Lyme disease is often in the news these days, so by now, most people know at least the basics about how it is contracted, what to do if you get a tick bite, and how to avoid it.
What about the other common tick-borne disease — anaplasmosis?
The Vermont Department of Health says that anaplasmosis is the second most commonly reported tick-borne disease in Vermont, and it's on the rise. In 2011, there were only 10 cases of suspected or confirmed anaplasmosis. In 2016, there were 201.
When not diagnosed and treated properly, over one-third of those with the disease end up hospitalized, and anaplasmosis can in rare cases be fatal, especially for those with compromised immune systems. While less than 1 percent of people infected die as a result, this is a disease to take seriously.
One of the hardest things about diagnosing this disease is that, unlike Lyme disease, there is no telltale rash, and the symptoms are fairly common: aches and pains, headaches, chills, fever, fatigue. So how do you know if it's anaplasmosis?
Anaplasmosis is caused by a bacteria transmitted by the black-legged tick, the same one that carries Lyme disease. Blood tests may help with diagnosing anaplasmosis. While blood tests for antibodies have a tendency toward false negatives, they can give helpful clues — evidence of low platelet or low white blood cell counts, and/or elevated liver enzyme levels — which can help a provider make a diagnosis.
Patients can also help with the diagnosis by providing information about recent tick bites, or about being in tick-prone environments. Some people are not aware that they have had a tick bite, but they do know that they walk in the woods a lot, or that they have been clearing brush, or that they have been in other areas where ticks tend to be located.
The antibiotic doxycycline is the most effective medication for treating this disease for both adults and children. Ideally, it should be used within the first five days, so it often is prescribed before the results of any specialized lab tests results are available. If symptoms don't improve in the first few days after taking doxycycline, this suggests that the disease is not anaplasmosis. Special circumstances may affect outcomes, so ultimately, any discussion of the disease and its treatment is best conducted with your own medical provider.
Of course, the best way to deal with the growing prevalence of anaplasmosis is to avoid the disease altogether. This doesn't mean you have to stay indoors. The following recommendations can help you prevent Lyme disease, anaplasmosis, and any bacteria carried by ticks.
The U.S. Centers for Disease Control recommends treating clothing and gear with products that contain 0.5 percent permethrin. Permethrin can be applied to clothing, shoes, boots, camping gear, and other fabric items used outdoors, and once it is dry, it is not harmful to touch. Also, it stays effective through several washings. Follow the directions for proper application.
For your skin, the CDC recommends EPA-approved insect repellents that contain DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD), or 2-undecanone. Note: these repellents are not suitable for babies and toddlers. To find the right repellent for you and your family, you can consult the website www.epa.gov/insect-repellents/find-repellent-right-you.
Other good practices to help you avoid any tick-borne disease include checking your clothing and gear packs for ticks as soon as you come inside. Remove any ticks you see, and then you can put your clothes through a high-heat dryer cycle to kill any you may have missed. Also, showering soon after you come inside will help to wash off unattached ticks and will also serve as an easy time to do a thorough check of your skin - don't forget to check your head, especially your ears, and in and around your hair. Pets need to bechecked too.
If you make these precautions part of your outdoor routine, most likely you won't need the information I've provided here for how to treat anaplasmosis. It's here in case you do.
David McCormack, family nurse practitioner, joined the staff of Grace Cottage Family Health in May. Formerly nursing supervisor at Brattleboro Memorial Hospital and a provider at Brattleboro Family Medicine, McCormack earned his Associates from Vermont Technical College, his BSN from the University of Vermont, and his Master of Science at the Massachusetts College of Pharmacy and Health Sciences, with a family nurse practitioner focus. He holds certifications in emergency nursing, advanced trauma nursing, and emergency pediatric nursing.
