread through the bite of an infected tick. Whereas black-legged ticks are the arachnids responsible for Lyme disease, the Rocky Mountain wood tick, the brown dog tick, and the American dog tick are the chief transmitters of RMSF.
Prompt medical intervention is crucial for a successful recovery from RMSF — the consequence of delaying treatment can be life-threatening. Here, we’ll discuss the broad strokes of RMSF, including signs, symptoms, testing, and treatment.
An Overview of Rocky Mountain Spotted Fever
RMSF is a gram-negative obligate intracellular bacteria — in other words, it’s a parasitic-like microorganism that grows and reproduces inside a host’s cells. As a pathogenic disease, it was first reported in the 1920s.
The disease is part of a larger category called Spotted Fever Rickettsiosis (SFR). In 2010, the name was given to signify a group of related conditions caused by the Rickettsia bacteria for which the available serologic testing can’t discriminate between the different species of the disease-causing bacteria.
Each year, there are approximately 2,000 new cases in the United States, as reported by the Centers for Disease Control and Prevention (CDC). However, in 2017 RMSF cases jumped to 6,248, with marginally fewer cases reported in 2018.
To better understand RMSF, it helps to know some facts about testing methods, times of the year when ticks are most active, and the profile of people who are most at risk of contracting the illness.
1. The Annual Incidences of RMSF Aren’t Precise.
Because the testing doesn’t identify which species of Rickettsia is the culprit, there’s no way to tell how many cases are specific to RMSF versus other Rickettsial diseases that may cause less serious types of spotted fevers. However, the mortality rate for RMSF may be between 5% and 10%, according to a review in The New England Journal of Medicine. By comparison, related Rickettsial bacteria like Ehrlichia and Anaplasmosis have fatality rates of 3% and 1%, respectively.
2. The Transmission of RMSF Varies Depending on Geography and Time of Year.
Ticks carrying RMSF tend to be most active in May through August, but there’s some variability due to geographic location in the U.S. and the type of tick that’s carrying the pathogen. Like Lyme disease, ticks carrying RMSF may be active year-round in parts of the country where temperatures stay above freezing.
Although RMSF can be found throughout the United States, the majority of cases come from these five states:
Arkansas
Missouri
North Carolina
Tennessee
Virginia
3. Certain Individuals May Be More At Risk of Acquiring RMSF.
People who live near wooded areas or in an area of the country known to be hospitable to ticks are at risk of acquiring the infection. Additional information from the CDC indicates:
Reported cases of RMSF occur more often in men than women.
Most cases occur in individuals over the age of 40. However, the mortality rate of RMSF is highest among children in the 10 and under age group.
People with glucose-6-phosphate dehydrogenase (G6PD) deficiency, a genetic disorder affecting red blood cells, show a higher propensity for the infection.
Immunocompromised individuals are more likely to require hospitalization from RMSF.
Symptoms of Rocky Mountain Spotted Fever
Because RMSF attacks the vascular system, one of the most vulnerable places in your body, severe illness is much more likely than you might encounter with other TBDs. On average, symptoms of RMSF generally start 12 days after a tick bite, but it can range from 5 to 21 days.
The telltale signs of infection include high fever, chills, muscle aches, and a rash. “Certainly, a history of a tick bite is a tipoff to infection,” says Dr. Rawls. “But because tick bites are painless and people often are not aware of being bitten, that history is not always helpful.”
Let’s take a closer look at the signs and symptoms of RMSF:
An important note about the rash: Typically, the rash associated with RMSF develops two to five days after the onset of fever. However, it can occur later in the course of the illness, even after treatment is started, says Dr. Rawls.
Small, pink, non-itchy spots, with a diameter of 1 to 5 millimeters, first show up on wrists, forearms, and ankles. The spots may spread to the trunk of the body and the soles of the feet as well. As the disease progresses, the spots may become red or purple, which is known as petechiae (puh-TEE-kee-uh).
However, just as some people don’t develop a rash when they contract Lyme disease, not everyone gets a rash with RMSF either.
Diagnosis of Rocky Mountain Spotted Fever
“Diagnosis is a real challenge because Rocky Mountain spotted fever resembles other, more common infectious diseases,” says Dr. Rawls. “But it’s critical to initiate therapy early in the course of the disease, especially if you live in an endemic area.”
Because time is of the essence, your healthcare provider will likely initiate treatment first, and then test to confirm the diagnosis of RMSF. Testing methods that may be used include:
General labs: Complete blood count (CBC), complete metabolic panel (CMP), liver panel, etc.
Indirect Immunofluorescent Assay (IFA): An antibody test that measures IgG and IgM antibodies for R. rickettsii
Polymerase chain reaction (PCR): This is a DNA test that may be most helpful when used to test a biopsy of the rash or lesion. Concentrations of R. rickettsii in the blood may be low, so a negative PCR doesn’t eliminate the diagnosis of RMSF.
Urinalyses: A test that may be useful to detect blood or protein in the urine
Treatment of Rocky Mountain Spotted Fever
“There are a lot of variables that play into why a person becomes sick with Rocky Mountain spotted fever, but if they become ill, they become very ill,” says Dr. Rawls. “It’s a microbe where, if you develop symptoms, you need antibiotics to try to knock down the infection as quickly as possible.”
Serious complications, like the loss of extremities (fingers, toes, or limbs), can occur due to a decrease in circulation, especially if treatment is delayed. For acute RMSF, the standard of care is doxycycline. “Herbal therapy shouldn’t be used as the primary therapy, but it can be used as a supportive measure,” advises Dr. Rawls.
The following are treatment recommendations, according to the CDC:
Doxycycline dose in an adult: 100 mg twice daily
Doxycycline dose in children < 45 kg (100 lbs): 2.2 mg / kg twice daily
Antibiotic therapy should be administered for 30 days, suggests Dr. Rawls, or until three days after the fever subsides. At a minimum, treatment with antibiotics should be no shorter than five to seven days as per CDC guidelines. If a patient doesn’t respond to doxycycline, that’s an indication that acute tick-borne infection isn’t present, and other infections such as a virus or Babesia may be causing symptoms.
If an individual doesn’t tolerate doxycycline, a broad-spectrum antibiotic called chloramphenicol may be used. However, this drug carries with it a high potential for side effects. The dosage for chloramphenicol is12.5 mg per kg of body weight orally every 6 hours. In certain cases, IV antibiotics may be required in some people with acute RMSF.
Incorporating Herbal Therapy
Although treatment for RMSF requires antibiotic therapy, herbs can be used to protect vascular cells, promote healing, and act as a complement to drug therapy. However, remember to consult with your doctor before adding natural remedies to your existing treatment protocol.
Here are some of Dr. Rawls’ preferred herbs and natural ingredients of choice:
1. To improve circulation and to enhance blood flow:
Ultimately, tick prevention is the key to avoiding RMSF. “We all should be vigilant about ticks,” urges Dr. Rawl. “Pay attention. If you get a tick bite, if you end up with symptoms of fever or a rash, you need to see a healthcare provider for that immediately. The quicker you get treatment, the less likely you are to have long-term ramifications.”
Dr. Rawls is a physician who overcame Lyme disease through natural herbal therapy. You can learn more about Lyme disease in Dr. Rawls’ new best selling book, Unlocking Lyme.
You can also learn about Dr. Rawls’ personal journey in overcoming Lyme disease and fibromyalgia in his popular blog post, My Chronic Lyme Journey.
Madison Area Lyme Support Group 