9. May 201
8 1:09  After the prolonged drizzle and the cold of late winter, it is finally fully mature in Maine. For many residents of Pine Street State, it's time to go nature, garden, hike, play, and work.
Unfortunately, the advent of warmer weather has its own problems. These include the growing geographical spread of ticks, these tiny arachnids, and the dangerous human diseases they carry. In addition to the rising rates of Lyme disease, the most well-known of these tick-borne diseases, Maine has a smaller but growing incidence of anaplasmosis, babesiosis, Ehrlichia, and the Powassan virus, all potentially serious and even fatal infections of concern should give for anyone who works or plays outside.
In 2017, nearly 1,800 mothers fell ill with Lyme disease, setting a new record for a disease that has increased dramatically in recent years. In 2016, 1,496 cases of Lyme were reported in Maine, following 1,210 cases in 2015, according to data from CDC Maine.
One of them was Karen Greenlaw, a 61-year-old nurse who lives in Orrington. She also had babesiosis, possibly from the same bite. Her symptoms started on Thanksgiving, a few weeks after she found a heavy tick on the floor of her bathroom.
"I thought I had a flu," she said. "I could not eat, I had a fever, I could not even move, I was so tired." A doctor in the nearest ambulance wiped his neck and took a blood sample, then sent her a prescription for an antiviral flu medication.
The throat swab was negative for influenza, but suggestive of Lyme disease and clearly positive for babesiosis. She was switched to an antibiotic. A later test also confirmed Lyme.
Greenlaw suffered from "unbearable fatigue" and missed two weeks of work before recovering.
"But I have not had any symptoms since," she said. "I think that's because I started medication early."
Dr. Robert Pinsky, an infectious disease specialist in Ellsworth and Bangor, said even more worrying than the growing problem of Lyme is the spike in anaplasma, babesiosis and other tick-borne infections.
"These may be very serious if not treated promptly," he said.
Most infections will respond to antibiotics and other medications, he said, but if treatment is delayed, any underlying damage can not be undone.
Because of the flu-like symptoms of Lyme and other ticks transmitted disease is similar, Pinsky said it is best to act quickly when they arise.
"If you get fever and chills, I would not ignore it," he said, "especially at this time of year the risk of infection is high."
Tick-borne diseases in Maine
Tick bites rarely cause discomfort at the time of their appearance and can go completely unnoticed. Early symptoms of illnesses found in Maine typically develop for one to two weeks, according to the US Centers for Disease Control and Prevention, and often include flu-like symptoms such as fever, fatigue, chills, and nausea.
Most of these diseases are transmitted through the deer tick, but Rocky Mountain Spotted Fever and Ehrlichiosis are borne by the lesser-known Lone Star Tick. In most cases, these diseases are effectively treated with oral antibiotics. Delayed treatment is likely to lead to serious complications
– Lyme disease is by far the most common of the tick-borne diseases. Early symptoms include flu-like symptoms as well as a characteristic "bull's-eye rash" that can develop around the tick bite. Left untreated, Lyme can cause long-term problems, including painful joint inflammation and neurological problems such as meningitis, facial paralysis, weakness and impaired muscle control.
– Anaplasmosis causes similar symptoms to Lyme. Left untreated, anaplasmosis can lead to internal bleeding, kidney failure, and death. About 662 cases were reported in Maine in 2017, compared to 372 cases in 2016 and 186 cases in 2015.
– Babesiosis is caused by microscopic parasites that infect red blood cells. Some people never develop symptoms, but in others, babesiosis can cause flu-like symptoms and severe anemia. In Maine, 117 cases of babesiosis were reported in 2017, compared to 82 cases in 2016 and 55 cases in 2015.
– Ehrlichiosis is a bacterial infection that can cause life-threatening breathing difficulties and blood clotting disorders. 20 cases were reported in Maine in 2017, compared to four cases in 2016 and only one case in 2015.
– Rocky Mountain Spotted Fever can lead to limb amputation, hearing loss, paralysis and mental retardation. In 2017, three people fell ill in Maine, four in 2016 and only one in 2015.
– The Powassan virus causes neurological problems such as brain inflammation and seizures. There is no specific treatment but due to shortness of breath and dehydration hospitalization may be required. Three cases were reported in Maine in 2017, one in 2016 and none in 2015.
All these diseases are preventable.
"To prevent Lyme disease and other tick-borne diseases, the best protection is to avoid contact with ticks." Bruce Bates, director of CDC Maine, has just released a press release. Bates and other public health experts recommend the following preventive measures for those who work or rest outdoors:
– Avoid wooded and brittle areas and high grasses.
– Walk in the middle of paths to avoid contact with plant compounds.
– Wear bright clothing so that ticks are more visible.
– Wear long sleeves and long pants, and slip the trouser cuffs into socks.
– Use a Federal Agency approved agency with proven ingredients such as DEET, Picaridin or IR3535. Apply to both clothing and exposed skin.
– Perform daily tick checks, including pets and equipment, preferably immediately after arrival.
Ticks that adhere and feed should be removed as soon as possible Tweezers or a special, slotted "ticks spoon". Grasp the tick near the head and pull it steadily until it releases.
Homeowners and managers of public areas such as parks or playgrounds can use professionally applied chemical pesticides to keep tick populations in check.
A Changing Landscape
"Maine is a very diverse landscape, with new areas of ticks and diseases following," said Chuck Lubelczyk, a scientist at the Institute for Vector-borne Diseases at the Maine Research Center for Clinical Research Medical Center in Scarborough. Lubelczyk has been investigating ticks in Maine since the mid-1990s.
"Ticks are moving inland and they are moving up the coast."
In these areas there are warmer temperatures and more residential areas, he explained, meaning that longer ticks are active and a growing human presence. A significant population of white-tailed deer, the primary feeding target for the deer tick, is another key factor.
Lubelczyk says that the percentage of ticks that carry disease-causing organisms in Maine has stabilized at about 50 to 60 percent. In recent years, Maine Midcoast has area, including Lincoln, Knox and Waldo counties, the fastest growth in reported cases of Lyme disease. But Hancock County also sees an increase, from 121 cases in 2015 to 152 cases in 2016 and 202 cases in 2017, according to data from the Maine Center for Disease Control and Prevention.
Lubelczyk said northern and western areas of Maine are still experiencing lower disease rates. But he expects this to change as venison spreads northward to Canada, where less than 1,000 cases of Lyme disease have been reported nationwide in 2016.
"Maine will not be the dead end," he said. Follow
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