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Larry Langdon
/ Categories: Lyme Disease

Tick Bites and Tick Borne Diseases

Ticks are small parasites that belong to the scientific classification Arachnida, which is the same family as spiders.

Ticks are excellent vectors for disease transmission and are second only to mosquitoes as vectors of infectious and toxic disease. 

Tick-borne diseases can be caused by bacteria, parasites or viruses, but the diseases caused by bacteria are most common.   Ticks need blood to complete their life cycle and tick-borne diseases are transmitted to humans through the bite of infected ticks.

Ticks are common in many parts of the world so tick-borne diseases are common.  Some tick-borne illnesses can lead to serious problems, but prompt antibiotic therapy can typically fix the problem. If left untreated, tick-borne diseases can be difficult to treat using conventional methods such as antibiotics.

Tick-borne illnesses have a wide range of symptoms from mild to severe.  Though tick-borne illnesses share many of the same symptoms, symptoms and treatment may vary for each disease depending on the type of bacteria, parasite, or virus that causes the illness.

Tick-borne infections have symptoms that are similar to those of many other diseases, leading to misdiagnosis and persistent sickness.

 

Common Tick Species And Diseases They Spread:

  • Blacklegged or deer tick (Ixodes scapularis)
    • Anaplasmosis
    • Babesiosis
    • Borrelia miyamotoi disease
    • Lyme disease
    • Powassan virus disease (can also be spread by Ixodes cookei)
  • Lone Star Tick (Amblyomma americanum)
    • Ehrlichia chaffeensis
    • Tularemia
  • American Dog Tick (Dermacentor variabilis)
    • Rocky Mountain spotted fever
    • Tularemia

 

Tick-Borne Diseases

Ticks can carry multiple infectious organisms that cause many tick borne diseases. Tick-borne illnesses include:

  • Anaplasmosis
  • Babesiosis
  • Borrelia Miyamotoi Infection
  • Colorado tick fever
  • Ehrlichiosis
  • Heartland Virus Infection
  • Lyme disease
  • Powassan encephalitis
  • Relapsing fever
  • Rocky Mountain spotted fever (RMSF)
  • Southern tick-associated rash
  • Tularemia

 

Anaplasmosis

Anaplasmosis formerly known as human granulocytic ehrlichiosis (HGE) is a tick-borne bacterial disease caused by the bacterium Anaplasma phagocytophilum and is transmitted through tick bite by black-legged or deer ticks (Ixodes scapularis).

Symptoms of Anaplasmosis

Symptoms appear within a week or two after the tick bite and may include one or more of the following:

  • Chills
  • Fever
  • Muscle aches
  • Diarrhea
  • Nausea or vomiting
  • Loss of appetite

If it is not treated promptly, later symptoms of the disease may include:

  • Bleeding complications
  • Organ shutdown
  • Respiratory failure
  • Death

A person is at a greater risk for complications if older, have a weakened immune system or delayed treatment.

Treatment for Anaplasmosis

Antibiotic doxycycline is widely used to treat anaplasmosis. Treatment can be effective if the infection is diagnosed early and treatment is started immediately. Antibiotics are much less effective in late-stage infections.

 

Babesiosis

Babesiosis is caused by microscopic parasites that infect red blood cells. Most cases of babesiosis are caused by Babesia microti, while some are caused by other strains of Babesia which are transmitted by infected black-legged or deer ticks (Ixodes scapularis). About 20% of patients diagnosed with Babesiosis also have Lyme disease.

Symptoms of Babesiosis

Some people do not experience any symptoms. For those who do, symptoms include:

  • Fatigue
  • Flu-like symptoms
  • Headaches
  • Hemoglobinuria
  • Hemolytic Anemia (due to the destruction of red blood cells)
  • High fever
  • Jaundice
  • Myalgia
  • Nausea
  • Renal failure
  • Sweating

Diagnosis of Babesiosis

Fever, hemolytic anemia, and exposure history. Babesiosis is diagnosed by looking at red blood cells under a microscope and finding Babesia parasites. Protozoa in a "Maltese cross" pattern on the periphery of the smear. Serologic testing and polymerase chain reaction tests are also used to diagnose.

 

Treatment for Babesiosis

Conventional treatment usually consists of combination of Atovaquone plus azithromycin or quinine plus clindamycin. Mild disease requires only symptomatic treatment. Exchange transfusion can be used in severely ill patients.

 

Borrelia Miyamotoi Infection

Borrelia miyamotoi infection is a recently identified tick-borne infection in humans.  It is caused by Borrelia miyamotoi a spiral-shaped bacteria that is distantly related to the bacteria that causes Lyme disease and is transmitted through the bite of blacklegged or deer tick (Ixodes scapularis).

Symptoms of Borrelia miyamotoi

  • Chills
  • Fatigue
  • Headaches
  • Joint and body pain
  • Relapsing fever

Treatment for Borrelia miyamotoi

Treatment typically involves a course of antibiotics.

 

Colorado Tick Fever

Colorado Tick Fever (CTF) is a rare disease that is spread by infected rocky mountain Wood tick (D. andersoni). CTF is caused by an RNA virus belonging to the genus Coltivirus.

