Tiny terrors: Deer tick bites can lead to Lyme disease
Valerie Cran Dahl of Salol, Minn., has been living with Lyme disease for nearly 30 years, she says.
In the summer of 1985, when she was 14, she distinctly remembers that she woke up to find "a dozen tiny poppy seed-sized ticks latched on to my right ankle, which was swollen and painful."
"I was an outdoor girl" and had been bitten by ticks a few times, she said. But pulling off these ticks was "very painful—unlike the annoying dog ticks that had bitten me."
She removed them all, but "that ankle remained swollen with a rash for several days."
Her symptoms included achiness and a fever or flu, she said. She spent "a few miserable days in bed."
Since then, Dahl has suffered failing health and has received "dozens of wrong diagnoses until I was finally diagnosed correctly in 2010," she said. "I have been disabled ... fighting hard, but not getting well."
Her symptoms "have lingered for a long time—on and off for the first few years." she said.
Over time, she has also experienced "constant moderate to severe leg pain—knees to toes, but hips too."
Migraine headaches and lingering symptoms of meningitis and encephalitis "got worse and worse as the years passed," she said.
Lyme disease, which is transferred to humans via a tick bite, is the most common tick-borne illness in North America and Europe, according to Mayo.com.
Black-legged ticks, more commonly known as deer ticks, which feed on the blood of animals and humans, can harbor the bacteria which causes Lyme disease and spread it when feeding.
The ticks are brown and when young, they're often no bigger than the head of a pin, which can make them nearly impossible to spot.
People who engage in outdoor activities, especially in the spring and summer, are at increased risk of getting Lyme disease, said Dr. Chris Henderson, family physician with Altru Health System in Grand Forks.
In most cases, in order to transmit Lyme disease, a deer tick must be attached for 36 to 48 hours, medical experts say. If you find an attached tick that looks swollen, it may have fed long enough to transmit bacteria. Removing the tick as soon as possible may prevent infection.
Signs and symptoms of Lyme disease vary and usually affect more than one system of the body, according to MayoClinic.com. The skin, joints and nervous system are affected most often.
If left untreated, infection can spread to joints, the heart and the nervous system, the CDC says.
The most common sign of infection is an expanding area of redness that begins at the site of the bite about a week after it occurred. The rash usually feels warm to the touch but is typically not itchy or painful.
"You hear about the bull's-eye rash, but 25 to 30 percent of people don't have that kind of rash—or a rash at all," Henderson said.
The disease "presents like a lot of other things—muscle soreness, headache, fever, stiff neck, sore joints," he said. "A known history of tick bites" would also increase the possibility of Lyme disease.
With Lyme disease, long-term complications can arise but are less common, Henderson said.
"Arthritis is a common one which causes pain if not treated. Neurological symptoms, which are less common, include meningitis, numbness and a certain weakness in a particular muscle."
In late stages of persistent Lyme disease, infection can cause damage to the nervous system, joints and brain, according to WebMD.
Lyme disease, which has been termed "the great imitator," may be misdiagnosed as multiple sclerosis, rheumatoid arthritis, fibromyalgia, chronic fatigue syndrome, lupus, Crohn's disease, HIV or other autoimmune and neurodegenerative diseases.
While the term "chronic Lyme disease" is controversial, a classification, called post-treatment Lyme disease syndrome, or PTLDS, has emerged and is defined as continuing or relapsing non-specific symptoms—such as fatigue, musculoskeletal pain and cognitive complaints—in a patient previously treated for Lyme disease.
Doctors usually treat Lyme disease with antibiotics.
"Doxycycline is usually the first (drug) we use," Henderson said. "It has benign side effects and is pretty well tolerated."
"(In the past) it was harder to isolate that bacteria (Borrelia burgdorferi)" which causes Lyme disease, he said. "Different types of blood or joint fluid serum tests are available now."
Each of those tests "have their own limitations."
Early diagnosis and treatment can be better for patients, he said, but "even if treated later, people are still likely to do very well."
