Rhode Island Articles: BACK
Tick-borne illnesses in South County highest recorded since 2002
Brenna McCabe
The Cigar
University of Rhode Island Student Newspaper
October 27, 2006
Most University of Rhode Island students would not remember the wet summer months of 1982, which were recreated this year, producing one of the wettest climates for Rhode Island in almost 25 years.
For Rhode Islanders, with the increased moisture comes an increase in the abundance of pesky deer ticks, also known as black-legged ticks, which made a 7.1 percent jump from last year's surveillance numbers. Because the Rhode Island tick population is on the rise, tick-borne illnesses have become more of a danger to the South County population. Now, professor and director of the URI Center for Vector-Borne Disease Thomas Mather is trying to make students and residents more aware of the problem.
"Our big initiative right now is prevention," Mather said. "We're really working on increasing public awareness - getting to people who are at greater risk first and then working our way down."
The URI entomologist described this year's tick "report card," or tick surveillance surveys, as showing too large of an increase to be ignored. According to Mather, this past season has accumulated the highest numbers since 2002.
"It's most likely related to the fact that we had a very moist May, June and July," he said.
The Tick Encounter Resource Center Web site, created by Mather and his research team as part of their tick-borne illness prevention program, showed a correspondence between the rise of lyme disease and certain months of the year when ticks are small in size.
The site also shows that South County contains one of the largest tick populations in the state, leaving residents at higher risk to contract illnesses like lyme disease and lesser-known parasites like babesiosis and anaplasmosis.
"If we could get diseases that people can remember and pronounce, maybe they would be more aware [of the problem]," Mather joked. "I've decided to name Babesiosis it's old name: Nantucket Fever. Doesn't that sound sexier?"
Babesiosis, a malaria-like parasite that destroys red blood cells, can be fatal. "People typically feel anemic and get really tired," Mather said, describing some of the symptoms of the disease. "We've already had one fatal case this year."
There have been more fatalities from babesiosis in the past 10 years than Triple E and the West Nile virus combined, Mather said.
"Most Rhode Islanders are aware of [problems with] mosquitoes ? they have their own calling cards because they have a buzz and an itchy bite," he said. "Ticks fall under the radar."
Mather's research showed that, on average, there have been about 40 cases of babesiosis each year during the past five years, including five fatalities in the last six years. Even if the disease doesn't lead to death, Mather said people may not realize the level of suffering the illnesses can still produce.
"I am told that the headaches [from anaplasmosis] are like being smacked across the back of your eyes with a baseball bat," Mather said.
The number of Triple E cases that land in intensive care units of hospitals do not compare to the fifty or so cases of babesiosis and anaplasmosis that place people in serious conditions each year, he said.
Mather added that it might seem like the prevention program is going in the wrong direction in light of the high numbers, but pointed out URI researchers now have the correct tools to aggressively battle Rhode Island's tick problem.
The one thing that will be crucial to their success, Mather said, is the help of Rhode Islanders, including students.
"They need to be aware that when we venture around the woods, even on campus ? they need to check themselves for ticks," he said.
Mather said that although smaller ticks can be a greater danger because of their size, ignoring large ticks can be just as harmful.
"I always tell my students that ticks come in small, medium and large sizes," he said. "Obviously, any tick that swells up with blood is going to be big."
To prevent tick-borne illnesses, Mather suggested checking waistlines, areas surrounding clothes constrictions and behind the arms after trekking near or in wooded areas.
Another tick-borne illness on the rise
Felice J. Freyer, Journal Medical Writer
The Providence Journal
Providence, RI
July 30, 2006
The illness -- babesiosis -- is carried by the same deer ticks that carry Lyme disease.
Doctors are seeing an increase this summer in a tick-borne illness that many people don't know about.
Called babesiosis, the illness is carried by the same deer ticks that carry Lyme disease (some ticks carry both). But while most people are familiar with Lyme disease, they may not think about babesiosis -- or get tested for it when they go for a Lyme test. That could mean unnecessary discomfort and, in rare cases, serious illness.
But in Rhode Island, ticks that carry the disease have been found only in South County.
Most infected people don't get ill, and their immune systems clear out the parasites that cause babesiosis. Those who get sick often feel as if they have the flu in the off-season -- fever, chills, sweating and muscle aches. People whose immune systems are weak will get these symptoms more severely, and can become seriously ill with anemia. But drug treatments are effective.