Symptoms of Colorado Tick Fever

Symptoms usually appear within one to 14 days after tick bite and may include:

  • Abdominal pain
  • Body aches
  • Chills
  • Encephalitis
  • Fatigue
  • Headache
  • Heart problems
  • Saddleback fever
  • Severe bleeding
  • Skin rash
  • Sore neck
  • Vomiting

It is common for patients to experience a two to three-day remission and have a recurrence accompanied with a drop in white blood cells.

Diagnosis of Colorado Tick Fever

Diagnosis is usually made with blood smears stained with immunofluorescence. Laboratory findings may include leukopenia or thrombocytopenia.

Treatment for Colorado Tick Fever

There is no conventional medical treatment for CTF. Cases are usually treated symptomatically with pain-relievers and fluids.

 

Ehrlichiosis

Ehrlichiosis is caused by Ehrlichia chaffeensis and spreads to people through the bite of infected ticks such as the Lone Star tick (Ambylomma americanum) and Dog tick (D. variabilis).

Symptoms of Ehrlichiosis

Early symptoms usually appear over the first five days of initial infection and can include:

  • Severe headache
  • Chills
  • Fever
  • Muscle aches
  • Upset stomach or nausea
  • Loss of appetite
  • Diarrhea
  • Confusion
  • Rash

Late-stage symptoms may include:

  • Damage to the brain or nervous system
  • Organ shutdown
  • Respiratory failure
  • Uncontrolled bleeding
  • Death

Diagnosis of Ehrlichiosis

Laboratory findings include leukopenia, thrombocytopenia and elevated serum transaminase levels. Diagnosis is also made with seroconversion during convalescence.

Treatment for Ehrlichiosis

Antibiotics doxycycline and tetracycline are commonly used to treat Ehrlichiosis. Severe illness can develop if initial antibiotic treatment is delayed. Very old or very young people and those with a weakened immune system are particularly vulnerable.

 

Heartland Virus Infection

Heartland virus infection is a tick borne viral disease that is caused by virus belonging to genus Phlebovirus and is spread through the bite of infected Lone Star tick (Amblyomma americanum).

Symptoms of Heartland Virus Infection

Most patients experience the following symptoms:

  • Decreased appetite
  • Decreased platelet counts
  • Decreased white blood cell counts
  • Fatigue
  • Fever
  • Headache
  • Increased levels of liver enzymes
  • Joint pain
  • Muscle or joint pain

 

Treatment for Heartland Virus

Currently, conventional medicine does not offer treatment for those diagnosed with Heartland virus.

 

Lyme Disease

Lyme disease is the most common tick-borne disease, which is caused by of bacteria Borrelia burgdorferi and is transmitted through the bite of an infected black-legged tick (Ixodes scapularis) commonly known as deer tick. The tick must be attached to human skin for about 36 to 48 hours for the disease to be transmitted.

Symptoms of Lyme disease

Stage 1 (early localized):

  • Erythema migrans the characteristic “bulls-eye” rash at the site of bite
  • Arthralgia
  • Fatigue
  • Fever
  • Flu-like symptoms
  • Headache
  • Lymphadenopathy

Stage 2 (early disseminated)

  • Adenopathy
  • Central nervous system symptoms
  • Cough and pharyngitis
  • Fever
  • Muscle and joint pain
  • Secondary cutaneous annular lesions

Stage 3 (late chronic)

  • Arthritis
  • Central nervous system impairment
  • Dermatitis
  • Facial palsy
  • Keratitis
  • Neurologic and myocardial abnormalities

Lyme disease may spread throughout the body for months or years after infection if left untreated, damaging the heart, joints, and neurological system, resulting in a wide range of symptoms.

Diagnosis of Lyme Disease

Lyme disease is diagnosed based on symptoms, EM rash, history of tick bite and laboratory testing. A two-stage blood test enzyme-linked immunosorbent assay (ELISA) and confirmation by Western blotting, polymerase chain reaction of the joint fluid may be helpful to diagnose.

Treatment for Lyme Disease

Treatment is most effective when detected and treated early with antibiotics. Commonly used antibiotics include doxycycline, amoxicillin, cefuroxime or erythromycin. Antibiotics are often not effective after the first few weeks of infection. 

 

Powassan Encephalitis

Powassan encephalitis is rare tick-borne disease caused by Powassan virus, a flavivirus which belongs to a group of viruses that can cause encephalitis or meningitis.  The virus is transmitted much faster than many other tick-borne microbes, usually in less than 15 minutes after tick attachment. 

Symptoms of Powassan Encephalitis

Initial symptoms can include:

  • Fever
  • Headache
  • Vomiting
  • Weakness

Symptoms of severe illness include:

  • Confusion
  • Dementia
  • Difficulty speaking
  • Encephalitis
  • Loss of coordination
  • Meningitis
  • Seizures
  • Death

Treatment for Powassan Encephalitis

There are no conventional medical treatments for Powassan encephalitis. People who have severe symptoms will require hospitalization to reduce swelling in the brain, stay hydrated and receive support for breathing.

