Fa­tal dis­eases can be spread by vi­cious vec­tors page

Arkansas Democrat-Gazette - - HEALTH BEAT - STORY BY SARAH DECLERK

Ticks are no strangers in Arkansas. Af­ter hik­ing or work­ing out­side, peo­ple may find the tiny arach­nids latched onto their skin, leav­ing an itchy bite. These crea­tures are more than a nui­sance, how­ever; they can also trans­mit life-threat­en­ing dis­eases.

The Arkansas De­part­ment of Health re­cently found two cases of Lyme dis­ease in Arkansas. Dr. Dirk Haselow, Arkansas state epi­demi­ol­o­gist, noted that the cases met the sur­veil­lance def­i­ni­tion for the ill­ness, which may dif­fer from a clin­i­cal di­ag­no­sis be­cause strict cri­te­ria is used to en­sure that sur­veil­lance cases re­main con­sis­tent across the coun­try and over time.

Although a slew of tick-re­lated ill­nesses ex­ist in Arkansas, Lyme dis­ease is fairly rare. The two re­cent cases were the first found in the state in nine years, Haselow said.

It is un­clear why Lyme dis­ease sud­denly reap­peared in Arkansas, but there are sev­eral rea­sons for the dis­ease’s rar­ity. Black-legged ticks, also called deer ticks, are the main Lyme-dis­ease cul­prits, but Arkansas has more lone star and brown dog ticks, which do not spread the dis­ease.

In ad­di­tion, ticks can­not trans­mit Lyme dis­ease to their eggs, so a tick must con­tract the bac­te­ria that causes Lyme dis­ease from an an­i­mal be­fore in­fect­ing a hu­man. Ac­cord­ing to Haselow, mice and deer are the pri­mary an­i­mals that har­bor the bac­te­ria, but ticks in Arkansas usu­ally feed on birds and lizards early in their lives, mak­ing them less likely to pick up the dis­ease and trans­mit it to hu­mans.

That is not to say that it is im­pos­si­ble to con­tract Lyme dis­ease in Arkansas, how­ever.

“We have all the an­i­mals that are ca­pa­ble of trans­mit­ting or hold­ing Lyme dis­ease. We have many ticks that are ca­pa­ble of trans­mit­ting Lyme dis­ease, and the en­vi­ron­ment is ca­pa­ble of sus­tain­ing it,” Haselow said.

The first sign of Lyme dis­ease is a bulls-eye shaped rash about four inches in di­am­e­ter at the site of the tick bite. Peo­ple may not re­mem­ber be­ing bit­ten, Haselow said, be­cause ticks that trans­mit Lyme dis­ease are of­ten mi­nus­cule. Ticks must em­bed in the skin for sev­eral hours to trans­mit the ill­ness, and peo­ple usu­ally no­tice and re­move larger ticks be­fore they can spread the dis­ease.

When di­ag­nosed right away, Lyme dis­ease can eas­ily be treated with doxy­cy­cline, an an­tibi­otic. If left un­treated, Lyme dis­ease can cause mi­grat­ing joint pain, and even­tu­ally, the ill­ness can dam­age the heart, brain and other or­gans, he said.

To meet the sur­veil­lance case def­i­ni­tion for Lyme dis­ease, he added, a pa­tient must ex­hibit the trade­mark rash, be di­ag­nosed by a physi­cian and have two sep­a­rate blood tests that con­firm the pres­ence of the dis­ease.

In Arkansas, South­ern tick-as­so­ci­ated rash ill­ness, com­monly called STARI, is of­ten con­fused with Lyme dis­ease, he said. The ill­ness also causes a bulls-eye shaped rash at the site of the bite, but the rash is only about 2 inches in di­am­e­ter. STARI usu­ally re­solves it­self with­out treat­ment, he added.

Rocky Moun­tain spot­ted fever is the most com­mon tick­borne dis­ease in Arkansas. Last year, the De­part­ment of Health counted 808 cases of Rocky Moun­tain spot­ted fever, com­pared to 198 cases of ehrli­chio­sis and 32 cases of tu­laremia, two other preva­lent tick-re­lated dis­eases.

Trans­mit­ted by the brown dog tick, Rocky Moun­tain spot­ted fever’s symp­toms in­clude a red-speck­led rash all over the body, fever, headache, nau­sea and vom­it­ing. If left un­treated, the ill­ness can cause menin­gi­tis, sep­sis and death.

A dis­ease na­tive to Arkansas, ehrli­chio­sis was first dis­cov­ered in Fort Chaf­fee. Ehrli­chio­sis is trans­mit­ted by the lone star tick, which has a white spot on its back. Symp­toms in­clude headache, malaise, joint pain, nau­sea and vom­it­ing, and the dis­ease can lead to menin­gi­tis and death. Both ehrli­chio­sis and Rocky Moun­tain spot­ted fever can be treated with doxy­cy­cline.

One of the most se­ri­ous tick-borne ill­nesses in the state is tu­laremia, which is spread by both brown dog and lone star ticks and causes an ar­ray of grave health prob­lems that could be fa­tal, in­clud­ing skin le­sions, vom­it­ing and di­ar­rhea, pneu­mo­nia and menin­gi­tis.

“We want peo­ple, when they go out­side, to be care­ful and to pro­tect them­selves from tick bites so that they can avoid all of these tick-borne ill­nesses,” Haselow said.

To keep the bugs at bay, na­ture lovers should wear long pants and sleeves in light col­ors doused with per­me­thrin, an in­sec­ti­cide. It is also im­por­tant to wear in­sect re­pel­lent and reap­ply the prod­uct ev­ery few hours as di­rected on the la­bel. Af­ter spend­ing time out­side, check for ticks and take a shower in or­der to find and re­move ticks as soon as pos­si­ble.

To prop­erly re­move a tick, use tweez­ers to grip the tick’s head as close to its mouth as pos­si­ble, and slowly pull the tick off. Do not grab the tick’s body and crush it, which could squeeze its saliva and stom­ach con­tents into the wound, mak­ing the trans­fer of dis­ease more likely.

The Arkansas De­part­ment of Health re­cently dis­cov­ered two cases of Lyme dis­ease in Arkansas. Prior to that, no cases that met the sur­veil­lance def­i­ni­tion for the ill­ness had been found in the state for nine years. The deer tick, pic­tured here, is one...

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