In 2004, there were 48 reported cases of babesiosis in Rhode Island, and in 2005, there were 43. So far this year, the Health Department has already received reports of 46 cases of babesiosis. Four Rhode Islanders have died from babesiosis in recent years, the most recent last year. (To put these numbers in perspective, consider that an average of 477 Lyme disease cases and 108 AIDS cases are reported each year.)
A person will experience symptoms of babesiosis three to four weeks after being bitten by an infected tick. With ticks still plentiful today, it looks as though the state will be heading for a record year for babesiosis.
The main reason is the increase in the number of ticks because of the wet weather, said Thomas N. Mather, the entomologist who is director of the University of Rhode Island's Center for Vector-Borne Disease.
"It's a relatively rare infection, but it's increasing for sure," Mather said. "People are still very confused about this. A lot of people think it's just another form of Lyme disease."
But the antibiotic treatment for Lyme disease won't touch the babesia, the blood parasites that cause babesiosis. And if you get both babesiosis and Lyme disease, your symptoms of both will be more severe. The antibiotic and antiparasitic medications used to treat babesia can eliminate the bugs from the bloodstream.
Mather, who has been studying the deer-tick population in Rhode Island for many years, has recently identified the areas where deer ticks are infected with babesia -- primarily the southern half of the state. (In contrast, ticks throughout the state are infected with Lyme disease, except for those in the far northeastern corner, chiefly Cumberland and part of Lincoln.)
The determining factor is the concentration of ticks: babesia-infected ticks live only in areas where there are a lot of ticks. Researchers consider those high concentration areas to be those where they can drag a cloth through bushes and collect 20 or more ticks per hour.
About 12 percent of ticks in the nymphal stage -- the tiny ones that are out in the spring and summer -- carry babesia, while 20 percent carry Lyme disease, Mather says. Some carry both.
The illness is caused by blood parasites called babesia, protozoans that are similar to those that cause malaria. They attack red blood cells. Babesia enter people's bloodstreams in one of two ways: the bite of a deer tick, which must stay attached for 48 hours before it can transmit the parasite; or through blood transfusions (there is no licensed screening test for babesia).
Most infected people have no symptoms, or only mild ones. People who have had their spleens removed, who are very old, or who have an illness that suppresses the immune system can become very ill.
"The tricky part is thinking about it and recognizing it," said Dr. Christopher C. Brown, an infectious disease specialist with an office in South Kingstown. "It's not hard to treat. People tend to respond well to treatment."
Dr. Jennifer Adelson Mitty, an infectious disease specialist who runs the Lyme disease clinic at Rhode Island Hospital, said that this year she is seeing more of all three diseases transmitted by deer ticks: Lyme disease, babesiosis and ehrlichiosis, a bacterial infection that attacks white blood cells. (Ehrlichiosis, also called anaplasmosis, is slightly more common but usually less serious than babesiosis, with an average of 51 cases a year in Rhode Island.)
The antibiotics that treat Lyme disease will also wipe out ehrlichiosis. But not babesiosis, Mitty said.
Asked which of the three is more worrisome, Mitty says it depends on the patient. "In an immunocompromised patient, I'd worry more about babesiosis," she said.
But anyone who gets sick with a fever in the summer should tell his or her doctor, she said.
Dr. Staci A. Fischer, an infectious disease specialist at Rhode Island Hospital, said that in this region, babesiosis is one of the most common diseases that a person can get through blood transfusions. That's because blood donors can temporarily carry the parasite in their blood without knowing it. Blood recipients are likely to have weakened immune systems that will allow the parasite to multiply and make the person ill.
Although a blood test can diagnose babesiosis in a sick person, a good screening test that would detect it in a healthy person's blood has not yet been developed, said Dr. Carolyn Te Young, medical director of the Rhode Island Blood Center.
But in the end, people have considerable control over whether they get any of the tick-borne illnesses. Mather notes that a tick has to be on your body for at least 24 hours before it can transmit illness, so checking yourself daily for the poppy-seed-sized bugs can dramatically reduce your risk of infection. You can also reduce the number of ticks in your yard, and keep them off you by spraying your clothes with permethrin and your skin with DEET.
"People don't have to be scared about tick-borne illness, if they're aware and take precautions," said Brown, the South Kingstown doctor. "People don't have to sit there worrying about it. They can do a lot to take care of themselves."
