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Tick-borne infections pose increasing threat to North Carolinians

By Marcia E. Herman-Giddens, PA, DrPH
Posted Tuesday, May 9, 2006

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Pittsboro, NC - In Chatham County, in an informal survey of people in Pittsboro, almost everyone spoken with had either had an illness themselves or knew of a person or pet that had suffered from a tick-borne illness. Last summer the state conducted a project in Chatham County to learn more about the TBIs in the area and it is hoped they will continue this summer.

Rising spring temperatures bring a rapid increase in the numbers of tick bites and the likelihood of tick-borne infections (TBIs). The number of North Carolinians suffering from a wide variety of often little known or understood tick bite infections, and in some cases, fatalities, continues to increase.

North Carolina leads the nation in cases and deaths from Rocky Mountain Spotted Fever (RMSF) – deaths that should be preventable. More than 500 cases of Rocky Mountain Spotted Fever, a rickettsial disease, were reported in 2004. Over 20% of the nation’s fatalities from RMSF are from our state even though we have less than 4% of the nation’s population.

Hundreds of Lyme disease cases along with dozens of cases of other tick-borne infections have also been reported. Actual numbers of all TBIs are higher since underreporting is common for any reportable disease due to a variety of reasons. In addition, ticks can cause other infections, which are not required to be reported and some cases are misdiagnosed.

Dr. Marcia Herman-Giddens, president of the new organization, Tick-borne Infections Council of North Carolina, Inc., called the problem “A major public health threat.” She explained, “Neither the public nor medical professionals have an adequate knowledge of tick-borne infections (TBIs). The state public health system needs to enhance their response.”

Misperceptions about symptoms and rashes often lead to delays in seeking treatment and getting the correct diagnosis. These delays may prolong treatment and increase fatalities. Forty percent or more of individuals with tick-borne infections and subsequent disease do not recall a tick bite or remember a rash of any sort. Diagnosis and treatment of Lyme disease is controversial and two standards of care exist within the medical community.

Dr. Herman-Giddens says, “Unnecessary deaths occur from rickettsial diseases and sometimes lives are ruined from long-term disabilities caused by Lyme or a Lyme-like disease spreading throughout the state. The four ticks in North Carolina most likely to bite humans can all transmit more than one infection, sometimes during the same bite.”

These ticks include the Lone Star Tick, the American Dog Tick, the Brown Dog Tick, and the Black-legged (deer) tick. Tick species and populations have increased with the growth in suburbanization and the deer population. Ticks are most likely to be found in grassy and wooded areas but may be in cities as well. The most aggressive type, the Lone Star, has spread into North Carolina over the past several decades.

Prevention strategies and proper removal can help. Tips are available on the organization’s website and at the Centers for Disease Control website.

TIC-NC’s mission is to increase the recognition, treatment, control, and understanding of tick-borne diseases in North Carolina. More information on ticks in North Carolina, standards of treatment, prevention, and related issues can be found at TIC-NC’s website, Membership is free and the organization encourages all citizens to join since almost everyone is at risk.

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