Tick-Borne Diseases

Anaplasmosis is a rare tick-borne disease caused by the bacterium anaplasma phagocytophilum. The disease can be fatal.  Six states (New York, Connecticut, Massachusetts, Rhode Island, Minnesota and Wisconsin) report 88 percent of all cases of anaplasmosis. The black-legged tick, most commonly known as the deer tick, is the carrier and can transmit the disease during any phase of its life-cycle (egg, larvae, nymph and adult).

Symptoms

Symptoms occur within one to two weeks of a tick bite and may include:

• Fever
• Headache
• Muscle pain
• Malaise
• Chills
• Nausea / abdominal pain
• Cough
• Confusion
• Rash (rare with anaplasmosis)

Treatment

Antibiotics are the first-line treatment for anaplasmosis among adults and children of all ages. If anaplasmosis is treated within the first five days, fever should subside in 24 to 72 hours. Anaplasmosis and other tick-borne diseases can be prevented by avoiding exposure to ticks. For more information check cdc.gov/anaplasmosis.

Caused by a parasite carried by deer and rodent ticks, Babesiosis is rarer than Lyme disease and can be fatal. The parasite infects the red blood cells, causing anemia. Infection is more common in those who have a compromised immune system or who have had their spleen removed. Babesiosis is transmitted by the bite of infected Ixodes scapularis ticks.

Symptoms

Symptoms may take up to one year to appear, and some individuals infected with the disease do not show any symptoms at all. Signs of babesiosis include:

• fever
• fatigue
• lack of appetite
• body aches
• headache

Treatment

Although there is no standard treatment for Babesiosis, a course of antibiotics and medications used to treat malaria has been effective in treating the disease. 

Learn how you can avoid tick-borne diseases.

Ehrlichiosis is a disease usually transmitted by the lone star tick, the black-legged tick and the western black-legged tick. Ehrlichiosis can be found anywhere in the United States, including in Rhode Island.

Symptoms

Typically, symptoms may start to appear five to 10 days following a tick bite. Some infected individuals may not experience any symptoms at all. Signs of ehrlichiosis may include:

• Fever
• Headache
• Fatigue
• Muscle aches
• Nausea
• Vomiting
• Diarrhea
• Cough
• Joint pains
• Rash

Treatment

The standard treatment for ehrlichiosis is a course of the antibiotic tetracycline. This "broad-spectrum" antibiotic is also used for bacterial infections such as Rocky Mountain spotted fever, typhus fever and other tick-related diseases.

Here's how you can avoid tick-borne diseases.

Lyme disease is transmitted when humans are bitten by deer ticks that carry the bacteria Borrelia burgdorferi. It can be difficult to diagnose, particularly in the later stages. Complaints may run the gamut from swollen joints to chest pains that send people to the emergency room fearing a heart attack.

Symptoms

One or more of the following signs may signal Lyme disease. These signs may be present at different times.

Early signs may include:

• Rash
• Muscle aches
• Joint pain and swelling
• Headache
• Stiff neck
• Fatigue
• Fever
• Heart abnormalities (less common)

Late signs may include:

• Arthritis, intermittent or chronic
• Memory loss
• Mood swings

One characteristic of Lyme disease is a rash in the shape of a bullseye, with the bite at the center. However, there are many atypical symptoms as well, and as many as 50 percent of infected patients do not develop skin rashes. Lyme disease infection can spread throughout the body, including joints, the heart, and the nervous system. Lyme disease can be difficult to diagnose; physicians base the diagnosis on symptoms, physical findings (such as a rash), and the possibility of exposure to infected ticks. 

Treatment

We test using the recommended two-tier testing with ELISA screening followed by Western blot for confirmation. In certain clinical presentations, we may also do additional serology testing for infections and/or non-infections that can appear similar to Lyme disease. We are also happy to review any outside Lyme testing that a patient has had in the past.

Research indicates that Lyme disease can be treated successfully with a few weeks of antibiotics. Some 10 to 20 percent of patients may continue to have symptoms after treatment; the vast majority of these patients suffering from post-treatment Lyme disease syndrome do see significant recovery over a period of 6 to 12 months. 

The best way to prevent Lyme disease is to avoid exposure to ticks. Make it a habit to use insect repellent and wear protective clothing in the woods or brush. 

Learn more about Lyme disease and other tick-borne illnesses at www.cdc.gov/ticks/symptoms.html.

Some 10 to 20 percent of patients who have been treated for Lyme disease with the recommended course of antibiotics may continue to have lingering symptoms of fatigue, joint and muscle pain, and perceived cognitive impairment (memory lapses, difficulty concentrating) after finishing treatment. In a small percentage of cases, these symptoms can last for more than six months. Although sometimes called chronic Lyme disease, this condition is properly known as Post-treatment Lyme Disease Syndrome (PTLDS).

The good news is that patients with PTLDS almost always get better with time. The vast majority of patients see a significant abatement in symptoms over the course of six to 12 months, although for some, it can take longer to feel completely well.

Clinical studies are ongoing to determine the cause of PTLDS in humans. We work from the position that the initial recommended course of antibiotics is usually effective in eliminating infection with the Lyme disease bacterium, although we do sometimes prescribe a limited additional course of antibiotics.

We do incorporate carefully regulated antibiotic therapy as one component of our treatment plan. We also focus on addressing the symptoms of PTLDS through a multi-pronged approach, which includes:

• Cognitive behavioral therapy, to assist with the cognitive and emotional issues some patients experience
• Physical therapy, to build strength and resilience and alleviate muscle and joint pain
• Complementary therapies, including non-traditional approaches such as yoga, acupuncture and more
• Consultation and/or referral to neurologists, rheumatologists, and other specialists as needed