Ticks are nasty, blood-sucking critters that can transmit a variety of illnesses when they attach themselves to humans and bite. Over several days their body engorges itself with blood until they get so large that they detach themselves or fall off. Their bite is painless and often goes unnoticed until a lump is felt.
Ticks are a notorious transmitter of serious diseases. The three best known and most common are: Rocky Mountain Spotted Fever, Ehrlichiosis and Lyme Disease.
The only "Rocky Mountain High" in this illness is the degree of fever. Although first described in the Rocky Mountains, this illness occurs in any wooded area, and, in fact, most cases occur in the Southeastern United States. The germ transmitted by the tick is a rickettsia, a special type of bacteria. These organisms have a life cycle that involves an animal species as a host, and we are accidental victims.
Symptoms usually begin about a week after a bite from a tick carrying this bacteria. The illness starts abruptly with fever, aches, chills, nausea and vomiting. Affected individuals look and feel seriously ill. Several days later the characteristic rash appears. Classically, the rash is first noticed around the wrists and hands and spreads to involve the whole body within hours. Although initially flat red bumps, the involved areas become bumpy as the disease progresses. More serious involvement includes the presence of tiny pinpoint hemorrhages called petechiae. Characteristically, the rash involves the palms and soles.
This very serious disease can last weeks. Involvement of the nervous system, heart, lungs and other vital organs is frequent. Shock and death can result.
Ehrlichicsis exists in two forms in humans. The first documented form is called Human Monocytic Ehrlichiosis (HME) and was discovered in the late 1980s. The germs causing these illnesses (Ehrlichia) are related to rickettsiae. They only live in animal cells, and we become accidental victims when ticks infected with this organism bite.
Human monocytic ehrlichiosis infection is usually symptomatic. The most common symptoms one to three weeks after the tick bite are fever, headache, body aches, vomiting and lethargy, similar to a viral flu-like infection. A variable appearing rash occurs in 30-50 percent of infections about one week after symptoms begin. This form of Ehrlichlosis is usually much milder than Rocky Mountain Spotted Fever and lasts one to two weeks before disappearing. Occasionally much more serious illness, including life threatening problems, occurs. Laboratory diagnosis is difficult. Specific antibiotic therapy appears to be helpful.
First noted in the Lyme, Connecticut region in the 1970s, this bacterial infection has now been reported in 48 states. Most cases are reported in the Northeastern United States, forested Midwest and forested West Coast. Once again we are accidental victims of an infected tick. The tick's usual host is the white footed mouse. It spends its immature development on this rodent. This is the tick stage most likely to transmit Lyme Disease. The adult ticks preferred host is the white-tailed deer although human transmission can occur in this stage.
Infection with this bacteria (called Borrelia burgdorfen) is generally divided into two stages: early disease and late-stage disease. Early disease is itself divided into two overlapping stages.
**Erythema migrans (EM) is a red circular patch that appears usually three days to one month after the bite of an infected tick at the site of the bite. The patch then expands, often to a large size. Sometimes many patches appear, varying in shape, depending on their location. Common sites are the thigh, groin, trunk and the armpits. The center of the rash may clear as it enlarges, resulting in a bulls-eye appearance. The rash may be warm, but it usually is not painful. Not all rashes that occur at the site of a tick bite are due to Lyme disease (i.e. an allergic reaction to tick saliva at the site of the bite which can be confused with the rash of Lyme disease). Allergic reactions to tick saliva usually occur within a few hours to a few days following the tick bite, but usually do not expand and normally disappear within a few days.
Lyme disease is often difficult to diagnose because its symptoms and signs mimic those of many other diseases. The fever, muscle aches and fatigue of Lyme disease can easily be mistaken for viral infections, such as influenza, infectious mononucleosis or chronic fatigue syndrome. Joint pain can be mistaken for other types of arthritis, such as rheumatoid arthritis, and neurologic signs can mimic those caused by other conditions, such as multiple sclerosis. At the same time, other types of arthritis or neurologic diseases can be misdiagnosed as Lyme disease.
Lyme disease is treated with antibiotics under the supervision of your child's doctor. Several antibiotics are effective. Usually they are given by mouth but may be given intravenously in more severe cases. Children treated in the early stages with antibiotics usually recover rapidly and completely. Most youngsters who are treated in later stages of the disease also respond well to antibiotics. Rare, indirect deaths from Lyme disease have been reported.
Inspect your child carefully and remove any attached ticks. For tick removal: grasp the tick with fine tweezers as close to the skin surface as possible, pull straight up with a slow, steady force and avoid crushing the tick or slipping off the body. Ultimately you do not want to force any material from the tick into your skin. Clean the area of tick attachment with disinfectant. Ticks (saved in a sealed container) can be submitted to certain local health departments for identification.
These tick bite associated illnesses are all serious. They are also treatable if diagnosed early in the disease. However, since many of the initial symptoms resemble common flu or viral infections, the history of a preceding tick bite, or even the history of having been in a forested area during tick season, could be important in making the correct diagnosis. Therefore, if your child becomes ill in the weeks after a tick bite, make sure you tell this crucial information to your physician.