Aitkin, Cass, Crow Wing, Morrison and Mille Lacs counties are all among those with the highest population of ticks in Minnesota. It also means we are home to the highest risk of tick-borne disease.
Of course not all tick bites result in disease but the numbers are becoming troubling. Enough so that local authorities recognize the importance of getting accurate information to the public and are offering an opportunity to learn more about ticks and the diseases they carry. A five person panel has been assembled to present the information. An evening presentation will be given 5:30–7 p.m. Monday, July 16 at the Arboretum and a morning session will be held 8:30-10 a.m. Tuesday, July 17 also at the Arboretum.
Dr. Peter Henry, medical director of emergency services at Essentia Health St. Joseph’s Medical Center, will serve on the panel. Other members include Dr. Kurt DeVine – Urgent Care, Essentia Health St. Joseph’s – Baxter Clinic, Gwen Anderson, RN/PHN Manager - Crow Wing County Public Health, David Neitzel, M.S., Epidemiologist - Acute Disease Investigation and Control, Minnesota Department of Health and Eric Goslovich, OHST - Safety and Health Officer, Minnesota Department of Natural Resources.
We enjoyed an earlier than usual spring this year and Dr. Henry said it has also meant earlier visits by patients concerned about tick bites. The three primary tick diseases in the state are lyme, anaplasmosis, and babesiosis, the last seen measurably less because it most often affects people who have a compromised immune system or who have had their spleen removed. The tiny deer tick, or black legged tick, is the transmitter of these diseases. In the spring the nymph is remarkably small and hard to spot or feel, unlike the larger wood ticks.
Anaplasmosis is now the most common of the tick disease seen in our area, replacing Lyme. “Anaplasmosis is not a new disease. It had previously been called ehrlichiosis.,” said Dr. Henry. ”Veterinarians have seen it in dogs for a very long time.”Typically the symptoms of anaplasmosis of headaches, muscle and joint aches, and fever are the more severe than lyme. Often fevers climb as high as or higher than 102 degrees.
The high fever is what brings most people in to the doctor once they’ve been infected says Dr. Henry. “Many people ignore the muscle and headache symptoms thinking they just have a virus or a bug,” which is, sometimes, the case. Not every muscle ache and headache is necessarily tick-borne disease, says Dr. Henry.
So, is testing for tick disease the first step in seeing these patients? Not always. If someone has a classic symptom of tick disease, a history of a tick bite and a rash, the Center for Disease Control says that is enough evidence to start treatment. “When testing is performed in the initial stages of the disease the test is not as accurate as we would like it to be. Because you’re testing for the antibody to the bacteria itself and in the early stages you might not have mounted enough antibodies yet to result in a positive test,” says Dr. Henry. “However our physicians are well aware of the symptoms and treatments due to the number of cases of tick-borne disease in our community.” Most people, by the time they develop a rash, would have a positive test, but even that’s not 100 percent.
“There’s a lot of misconception about the bulls-eye,” says Dr. Henry. “Many people see the little purple- red ring that’s typically a centimeter or penny- size or less right where the tick has bit them. That’s a local allergic reaction to the tick bite. The saliva from the tick actually causes a local irritation and allergic reaction.” The red ring often fools people. The actual target lesion or “bulls-eye” is larger and will slowing expand in size. It is most often found at the site of the bite or but can be found any place else on the body. It is also not unusual to have more than one bulls-eye. Statistics vary but Dr. Henry also says anywhere from 20-40 percent of victims will never develop a rash and 20-30 percent of those with confirmed lyme disease aren’t even aware they’ve had a tick bite. Adult deer ticks are tiny and the nymphs even smaller so these are often missed by those that are bitten.
Dr. Henry is pleased for the opportunity to serve on the panel and believes it is a great time to get some important information to the public. “My personal goal would be to get better information about prevention to the public. That’s really the key to stopping these illnesses in the first place because they are preventable.”
Before going outdoors follow a few important steps:
Wear light colored clothing when walking in tall grass or wooded areas so ticks can be spotted easily.
Tuck your pants inside of your socks.
Check thoroughly every time you’re outdoors and in a tick environment. Do a head to toe check in a well lit room.
If possible have someone else check the areas that you can’t see yourself such as your hairlines and back.
Use a repellent. Most effective brands have high levels of DEET so follow directions carefully on how to apply.
Check dogs, cats and other pets for ticks often and don’t allow them to sleep in your bed.
The risk of transmission goes down significantly if an infected tick is removed within the first 24-48 hours. Transmission of the disease usually happens if a tick is attached beyond that time.
Removing the tick
The proper way to remove a wood tick is to grasp it near its head and slowly pull it out. Do not grab it by the body. Gently pull it straight out until it is free. If a small part of the mouth remains there’s no need to remove it, says Dr. Henry. Digging too much may lead to the risk of infection and your body will automatically expel the remainder as the skin gets rejuvenated. It is important to remove the body because the bacteria are contained in the stomach.
“If you have symptoms of tick-borne disease is when you should seek treatment,” says Dr. Henry. Essentia Health provides many different options for the community including ConvenientCare, Urgent Care or a family care provider. ConvenientCare is located at Baxter Cub Foods,14133 Edgewood Drive in Baxter, and is open 8 a.m. to 8 p.m. Monday and Friday, 9 a.m. to 3 p.m. Saturday and Sunday. UrgentCare is located at Essentia Health St. Joseph’s-Baxter Clinic, 13060 Isle Drive in Baxter, and is available 8 a.m. to 8 p.m. Monday-Friday, 9 a.m. to 3 p.m. Saturday, 11 a.m. to 3 p.m. Sunday, 9 a.m. to 1 p.m. holidays. Both ConvenientCare and UrgentCare are walk-in services with no appointment needed. If your symptoms are severe the Emergency Department sees patients when UrgentCare and ConvenientCare are closed.
Dr. Henry moves cautiously when it comes to prescribing medicine for possible tick disease. The symptoms of tick-borne illness mimic that of other common diseases. We treat each patient individually and responsibly so they are receiving the correct antibiotics. Being good stewards of antibiotics is beneficial for the entire community so the treatments can continue to be effective. The overuse or inappropriate use of antibiotics creates the possibility that the bacteria will develop resistance to current anti-biotic options for treatment. Prolonged use of antibiotics has the potential for significant side effect and adverse health risks. The key to treating any disease is a relationship a patient has with their care provider.
To attend one of the panel discussions and learn more on prevention for tick-borne diseases register to attend a session on-line at EssentiaHealth.org or call (218) 828-7414.