Tick-borne disease on the rise
VERMONT- The tick-borne disease anaplasmosis is on the rise, and is largely affecting populations over age 50, according to Bradley Tompkins, epidemiologist and program chief of tick-borne and enteric diseases for the Vermont Department of Health.
Tompkins says the department of health has tallied 2017 data, and cases of anaplasmosis doubled from last year’s 200 to 400. That number is much higher than when the department began tracking the disease. “We’ve been keeping track since 2008 and we started off with three or four cases a year,” says Tompkins. “Since 2010, the numbers have gone up each and every year.”
Tompkins says that, like Lyme disease, anaplasmosis is transmitted by the black-legged tick. Symptoms include fever, fatigue, muscle ache, confusion, liver inflammation, and dehydration.
According to Dr. Marie George, medical director of infectious disease at Southern Vermont Medical Center, the illness can be diagnosed with a blood test, which is done through a panel test that tests for several tick-borne illnesses at once. Treatment is typically doxycycline, an antibiotic. “People usually feel better within a day,” says George.
Untreated, says Tompkins, the infection, which affects the liver and gets into the blood stream, affecting blood counts, can be fatal. “It can be fatal if you are not diagnosed within a timely period,” says Tompkins. “Particularly if you are an older individual.”
Tompkins says a unique feature of the disease is that it is affecting mainly older populations in Vermont. “It’s ages 50 and above where we see a sharp increase,” says Tompkins. “It’s really making older Vermonters sick. It comes on like you get hit by a train. All of a sudden you feel horrible.”
It’s possible, Tompkins says, that younger Vermonters are getting the disease but are not experiencing symptoms. Those who are experiencing symptoms, though, are finding themselves very ill. “It hospitalizes a significant amount of the people,” says Tomkins. “Four percent of Vermonters get hospitalized (when they have) Lyme disease. With anaplasmosis it’s about 31%. That’s a really high number.”
Though Lyme disease remains a problem in Vermont, anaplasmosis has become a focus in emergency rooms and hospitals. George says that so far this year, she has seen a much higher number of anaplasmosis diagnoses than Lyme disease. “I’m not sure whether that’s because people are being more proactive about Lyme symptoms and are seeing their family doctor earlier and therefore don’t get sick to the point where I’d see them at the hospital,” says George.
Tompkins says that while he certainly hopes it’s the case that people are being more proactive about getting treated earlier for Lyme disease, it is the case that anaplasmosis is highly prevalent. He says the increase from 200 cases in 2016 to 400 in 2017 is staggering. “It’s one thing to go from three to 10,” he says. “That’s a tripling, but it’s a very small number. But when you go from 200 to 400 that’s a significant increase. There’s no explaining that away with math.”
As with other tick-borne illnesses, recommendations from the department of health and from physicians are rooted in prevention. “My mantra isn’t what are we going to do about the illness after you get it, it’s getting no tick bites,” says George.
George encourages the use of permethrin, a solution that cannot be put on the skin but is sprayed onto clothing and kills ticks on contact. It lasts on clothing for several washes. Additionally, George says, if you’re doing something high-risk such as hiking or yard work, a repellant such as Deet, picaridin, or IR3535 should be used. As for natural sprays, medical professionals do not recommend them, since they are not scientifically tested.
“Natural sprays are unregulated and have not undergone rigorous testing for safety,” says Dr. Trey Dobson, emergency medicine doctor at Southern Vermont Medical Center. “It is unlikely that their efficacy has been demonstrated through scientific study.”
“If you do have exposed skin, use an EPA-registered tick repellant,” says Tompkins. “There are a lot of products that claim to be safe and effective at repelling ticks, but we want people to use something that has been scientifically tested to be safe and effective.”
It is also recommended that when possible, long sleeves, pants, and socks are worn t and that people do routine tick checks after being outdoors.
George emphasizes that ticks are extremely widespread, and that no one is immune to them. “The CDC has said the amount of tick-borne illnesses has gone up three times higher than they ever thought,” says George. “People’s risk is very high, particularly in the spring. And they should always be vigilant, always. People say all the time, ‘Oh, ticks don’t like me,’ or ‘I never had a tick bite.’ I can’t tell how many cases I’ve had of people who say ‘I check myself all the time, and I still got a tick-borne illness.’ You can’t depend on just giving it lip service. You must do the work of prevention.”