By Edward Butler, M.D.
Traveler’s Health and Infectious Disease Services
at Lawrence Memorial Hospital of Medford and Melrose Wakefield Hospital
Ticks are small, but can cause serious diseases, such as Lyme disease.
Tickborne diseases, such as Lyme disease and Rocky Mountain spotted fever, are a major concern for us here in Massachusetts and throughout New England. In particular, people who live in wooded areas, those who enjoy the outdoors, and people who live in rural areas are at risk for the diseases ticks carry.
But that doesn’t mean people who live in urban areas are safe. No matter where we are, we all need to be mindful of the dangers ticks pose to us. Tickborne diseases can strike when we least expect it, and the risk only continues to grow.
Can you spot the tick?
One of the most common ways to contract a tickborne illness is to spend time outside, particularly in rural or natural areas. In my previous post on the diseases ticks carry, I mentioned that avoiding the outdoors altogether isn’t good way to avoid ticks. See if you can spot the tick danger in this next story.
I once treated a grandmother who had Lyme disease. She wasn’t the sort of patient I typically see for tickborne illness. This woman didn’t live out in the country or back in the woods; instead, she lived on the 10th floor of an apartment building in a fairly good-sized town in eastern Massachusetts. She wasn’t an outdoorswoman by any stretch of the imagination, but she found a tick on herself and got help quickly. She just couldn’t figure out where she could have picked up a tick.
Did you spot the patient’s risk? I mentioned that she’s a grandmother. She told me she had recently watched her grandchildren in her apartment. We deduced that one of her grandkids had brought in a tick, the tick made its way to Grandma, and that’s how she got sick.
It really is that simple. Even if you’re in an urban area, you’re at risk for tick bites. That’s why it’s important to get in the habit of performing regular checks for ticks, even if you don’t frequently go outdoors. Make sure to check your hair, the back of your neck, and behind your knees, as these are some of ticks’ favorite places to hide.
Tickborne diseases without a tick?
Unfortunately, even if you do everything possible to protect yourself from tick bites, you may not be out of the woods when it comes to the diseases ticks carry. That’s because it’s possible for you to get one particular tickborne disease without a tick biting you.
One of the many parasites ticks can carry is called Babesia microti (bah-BEE-zee-ah my-CROW-tee). Babesia microti parasites cause a disease called babesiosis (bah-BEE-zee-oh-sis) that is very similar to malaria. People can carry the parasites in their blood cells for up to 12 months, and many never show any symptoms.
It’s quite possible for someone to be infected in July, for example, and pass the parasites on through a blood transfusion or blood donation in January without ever realizing there was a problem. A mother who is infected with Babesia microti parasites can even pass the parasites to her baby in the womb or during delivery.
We currently have no screening for Babesia parasites in blood from donors. That’s one of the reasons babesiosis has quickly become the No. 1 cause of blood transfusion-related disease in Massachusetts. Nationwide, the Centers for Disease Control and Prevention (CDC) notes that babesiosis has become the most widely reported parasitic infection transmitted through blood transfusions.
Though many people with babesosis never show any symptoms, some people are at much greater risk if they are infected, including:
- Older adults
- People who don’t have a spleen
- People with other illnesses
- People with suppressed immune systems (for example, patients taking immune-suppressing medication after organ transplants, patients with HIV or AIDS, etc.)
The Food and Drug Administration is currently working with manufacturers to develop an approved blood test for Babesia microti. For now, our best bet is to monitor high-risk patients for symptoms of babesiosis. Symptoms include:
- Chills and/or sweats
- Intermittent fever
- Joint and/or muscle pain
If you think you may have babesiosis from a tick bite or blood transfusion, see your doctor as soon as possible.
Ticks and tick diseases are gaining ground
Tickborne diseases spread to humans primarily in the warmer-weather months. The season for these diseases in our area is mid-March through October.
But the effects of climate change have had a clear impact on illnesses spread by ticks and other animals. As our region stays warmer for longer periods during the year, the areas ticks can colonize get larger. That gives the diseases they carry a better chance to spread.
This is likely due at least in part to increasing temperatures. Researchers used a climate change model to study the movement of the deer tick, Ixodes scapularis, throughout North America. Using this model, the researchers predicted the actual movement patterns of the deer tick with an 89 percent accuracy rate. Deer ticks continue to spread throughout the region and to points north of us, putting more people at risk for the diseases they carry.
New tick dangers on the horizon
As temperatures rise and the deer tick makes its way north, other tick species — and the diseases they bring with them — are heading our way from points south. One such tick species is Amblyomma americanum, commonly known as the lone star tick. As the CDC notes, this species “may be quite aggressive.” The habitat of this tick has increased in the past 20 to 30 years, with sightings reported as far north as Maine and Quebec.
While the lone star tick doesn’t cause Lyme disease, it does cause a similar disease called southern tick-associated rash illness (STARI). Though scientists haven’t positively identified the virus or bacterium that causes STARI yet, we do know the lone star tick infects humans.
STARI patients tend to recover faster after treatment with antibiotics than patients with Lyme disease. But recovered STARI patients may be at risk for a peculiar phenomenon: an allergy to red meat. As PBS reported in 2014, some patients who have been bitten by a lone star tick and recovered successfully have later shown an allergy to red meat. This allergy may be fatal if patients don’t avoid foods like steak, hamburger, and bacon, among others.
The dangers of tickborne disease are real and growing. All of us need to be cautious of these dangers and do everything we can to protect ourselves. If you think you may have a tickborne disease, see your doctor as soon as possible to begin testing and treatment.
Tags: Infectious Disease, summer safety, tick diseases, tick prevention, ticks