Tick season seemed to start earlier this year than usual. One of my partners in our practice in March said she awoke one morning with a deer tick, and we knew the season was here. This month alone, June that is, I’ve treated 3 cases of RMSF, or Rocky Mountain Spotted Fever, which is one of the common tick‐related illnesses we treat here. Tick‐borne illness is one of the interesting things I’ve learned about since practicing in North Carolina, as these illnesses are more common in the Southeast. But apparently they are an issue all over the US during this time. The illnesses include the above‐mentioned RMSF, Ehrlichiosis, Tularemia, and Lyme disease.
Lyme disease is actually very rare in North Carolina, because the tick that carries the disease is rarely found here. I had to refresh my memory on the different kinds and flavors of ticks, so that I could identify them on patients more easily.
The usual season for ticks is now, during the spring and summer months. The different types of ticks vary from dog ticks to deer ticks to Lone Star ticks. The American dog tick is generally a reddish‐brown color and becomes large and red after it’s attached itself and fed. Deer ticks are usually smaller and darker than dog ticks. The Lone Star tick is also small and reddish‐brown in color but usually also has a white spot on the back. Clear as mud? If confused like I was, you can go to the CDC website (Center for Disease Control and Prevention) to see pictures.
I also have a hard time identifying which is which, so I’ve posted a picture of types in my examination rooms for patients to point them out. Lone Star ticks are probably the most common type in this area, and they cause symptoms such as fever, headaches, myalgias (body aches), and possibly a round, “bulls‐eye” rash where they have bitten. This is the classic rash called erythema migrans, and it’s very helpful to see when trying to diagnose the illness. Not all tick bites will cause the illnesses if caught early enough. The best way to remove them is with tweezers and picking the whole body off, but most importantly the head. If you don’t know whether you’ve removed the entire body, don’t play around with it, have you doctor look at it and remove the rest as quickly as you see it. Don’t use matches or ointments, because they don’t work well all the time.
Once symptoms have been identified, your doctor may go ahead and start treatment, or do blood work. Labs that are affected by tick‐borne illnesses include white blood cell count, platelet count, liver labs, and sodium. There are also antibody tests for RMSF, Erhlichiosis, and Lyme disease. Once I generally have a good idea that a person has been affected, I usually will start treatment with Doxycycline, which is the most common antibiotic that treats all the common types of tick‐borne illnesses. The medicine is prescribed either for 1 or 2 weeks, depending on the severity of symptoms.
Now, to say a word about Lyme disease in North Carolina‐‐‐it’s present, but not very common. In 2008, the CDC reports 16 cases were reported in North Carolina versus 2000‐3000 cases in the upper north states of Connecticut and Minnesota. Because of its long term effects and consequences, such as arthritis and neurologic effects, Lyme disease is taken seriously, but the other types of tick‐borne illnesses are far more common than Lyme disease here in North Carolina. Be careful this summer!
Be Healthy and Be Blessed, Dr. Swiner
Disease Control and Prevention)