 

 

Relapsing Fever

Tick- borne Relapsing fever is caused by Spirochete bacteria of Borrelia species such as B. hermsii, B. parkeriB. duttoniB. miyamotoi and transmitted by ticks of the Ornithodoros species.

Symptoms of Relapsing Fever

Signs and symptoms can include:

  • Recurring high fevers with irregular pattern
  • Arthralgias
  • Coma
  • Cranial nerve palsy
  • Dizziness
  • Epistaxis
  • Hemoptysis
  • High fever delirium,
  • Influenza-like symptoms
  • Iridocyclitis
  • May include:
  • Meningeal signs
  • Myocarditis
  • Nausea
  • Pneumonitis
  • Rupture of the spleen
  • Splenomegaly
  • Vomiting

Diagnosis of Relapsing Fever

Detection of spirochetes in blood, bone marrow and cerebrospinal fluid during febrile episode. Laboratory findings may include normal or elevated leukocyte count, and thrombocytopenia.

Treatment of Relapsing Fever

 Antibiotics doxycycline, tetracycline, or erythromycin are the treatment of choice for relapsing fever. Treatment may lead to Jarisch-Herxheimer reaction.

 

 

Rocky Mountain Spotted Fever

Rocky Mountain Spotted Fever (RMSF) is one of the deadliest tick-borne diseases. RMSF is caused by bacteria Rickettsia rickettsii and transmitted by the Rocky Mountain wood tick (Dermacentor andersoni), American Dog tick (Dermacentor variabilis) and brown dog tick (Rhipicephalus sangunineus). RMSF is particularly dangerous because the onset is abrupt and the disease can progress rapidly to a serious, life-threatening illness.

Symptoms of Rocky Mountain Spotted Fever

Signs and symptoms can include:

  • Headache
  • Fever
  • Chills
  • Rash
  • Nausea
  • Vomiting
  • Stomach pain
  • Lack of appetite

Symptoms of severe illness include:

  • Altered mental status
  • Coma
  • Delirium
  • Dementia
  • Difficulty speaking
  • Encephalitis
  • Hypotension
  • Insomnia
  • Loss of coordination
  • Meningitis
  • Seizures

Without treatment, the following can occur:

  • Brain and heart damage
  • Cardiac arrest
  • Circulatory failure
  • Pneumonia
  • Tissue necrosis

Diagnosis of Rocky Mountain Spotted Fever

Clinical signs and symptoms. Skin biopsy of rash with immunofluorescent staining. Laboratory testing has limited usefulness. Routine findings include thrombocytopenia and hyponatremia

Treatment for Rocky Mountain Spotted Fever

Antibiotic therapy, typically consisting of doxycycline, tetracycline or chloramphenicol is used. Doxycycline is the first line management in adults and children of all ages. It is important to start antibiotics early.

 

Southern Tick-Associated Rash

STAR, also known as Masters Disease, is transmitted by Lone Star tick (Ambylomma americanum). The rash looks like that of Lyme disease and generally appears seven days after the tick bite, growing to a diameter of three inches or more.

 

Symptoms of Southern Tick-Associated Rash

The symptoms of STAR are similar to those seen in Lyme disease:

  • A red, expanding “bull’s-eye”
  • Fatigue
  • Headache
  • Fever
  • Joint and muscle pains

Treatment for Southern Tick-Associated Rash

It is often treated with oral antibiotics.

 

 

Tularemia

Tularemia is a potentially serious illness that is caused by bacterium Francisella tularensis and transmitted by Lone Star tick (A. americanum), Wood tick (D. andersoni) and Dog tick (D. variabilis)

Symptoms of Tularemia

Symptoms may include:

  • Acute respiratory distress syndrome
  • Chills
  • Cough & sore throat
  • Fatigue
  • Fever
  • Headache
  • Malaise
  • Myalgia
  • Nausea, or vomiting
  • Pericarditis
  • Pleural effusions
  • Pneumonia
  • Skin ulcers

Diagnosis of Tularemia

Clinical signs and symptoms. Acute and convalescent titers. Presence of leukocytosis. Chest X-ray usually shows a triad of oval opacities, hilar adenopathy and pleural effusions.

Treatment for Tularemia

Antibiotics used to treat tularemia include doxycycline, streptomycin, gentamicin and ciprofloxacin.

 

Prevention of Tick-borne Diseases

Currently there are no vaccines to prevent these diseases and the most effective way to prevent tick-borne diseases is to prevent tick bites.

Here are some steps that people can take before going outdoors to reduce the risk:

  • Wearing covered shoes, long-sleeved shirts, and tucking pants into socks.
  • Tying up long hair.
  • Avoiding sitting on the ground.
  • Wearing light-colored clothing to make it easier to spot ticks.
  • Apply insect repellents containing DEET (less than 30%), picardin or ethyl butyl acetylamino propionate to skin and clothing.
  • Do not use insect repellents on children less than 2 months old.
  • Tick bites often go unnoticed as they are usually painless and small. With the prevalence of tick-borne diseases on the rise, it is important to look for signs of tick bite and remove attached ticks after spending time outdoors.

 

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