South Carolina Articles: BACK
Tick-borne disease hard to spot
Peter Frost, McClatchy Newspapers
HILTON HEAD ISLAND
June 10, 2007Most every day, Marge Agin bikes 10 miles in the morning and plays 18 holes of golf in the afternoon. Later, she and husband Norm walk their two black labs a couple of miles along Palmetto Bluff's nature trails.
The tanned, muscular 70-year-old eats healthily and stays fit. Aside from the aches and pains associated with her rigorous exercise schedule, she's had few problems with her body.
Then last month, just before going to bed, her knee began to bother her.
"It must have been a pulled ligament, I thought. No big deal," she said.
She went to the doctor and started anti-inflammatory medication for the swelling and to ease the pain.
The next day, she could hardly get out of bed. Her whole body ached. She had a headache and a severe fever. Even brushing her teeth was taxing.
To her doctor, Jack Frost, it appeared to be a classic case of a medication allergy. He ordered more tests and pulled her off the medication.
A few days later, she still hadn't improved. Her whole body was itchy. A rash developed on her feet, and later, on her stomach and back.
"I was very, very nervous at that point," Agin said. "I was beginning to think, 'Oh my God, maybe I have some terrible disease.' I was beginning to think that [age] 70 was finally catching up to me."
Two weeks and a battery of blood tests later, she was diagnosed with ehrlichiosis, a rare bacterial disease transmitted by ticks. Twelve South Carolinians were diagnosed with the disease in 2005, the last year data were available.
Though rare, the highest incidence rate of ehrlichiosis and another tick-borne illness, Rocky Mountain Spotted Fever, are in mid-Atlantic and Southeastern states, including South Carolina.
Three types of ticks in South Carolina - the Lone Star, dog and deer - transmit ehrlichiosis, which can take up to two weeks to produce symptoms. Most common symptoms include sudden high fever, fatigue, muscle aches, headaches and, in some cases, a rash. About half of patients require hospitalization.
If treated early with an antibiotic, the disease can be cured within a couple of weeks, said Dr. Robert Ball, an infectious disease consultant for the S.C. Department of Health and Environmental Control.
If misdiagnosed, patients can develop low counts of bacteria-fighting white blood cells and platelets, and kidney failure. In rare cases, the disease can cause death.
Because it's so rare, it's also difficult to diagnose.
Unlike maladies that show up clearly in blood tests or other screenings, ehrlichiosis diagnoses rely on a combination of laboratory findings and physical examinations.
"One of the key things you need to look for is the rash, but that doesn't always appear right away, and in some cases not at all," Frost said. "It's really a multi-factored diagnosis.
"You've got to put together all the pieces, and I was lucky I was able to put them all together."
Diagnosing other tick-borne illnesses can be equally challenging.
Rocky Mountain Spotted Fever, for example, is often overlooked here because of its name, doctors said.Courtesy MyrtleBeachOnLine: http://www.myrtlebeachonline.com/news/local/story/95143.html
© 2006 The National Lyme Disease Memorial Park Project