Babesiosis: Key facts
Cause: Babesia, malaria-like parasites that attack the red blood cells.
Transmission: Deer-tick bites or blood transfusions. Deer tick must remain on the skin for 48 hours to transmit infection.
Symptoms: Fever, chills, sweating, muscle aches, anemia. Most people have no symptoms, however, and their immune systems eliminate the parasites.
Who's in danger: People without spleens, elderly people, and people whose immune systems are weakened can get sick from babesia, sometimes severely.
Treatment: Clindamycin plus quinine, or atovaquone plus azithromycin. These drugs can eliminate the parasites.
Geographic distribution: Most common in the Northeast and Midwest.
Keeping ticks at bay
Check yourself thoroughly for ticks every day. The size of a poppy seed, they tend to crawl to constricted places such as waist bands, the back of the knee, or armpits. If you find a tick, remove it with pointed tweezers.
Apply a repellent containing permethrin on your clothing and one containing DEET on your skin when you go into tick-infested areas. DEET will keep a tick from biting, but not from crawling to a spot where there's no DEET. Wearing long pants tucked into socks and sprayed with permethrin is a good way to keep ticks off you.
Keep the edge of your yard clear of leaf litter.
Hire a trained professional to apply tick treatment to the perimeter of your yard.
Courtesy: www.lymeinfo.net
lymeinfo-subscribe@yahoogroups.com
Another tick-caused disease: Bell's Palsy
Sophie Olsen
The Narragansett Times
Narragansett, RI
August 23, 2006
SOUTH KINGSTOWN - When AnnMarie Biegner's "almost" six-year-old daughter was diagnosed with Bell's Palsy recently, she said she was shocked to learn her daughter had contracted it through a tick bite.
Bell's Palsy, which causes the facial muscles to weaken or become paralyzed, affects roughly 40,000 people in the United States a year.
The condition is not permanent, and while there are several ways to contract the virus, Bell's Palsy can manifest as a symptom of Lyme disease, said URI expert Dr. Thomas Mather in an interview Monday.
Biegner said her husband pulled a tick off their daughter several weeks ago and watched closely for the "bull's eye" that is a common indicator of Lyme Disease, but that they never spotted "even a little bump," she said.
"Twelve days after the tick bite she complained of a headache," said Biegner, adding that because of the vomiting and fever that followed two days later, she brought her daughter to the pediatrician.
The doctor put her on antibiotics and clinically diagnosed her with Lyme disease. A short time later Biegner and her husband noticed changes in their daughter's facial expressions.
"Her smile was different and she could not blink," said Biegner.
Biegner said her husband was the one who suggested that perhaps their daughter had contracted Bell's Palsy.
"He works with teenagers and remembered a student who had gotten Bell's Palsy from Lyme disease. I had no idea."
The Biegners took their daughter to the emergency room, where they confirmed that her crooked smile was from Bell's Palsy. While they are still waiting for the official blood test results, Biegner's daughter is on antibiotics to help combat the virus.
"I was so darn surprised. I didn't know it could occur through a tick bite."
Mather said it is uncommon for a person to contract Bell's Palsy from Lyme Disease, but that because of southern Rhode Island's explosive tick population, physicians do see more cases of Bell's Palsy in the summer months because of Lyme disease.
"In this part of Rhode Island physicians see a greater summer onset of Bell's Palsy and they suspect it is because of Lyme Disease first," he said. "[Bell's Palsy] is a neurological manifestation that affects the seventh cranial nerve, and Lyme disease causes it only when it has gone into the acute stage."
Besides Lyme disease, Bell's Palsy is also caused by the herpes virus, mumps, and HIV. Tuberculosis can also cause the facial nerve to become inflamed and swell, ultimately resulting in facial paralysis.
"Usually with the appropriate antibiotic therapy it will go away," said Mather.
Biegner said it is just "a waiting game now" for her daughter's symptoms to subside.
"It's definitely not going to be easy when she starts kindergarten," she said. "The way it is now they are going to think she has a speech impediment.
"I want parents to be aware so that they can get help and understand it," said Biegner. "I had no idea. It just plain stinks."
Courtesy: www.lymeinfo.net
lymeinfo-subscribe@yahoogroups.com
© 2006 The National Lyme Disease Memorial Park Project
