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Tick diseases can be deadly

May 20, 2009
It's that time of year again. The time when almost everyone wants to get outside and enjoy the things that were put on the back burner all winter: hiking, fishing, bike riding and just hanging out around the playgrounds and parks.

But it's also the time of year when ticks have reproduced and their hungry offspring are just hanging around, waiting for a passerby to come close enough to latch onto. And most people shiver at the thought of finding the little varmints crawling on them or becoming tick food.

Many people agree that tick populations have increased in the last few years. No one really knows for sure why. But many people who used to go into the woods during the spring and summer, whether mushroom hunting, hiking or squirrel hunting, have changed their minds about their outdoor activities and tend to stay away from tick-infested areas. And with good reason. The increase in tick populations has also brought an increase in tick-borne diseases. And some can be deadly.

Last year brought about several cases of people in Southern Indiana being hospitalized due to tick-borne diseases, and some of those people never recovered. Esther Schwartz was one of the lucky ones.

Schwartz, who lives on a farm near Riddle in Crawford County, went blackberry picking near her home last summer and, even though she used an insect repellent with DEET, she still found a few ticks on her each day and removed them immediately. But one of them, probably a small, lone star tick, was able to stay attached long enough to inject a tiny amount of saliva laced with ehrlichiosis. Difficulty diagnosing the disease almost cost Schwartz her life.

"Many of the ticks I found were real tiny and hard to see," Schwartz said. "But it started on a Monday — I had a real bad fever and a severe headache. I thought it was the flu, but it didn't get better. On Thursday, I was still sick."

Her parents, Mose and Mary Schwartz, took her to a local doctor who thought she had the flu or a bad sinus infection. She was given a prescription for antibiotics.

"Her temperature came down some after that," Mary said. "So, the antibiotics helped some, but we know now it wasn't the right type of antibiotic. She was still weak. Then, on Sunday, she had gotten even weaker, her lips were blue and it was real hard to arouse her. She couldn't answer questions."

"I was just miserable," Esther added. "I couldn't think straight."

On Sunday afternoon, she was taken to a hospital in Paoli.

"By then, I was in really bad shape," Esther said. "I was so weak I couldn't even breathe very well; I would actually get tired from breathing. In the hospital, I was sedated and a breathing tube was inserted down my throat."

"Her blood pressure and oxygen were dangerously low," Mary added. "She was a sick girl. And they couldn't get her stabilized, so the decision was made to send her to the hospital in New Albany. We stayed with her the whole time and were told to expect the worse."

Esther was flown to Floyd Memorial Hospital and Health Services in a helicopter but doesn't remember the trip.

"I don't remember anything that happened for 14 days," she said. "But they treated me with a broad-spectrum antibiotic, and I slowly began to respond. Finally, after 16 days, I was able to go home."

Some other people in Southern Indiana weren't as lucky. Nancy Layton, of Jasper, was bitten by a tick while helping her husband, Owen, mow a local cemetery. She eventually was sent to Jewish Hospital in Louisville and was given several antibiotics but nothing they tried worked. She died a few days later.

"They were trying everything to save her," Owen said. "But we know now that a tick bite, from a little lone star tick, was to blame. She had Human Monocytic Ehrlichiosis."

Tom Kingsley, of Laconia, became sick with similar symptoms and passed away last year. Some officials were reluctant to say he died of ehrlichiosis, but his wife, Pam, is convinced, as are some doctors, that it was the tick disease that claimed his life.

Several other people in Southern Indiana suffered similar symptoms but were treated with broad-spectrum antibiotics and recovered.

Dr. Robert Pinger, director of the Public Health Laboratory at Ball State University in Muncie, said the first case of ehrlichiosis caused by a lone star tick in Southern Indiana was diagnosed in 1994.

Ehrlichiosis is characterized by fever, headache, muscle aches, nausea and vomiting. The disease can be serious but usually not fatal. Lone star ticks infected with Ehrlichiosis chaffeenis, the cause of human ehrlichiosis, have been collected from Warrick, Spencer, Crawford, Har-rison, Pike and Orange counties.

The disease can be treated with antibiotics such as tetracycline.

The lone star tick is slightly smaller than the American dog tick but has larger mouth parts. The female has a single white spot near the center of her back. The males and nymphs are much smaller than the females. All three stages of the tick — larvae, nymphs and adults — are quite active and move quickly. The lone star tick differs from the dog tick in that all three stages will attach to humans.

The immature stages of the lone star tick, sometimes referred to as "turkey ticks" or "deer ticks," will even attach to ground-feeding birds and can be carried to distant locations.

Adult lone star ticks appear in late March. Their numbers peak in May and June and decline in July. Nymphs appear in April, peak in May and June and can be found throughout the summer. They can also be seen again in late fall.

Insect repellents can help keep ticks at bay; they should contain 20 to 25 percent DEET. Permethrin clothing treatment kills ticks but needs to be applied beforehand and allowed to dry overnight. The treatment is usually good for up to a week. Another good repellent is Chlorpyrifos (Dursban).

Pinger said some people are now keeping guineafowl, sometimes known as guineas or guinea hens, to control ticks on their property. It is believed that guineafowl will feed on ticks and other small insects yet won't damage gardens or flower beds.

"If you get Rocky Mountain Spotted Fever from a tick, you will be immune for the rest of your life," Pinger said.

"But with ehrlichiosis, you may be immune if you're infected by the exact same strain again, but that's not likely."

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