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Complements of Deer Ticks: Another Emerging Infection

Created Jul 01 2015, 8:00 PM by Lippincott Solutions
  • ticks
  • B. miyamotoi
  • emerging infections
  • Borrelia miyamotoi
  • infection
  • infectious diseases
  • Tick-borne illness

Thursday, July 2, 2015

As people venture outdoors in the summer, we hear about more cases of Lyme disease. Did you know that Lyme disease isn’t the only infection ticks carry? Recently three cases of human infection with Borrelia miyamotoi bacteria have been identified in the United States. One case was an 80-year-old, immunocompromised woman who experienced a steady decline over four months that included increasing confusion, withdrawal from social interactions, diminished appetite, weight loss, difficulty hearing, and unsteady gait. Diagnostic testing revealed the presence of B. miyamotoi in her cerebrospinal fluid; fortunately she recovered after treatment with antibiotics. Two other patients infected with the bacteria experienced flu-like symptoms—high fever, chills, headache, and muscle aches. They too recovered after a course of antibiotics.

What caused these infections?

The B. miyamotoi bacteria was the identified cause of these infections, a spiral-shaped bacteria, carried by two types of ticks, eastern black-legged ticks, commonly referred to as deer ticks, and the western black-legged ticks. The B. miyamotoi bacteria are spread to humans through the bite of one of these types of ticks.

How is B. miyamotoi diagnosed?

Symptoms are commonly nonspecific and flu-like, therefore diagnosis is typically overlooked until the patient’s condition worsens and hospitalization is required.  Since there’s no characteristic rash, laboratory testing is needed to confirm the diagnosis. When tests for more common infectious diseases are negative, the treating practitioner may order a blood polymerase chain reaction (PCR) test that looks specifically at DNA to identify the B. miyamotoi bacteria.

How is B. miyamotoi treated?

Patients with B. miyamotoi infection are usually treated with a two-week course of the antibiotic, doxycycline.

Preventing tick bites

You can teach patients, friends, and family members how to avoid this infection by protecting themselves against ticks. Ticks live near the ground in wooded and bushy areas with tall grasses. They aren’t able to jump or fly; instead they climb grasses or shrubs. When a person, animal or object comes in contact with a grass or shrub, the tick climbs on the person, animal or object and seeks a site for attachment.

To prevent tick bites, encourage individuals to walk in the center of trails when walking in wooded or bushy areas. In addition, encourage them to:

  • Repel ticks by using products that contain 20 to 30% DEET on clothing and exposed skin; follow the manufacturer’s application instructions. Instruct parents to apply a repellent on children taking care to avoid the hands, eyes, and mouth.
  • Treat clothing and gear, such as tents, sleeping bags, pants, socks, and shirts with a product that contains 0.5% permethrin. Inform them that pretreated clothing is also available.
  • Shower or bathe after coming indoors to find and wash off ticks that might be crawling on you.
  • Examine your body to check for ticks; use a mirror to view all parts of the body. Parents should check their children.
  • Place clothing in a hot dryer for about an hour to kill any remaining ticks.
  • Carefully examine gear and pets because ticks can latch onto them and then attach to people later on at home.

If prevention measures fail

If despite prevention measures a tick latches on and bites, encourage them to follow the recommended steps by the Centers for Disease Control and Prevention for tick removal.

  1. Using fine-tipped tweezers, grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure; don’t twist or jerk the tick because doing so can cause the mouthparts to break off in the skin. If the mouthparts break off, remove them with clean tweezers; if you can’t remove them easily, allow them to remain and let the skin heal.
  3. Thoroughly clean the bite area and your hands with alcohol, an iodine scrub, or soap and water.

What areas are you traveling to this summer?  What measures will you take to prevent tick-borne illness?