EHRLICHIOSIS - ON THE RISE IN MISSOURI

Kansas City Star, The (MO)
2007-08-11
Section: NEWS
Edition: 2
Page: B1

Illnesses from ticks are on the rise in Missouri
JONATHAN KEALING, The Kansas City Star

If you can stand the heat and are planning an outdoor adventure in Missouri, make sure you pack plenty of bug spray with DEET.
Tick-borne diseases are more prevalent this year than in years past, according to the Missouri Department of Health and Senior Services.
Cases of four such diseases have jumped considerably compared with the five-year median: Ehrlichiosis, up to 117 cases from 40; Rocky Mountain spotted fever cases, to 186 cases from 64; tularemia, to 18 cases from 12; and Lyme disease, to 35 cases from 22. The health department says the rise in infections is due in large part to increased recognition and reporting by physicians, as well as changes in lifestyle, including more homes built in old forests and more time spent outdoors.
"South of the Missouri River is seeing more activity than north of the Missouri River, with a few notable exceptions, including Boone County and Clay County," said Karen Yates, the state's vector-borne disease program coordinator. "I think that relates a lot to the accessibility of health care."
Barbara Dawson, communicable disease nurse for the Clay County Public Health Center, said some of the increase might be just better reporting. "And there are a lot of woods up here," she said, "so there are a lot of places ticks can be."
Dawson said Clay County has 15 cases, six of ehrlichiosis and nine of Rocky Mountain spotted fever, but not all are confirmed.
She also emphasized that the reports are based on where the diagnosing hospital or doctor's office is located, not where the victim lives.
Kansas has recorded 13 total cases of all four diseases, said Joe Blubaugh, director of communications for the Kansas Department of Health and Environment. At this time last year, Kansas had six cases.
Missouri "has much more wooded areas, and we're a lot more open," he said. "They have a lot more people, too."
According to Yates, children are especially vulnerable to severe cases of Rocky Mountain spotted fever.
On the other hand, ehrlichiosis tends to be more severe for those over age 40. She said that anyone with a compromised immune system or who is undergoing therapy with immunosuppressants has a greater risk of infection from these diseases.
Terri Wolfe, an aide to Kansas City Councilwoman Deb Hermann, has witnessed the terrible effects of tick-borne diseases personally. Her mother, Roberta Linch, 73, of Preston, Mo., contracted ehrlichiosis recently and had to be hospitalized. When she finished a course of antibiotics, she contracted what doctors think is West Nile virus, spread by mosquitoes.
"It's absolutely terrifying," Wolfe said. "Their health goes down so quickly."
Wolfe said she's taken precautions, like stocking up on tick and mosquito spray, but there is only so much that can be done.
Linch is recovering at Wolfe's sister's home in Liberty.
When will the tick population subside?
If this hot weather is good for something, it's keeping the tick population down.
"With the really, really hot weather, the ticks tend to retreat into a moister area," Yates said.
But when it cools down, they'll be back again. There must be sustained temperatures of 40-45 degrees for a long time before the tick population will die for the season.
Tick bite prevention tips
** Avoid wooded and bushy areas with high grass.
** Wear long pants, long sleeves and long socks. Tuck pant legs into socks or boots and tuck shirts into pants.
** Use insect repellents containing 20 to 50 percent DEET.
** Coat clothes with products containing permethrin. But keep these products off skin and review garment labels as well.
** Do a tick check of clothing before going indoors. Then, inspect your body carefully, paying close attention to armpits, scalp and groin.
** Wash your clothes in hot water and dry them for at least one hour using high heat.
Tick removal
** Using fine-tipped tweezers, grasp the tick very close to your skin.
** In one motion, pull the tick's body away from your skin. Don't worry if the tick's mouth parts remain in your skin. It can no longer infect you.
** Clean your skin with soap and warm water.
** If you accidentally crush the tick, clean your skin with soap and warm water, or with alcohol.
** Do not use petroleum jelly, a hot match, nail polish or other products to remove ticks.
Source: Missouri Department of Health and Senior Services
Tick-borne disease symptoms and treatment:
Disease Symptoms Treatment
Rocky Mountainspotted feverSudden fever, severe headache, tiredness, deep muscle pain, chills or nausea. Sometimes a rash is also a symptom. Antibiotics. Sometimes hospitalization is needed.
Ehrlichiosis Fever, headache, malaise, muscle aches, nausea, vomiting, diarrhea, cough, joint pains and confusion. Rash is rare. Tetracycline antibiotics for adults.
Lyme disease Fever, fatigue, headaches, aching joints, nausea and a skin rash callederythema migrans, usually at the site of the bite. Prompt treatment with antibiotics can cure the disease. Untreated, it can cause a host of other more severe symptoms.
Tularemia Skin transmission: Ulcerative skin lesion and swollen glandsIngestion, i.e. by eatingwithout washing hands after coming in contact with a tick or by eating undercooked game meat that has been infected by a tick: Throat infection, abdominal pain, diarrhea and vomiting.Treatment with antibiotics, including streptomycin and gentamicin.
Source: Missouri Department of Health and Senior Services
@ For information on tick-borne disease symptoms and treatment, go to KansasCity.com.