Since 2011, Pennsylvania has led the nation in cases of Lyme disease, with more than 10,000 reported cases in 2018 (the most recent year CDC data is available). These cases accounted for 30 percent of all reported Lyme disease cases in the U.S. that year. More than 300 of the reported cases were in Lancaster County.
While Lyme is the most common tick-borne disease in Pennsylvania, other infections such as Erhlichiosis, Babesiosis, Tularemia, Rocky Mountain Spotted Fever (RMSF), and Powassan virus are also transmitted by infected ticks, providing more reasons to take precautions when outdoors in spring and summer. Most cases of tick-borne diseases occur during the summer months.
The Culprit: The Black-Legged Tick
To get any of these infections, you must be bitten by an infected black-legged tick (deer tick), American dog tick, or other infected tick. Lyme disease requires the tick to be in place for at least 24 hours in order to develop an infection. In contrast, Powassan virus can be passed from infected tick to human in just 15 minutes.
Symptoms of Tick-Borne Disease
Symptoms of Lyme disease typically appear seven to 14 days after being infected, and are similar to the flu—chills, fever, headache, sore throat, fatigue, and muscle and joint aches. What distinguishes the infection is a red rash that looks like a bull’s eye. The rash develops in approximately 70-80 percent of people who contract Lyme disease. Without treatment, the disease may progress to late phase symptoms, including rheumatologic, cardiac, and neurologic conditions.
Some people do not develop a rash after becoming infected, and many don’t notice it if they do. In addition, many don’t make the connection between their flu-like symptoms and a recent tick bite. Often, people don’t even realize they have a tick bite. Black-legged ticks are the size of poppy seeds and can be hard to see.
Erhlichiosis causes fever, headache, muscle aches, red eyes, and a rash. Severe illness can result in brain infection due to meningitis or encephalitis, respiratory failure, severe bleeding, and even death.
Babesiosis and Tularemia
Babesiosis can cause fevers, headache, joint and muscle pain, as well as a decrease in red blood cells. Generally, this infection is self-limiting, so symptoms usually resolve on their own in healthy people. However, certain elderly patients or patients with weak immune systems can develop complications, leading to organ malfunction and death.
Symptoms of Tularemia, also called “rabbit fever,” include sudden onset of fever, chills, body aches, and swollen lymph glands
Rocky Mountain Spotted Fever
Despite its name, Rocky Mountain Spotted Fever (RMSF) sometimes occurs in the Northeastern states, including Pennsylvania. Symptoms include high fever, severe headaches, muscle aches, and a spotted, purplish rash. The rash often begins on the wrists and ankles, and then spreads to the arms, legs, and torso. Complications can be quite severe, including brain infection, heart, lung, and kidney failure, and even death.
Powassan virus infections are rare. The CDC reports just 75 cases of Powassan virus in the U.S. over the past 10 years and only one case in Pennsylvania. Symptoms of infection, which can appear one week to one month following a tick bite, include fever, headache, and weakness.
Many people develop no symptoms. However, in some cases, symptoms progress and may include vomiting, weakness, confusion, and seizures. This occurs when there is inflammation and infection of the brain (encephalitis). Long-term neurologic problems may occur. Approximately one in 10 people with severe Powassan viral infection die of the disease.
Treatments for Lyme Disease and Other Tick-Borne Infections
When Lyme disease is detected early, it can be very successfully treated with two to four weeks of antibiotics. If untreated, Lyme disease can result in serious complications affecting the joints, nervous system, and heart. Ehrlichiosis, Babesiosis, Tularemia, and RMSF all can be treated with antibiotics as well.
There is no specific medication to cure or treat Powassan. Severe cases may require hospitalization.
There is no vaccine to protect against any of these infections, but there are relatively easy steps you can take to avoid developing the diseases in the first place:
- Wear long pants, long-sleeved shirts, and socks when in wooded areas with high grass where ticks like to live. Tuck pant legs into socks or boots and shirts into pants.
- Wear light-colored clothing in order to be able to identify the dark-colored ticks.
- Wear a hat.
- Wear insect repellent that contains 10-30% DEET on clothing and exposed skin (not on the face) when outdoors. Apply sparingly on exposed skin. Do not use DEET on babies under 2 months of age.
- Treat clothing and gear with products containing 0.5% permethrin. Permethrin can be used to treat boots, clothing, and camping gear and remains protective through several washings.
- Do a full body tick check after spending time outdoors. Check your children carefully, including around the ears, under the arms, behind the knees, around the waist, inside the belly button, and on the scalp.
- Shower soon after being outdoors to wash off ticks that haven’t attached to your skin.
- Call your doctor if you develop symptoms.
How To Remove A Tick
There is no need to panic if you find a tick attached to you or your child’s skin. Prompt and proper removal of the tick helps prevent possible transmission of these infections. The Centers for Disease Control and Prevention recommends you take these 4 steps:
- Grasp the tick as close to the skin's surface as possible with fine-tipped tweezers.
- Pull upward with steady, even pressure. Don't twist the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouthparts with tweezers.
- After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol or soap and water.
- Never crush a tick with your fingers. Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet.