Tick Bite-Related Doctors’ Visits on the Rise

Just as the COVID-19 pandemic had us on our toes by mid-March, the arrival of spring also introduced what the Pennsylvania Department of Health has cautioned will be a dangerous season for deer ticks. On June 2, the DOH issued an advisory to healthcare organizations stating that tick bite-related emergency department visits have recently increased in Pennsylvania. They also caution that rare diseases have been found in ticks in multiple Pennsylvania counties. “We know that the summer season is coming, and we will be outdoors more,” says Dr. Deepak Garg, infectious disease specialist at Penn Highlands Healthcare. “That means there’s more risk for tick exposure.”

Dr. Garg’s colleague Shelly Brown, infectious disease coordinator at Penn Highlands Huntington, explains why. “Anytime it’s above 40 degrees, ticks are active—even in January,” Brown says. “In our region, we had a lot of warmer days this year.”

As part of the June 2 DOH advisory, state health officials advise that “healthcare … for tickborne illnesses should not be delayed due to the COVID-19 pandemic.” Here, the infectious disease experts at Penn Highlands Healthcare provide recommendations on identifying, understanding, and treating tickborne illness.

• It’s not always Lyme disease. Brown highlights a fact that has stumped many patients: while Lyme disease is the most commonly reported tickborne disease (and two summers ago was reported in all 67 counties in the Commonwealth), tick bites are responsible for other diseases as well. Rocky Mountain spotted fever, anaplasmosis, and babesiosis are all tickborne illnesses with similar symptoms to Lyme disease—but, says Brown, the diagnoses for these are less common because only occasionally can they be detected in a test, if at all. Evidence of rarer diseases known as B. miyamotoi and Powassan virus, which may cause swelling in and around the brain and spinal cord, have also been documented. Patients should remember that just because a Lyme test comes back negative doesn’t mean that the symptoms weren’t caused by a tick.

• Identify the symptoms. The notorious “bullseye rash” occurs in approximately 70 to 80 percent of individuals infected with Lyme disease. However, the rash can also manifest with a different appearance, or may be totally absent.
  
  According to the DOH, any combination of fever, fatigue, vomiting, weakness, headache, muscle aches, or joint pain—and in more serious cases, confusion, seizures, or difficulty speaking—may indicate a tickborne illness.

• The good news. It might seem that tickborne illnesses are as evasive as the little buggers themselves. However, if they’re caught early enough, most are treated with an antibiotic. The DOH states: “People treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely.” Again, though, it’s important to take symptoms seriously, as the DOH mentions that if left untreated, the disease can spread to the joints, heart and nervous system.

• Bigger than bugs. “Prevention is always the best cure,” says Dr. Garg. Using wise judgment, we can lessen the risk of tickborne illness by following some simple rules:

• Keep the outdoors around your home manicured can help, as Brown says ticks lie face-up in grass, leaf litter, or plants while they just wait for a warm body to walk by so they can latch on.

• Wear light-colored clothing. This doesn’t deter them, but “it can help you spot them,” says Brown.

• After coming inside, check clothing, pets and outdoor items. Throw clothes in the dryer for 10 minutes—“Hot, dry heat will kill ticks,” Brown says.

• And if one has latched on, “Do not panic,” Dr. Garg says. “It takes 24 hours for the tick to be on your body to transmit Lyme disease. Remove it, and call your primary care provider.” How to remove a tick? The CDC recommends using clean tweezers applied close to the skin’s surface. Using stable pressure, tug upward on the insect. After removing the tick, use rubbing alcohol or soap and water to clean the skin. Then discard the tick in a tightly contained container or down the toilet.

If you experience symptoms of tickborne illness or discover a tick has latched on, call your primary care provider or the specialists at Penn Highlands Infectious Disease at 814-371-4320. Also visit www.phhealthcare.org/infectiousdisease.