Above: East Asian tick, also known as the Longhorned tick, has now appeared in Virginia.
Opinions differ in medical community over tick bites, treatment
By John McCaslin
Suffice to say, the medical community has a tremendous amount to learn when it comes to ticks, tick bites and tick-borne diseases. And they would be the first to admit it.
Consider two of the area’’s top tick experts don’t completely see eye-to-eye when it comes to the tiny bloodsuckers and how they harm humans. Take Dr. Nevena Zubcevik, co-director of Harvard Medical School’s Dean Center for Tick Borne Illness. For several years she’s been sounding the alarm that veteran doctors — and even worse yet, graduating medical students — aren’t nearly up to speed on a tick-borne disease epidemic growing worse by the day.
For instance, many doctors today will inform patients a tick has to sink its razor sharp jaws into human flesh for 24 to 48 hours before the little bugger spits its debilitating Lyme bacteria or else some other disease-causing crud into an unsuspecting person’s bloodstream. Not true, at least in the opinion of Dr. Zubcevik.
Dr. Zubcevik says only after 10 to 15 minutes of the tick embeds itself into a victim it can inject who knows how many of the 10 most common strains of tick-related viruses. Then there’s the much-hyped bull’s-eye rash one strains their eyes to see in the days and weeks after prying a tick from their waistband, shoulder, armpit or anywhere else that blood flows — and when one isn’t found the person assumes they are out of the woods, right? Wrong.
In fact, Dr. Zubcevik told an audience of medical professionals that tick-bite victims who discover a bull’s eye rash should consider themselves lucky, because she insists they appear only about 20 percent of the time.
And how about the medically trendy “two-day” course of doxycycline to cure the less severe tick bite? If it was the Harvard doctor’s patient she’d prescribe up to 200 milligrams of doxycycline twice a day for 20 full days, regardless of how short a duration the tick fed on its host.
Reached by me to expand further on what is arguably unorthodox guidance on ticks, Dr. Zubcevik referred us to her fellow tick expert in the mid-Atlantic: Dr. John Aucott, director of the Johns Hopkins Lyme Disease Clinical Research Center in Maryland. With more than 15 years of research experience on the crippling effects of Lyme, Dr. Aucott has published numerous studies on the characteristics of early Lyme disease, even the differences seen in males and females, with an emphasis on prospects for prevention, diagnosis and treatment.
Without question, Drs. Zubcevik and Aucott are in agreement on most tick matters, but they also have their differences when it comes to what the ordinary person should know when it comes to tick bites and what often follows in their wake.
Dr. Aucott opiniones that if a tick is discovered “very early” in the gorging process, he would recommend “not taking a full course” of precautionary antibiotics, particularly in areas such as ours where tick bites are a regular occurrence.
“If you did that you’d be on antibiotics all spring, summer and fall,” the doctor points out.
Rather, says Dr. Aucott, if the tick is removed within “48 hours” then a “single dose of prophylactic antibiotics” can often arrest development of Lyme disease, which remains difficult to diagnose. “The baseline to remember is not all tick bites result in tick-borne diseases,” Dr. Aucott says. “Two to 5 percent [of ticks] at most transmit disease.”
As for a telltale rash? “I believe 70 to 80 percent get the rash,” answers the doctor, although it doesn’t always appear in the shape of a bulls-eye. Dr. Aucott, like others in the medical field, stresses tick bite prevention is key. People must take protective measures when outdoors. He says, “Just like when we get into a car and automatically put on a seatbelt to prevent injury. We have to do the same thing with ticks.”
He rattles off the usual safety precautions, like powerful bug sprays, tucking pants into socks and shirts into pants, basically “staying out of the bushes.” And then performing thorough tick checks, which for families in this region is a nightly ritual like brushing teeth. And if no rash appears to warn of Lyme, sooner or later one of the other numerous signs of tick-borne diseases will likely appear, including but not limited to headaches, body aches, fever, chills, irregular heartbeat, malaise, shortness of breath, and brain fog.