If you're treated with appropriate antibiotics in the early stages of the disease, you're likely to recover completely, Mayo doctors say. In later stages, response to treatment may be slower, but the majority of people with Lyme disease recover completely with appropriate treatment.
Left untreated, symptoms may include loss of the ability to move one or both sides of the face, joint pain, severe headaches with neck stiffness or heart palpitations, among others.
Last year in North Dakota, only one case of Lyme disease was reported in each of three northeastern counties—Grand Forks, Walsh and Benson. They were among eight cases statewide that were reported to the North Dakota Department of Health.
In other years, reported cases in the state totaled 29 in 2013, 15 in 2012, 26 in 2011 and 33 in 2010.
According to the Minnesota Health Department, the number of Lyme disease cases has been increasing dramatically since the 1990s. In 2013, 1,431 confirmed cases and an additional 909 probable cases were reported.
A variety of factors, including increasing physician awareness, increasing infection rates in ticks and expanding tick distribution may have led to this trend, the department said.
You're more likely to get Lyme disease if you live or spend time in grassy or heavily wooded areas where ticks carrying the disease thrive, according to Mayo.com. It's important to take precautions in areas where Lyme disease is prevalent.
"You should wear long pants and long-sleeved clothing and wear an insect repellant such as DEET," said Javin Bedard, environmental health manager for the Grand Forks Public Health office.
"Public Health recommends that you check yourself for ticks, especially if you've been in tall grass and rural areas."
Recent studies by UND researchers have revealed that the deer tick is showing up our area, he said. "The potential is there (to acquire Lyme disease)."
Ticks depend on moisture, so homeowners are advised to keep their grass mowed, he said.
When conditions dry out, ticks "retreat to the under mass, or forest litter, to stay in moisture."
The potential is there to pick up a deer tick at any time, Bedard said, but the ticks become more active as the summer progresses.
When removing a tick, it's most critical to be sure the mouth part is removed, Henderson said.
"If you don't think you can get it out completely, come in (to Altru Clinic) and we'll take it out. The mouth part can cause problems if it stays in there. It can be pretty irritating."
Lyme disease "is endemic—meaning it's present in the population," he said. "It has been spreading further west with the migration of ticks. (But) people don't need to worry."
"(They) should be aware that if they come in ... with symptoms of fever, aches, etc., it's probably not going to be Lyme disease. Especially in December or January, I'm not going to suspect Lyme disease."
Symptoms of Lyme disease
The signs and symptoms of Lyme disease vary and usually affect more than one system of the body. The skin, joints and nervous system are affected most often.
Early signs and symptoms may occur within a month after you've been infected:
• Rash: A small, red bump may appear at the site of the tick bite. This small bump is normal after a tick bite and doesn't indicate Lyme disease. However, over the next few days, the redness may expand, forming a rash in a bull's eye pattern, with a red outer ring surrounding a clear area. This rash is one of the hallmarks of Lyme disease.
• Flu-like symptoms: Fever, chills, fatigue, body aches and a headache may accompany the rash.
In some people, the rash may spread to other parts of the body and, several weeks to months after you've been infected, you may experience:
• Joint pain: You may develop bouts of severe joint pain and swelling. Your knees are especially likely to be affected, but the pain can shift from one joint to another.
• Neurological problems. Weeks, months and even years after you were infected, you may experience inflammation of the membranes surrounding your brain (meningitis), temporary paralysis of one side of your face (Bell's palsy), numbness or weakness in your limbs and impaired muscle movement.
Only a minority of deer tick bites lead to Lyme disease. The longer the tick remains attached to your skin, the greater your risk of getting the disease.
If you think you've been bitten by a deer tick and experience symptoms of Lyme disease - particularly if you live in an area where it is prevalent - contact your doctor immediately. Treatment for Lyme disease is most effective if begun early.
See your doctor even if symptoms disappear, because the absence of symptoms doesn't mean the disease is gone.
Left untreated, Lyme disease can spread to other parts of the body from several months to years after infection, causing arthritis and nervous system problems.
Ticks can also transmit other illnesses, such as babesiosis and Colorado tick fever.