Amazingly, Dr. Aucott tells us that certain people with “healthy immune systems” can actually get Lyme and never know they even have it until the disease eventually disappears from their bodies. In other words, that headache might not have been from pollen after all.
Meanwhile, diagnosing tick-borne diseases remains a serious issue. Many people suffering from Lyme (bacterium Borrelia burgdorferi) or other tick-borne diseases don’t initially test positive in blood samples. And if left untreated those diseases can all spell serious medical consequences, including musculoskeletal, nervous system and heart problems. If getting tested, wait until any early stage of infection has passed.
With Lyme there is also the ELISA assay test, which looks for the disease’s antibodies, and then there’s the Western Blot assay, which is considered the most reliable test available today.
There is hope on the horizon. Dr. Aucott says the medical field continues its work on an effective Lyme disease vaccine for humans, albeit the process is taking “years to accomplish.” How many of the other tick-borne diseases, besides Lyme, such a vaccine might prevent remains to be seen.
Take the dreaded TBRDs (Tick Borne Rickettsial Diseases), which is difficult to diagnose and are increasing in number, put more people in the hospital, and are deadlier than Lyme. TBRD symptoms sometimes don’t develop until “years” after the tick bite.
And then there’s two types of POW, or Powassan virus, which are also difficult to diagnose, more debilitating and deadlier than Lyme. Virginia has now recorded its first case of POW. No antiviral drug exists for the virus, which can be transmitted from the bites of six known species of ticks. Time interval for POW transmission to humans: less than 12 hours. Fortunately, the majority of POW cases are in northern states, from New England into the upper Midwest, while Lyme disease rules here in this county.
One more thing: if you have an opossum in your yard, keep it alive and hope for offspring. The National Wildlife Federation states that with the huge rise in deer tick populations and spread of Lyme “opossums act like little vacuum cleaners . . . with a single opossum hoovering up and killing as many as 4,000 ticks per week.”
Bottom line: Dr. Aucott says if you notice any fatigue, soreness or fever during these warmer months, be suspicious first of Lyme. “We like to say there’s no summer flu,” is how the doctor puts it.
Longhorned or East Asian Tick
By Debbie Eisele
Recent news has discussed the identification of a new tick found in Hunterdon County, New Jersey. This particular county was the first location to find the longhorned or East Asian tick on livestock. Since then, the tick has been spotted in multiple N.J. counties, and now in Albemarle County here in Virginia.
According to the Virginia Department of Agriculture and Consumer Services (VDACS): “On May 14, the National Veterinary Services Laboratory in Ames, Iowa confirmed the finding of the Haemaphysalis longicornis tick (otherwise known as the East Asian or Longhorned tick) in Virginia. The tick appeared on an orphaned calf on a beef farm in Albemarle County.”
VDACS noted that Virginia state veterinary officials are collaborating with the U.S. Department of Agriculture and other federal entities “to determine the extent and significance of this Virginia finding.”
Livestock owners and those who spend time outdoors need to be on the lookout for these critters. “This pest is so new that there is a lot we don’t know yet, but we’re learning every day,” said Elaine Lidholm from VDACS. “Livestock producers and owners should notify VDACS if they notice any unusual ticks that have not been seen before or that occur in large numbers on an individual animal.”
Virginia Cooperative Extension provides an online resource with information on commonly found ticks. If you find a tick that does not appear to be one of the ones typically found in this area, take in a sample in a container for either VDACS or Virginia Cooperative Extension employees to view. VDACS said, “Livestock producers should work with their herd veterinarians to develop a tick prevention and control program. Livestock owners also may contact VDACS’ Office of Veterinary Services at 804-786-2483.” To locate your local Cooperative Extension office you may visit www.ext.vt.edu.
About the author:
John McCaslin is editor for Rappahannock News, a sister company of Piedmont Lifestyle Publications.