The Maine Centers for Disease Control has released the update 2014 numbers for three important tickborne diseases in the state: Lyme disease, anaplasmosis and babesiosis.

Image/ National Atlas of the United States
Image/ National Atlas of the United States

The case count for Lyme disease in 2014 as of Jan. 5  is 1,334. Health officials do note that due to passive reporting, it can take a couple of months to tally all the cases, thus this number will likely get higher.

In 2013, Maine saw 1,375 cases total for the year.

The Lyme disease bacterium, Borrelia burgdorferi, is spread through the bite of infected ticks. According to the Centers for Disease Control and Prevention (CDC), the blacklegged tick (or deer tick, Ixodes scapularis) spreads the disease in the northeastern, mid-Atlantic, and north-central United States, and the western blacklegged tick (Ixodes pacificus) spreads the disease on the Pacific Coast. Most humans are infected through the bites of immature ticks called nymphs.

Early stages of Lyme disease manifests itself with a red, expanding rash called erythema migrans (EM) seen about 70% of the time. In addition, non-specific symptoms like fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes.

Later symptoms may include Bell’s palsy, arthritis, severe headaches, heart palpitations and dizziness and shooting pains. Neurological symptoms may also be experienced. Many chronic Lyme sufferers experience these symptoms for years.

The tickborne disease that showed the biggest increase from 2013 to 2014 in Maine was anaplasmosis. In 2014, 190 cases were reported more than doubling the 94 cases seen in all of 2013.

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The organism that causes this disease is called Anaplasma phagocytophilum. It is an intracellular pathogen that is part of the Rickettsia (the same group of bacteria that cause Rocky Mountain spotted fever amongst other diseases) family.

Formerly known as human granulocytic ehrlichiosis, and as the former name of the disease implies, it’s an infection of the white blood cells.

Black-legged tick
Ixodes scapularis, a Black-legged tick/CDC

People get this infection through the bite of an infected tick. Depending on the part of the United States you are, the tick species is different: the eastern part of the country is the black-legged tick, Ixodes scapularis, and in the western part of the country, Ixodes pacificus, is usually involved. These are deer ticks that are also involved in the transmission of Lyme disease.

After a period of a couple of days to a few weeks, most people infected with Anaplasma show influenza- like symptoms (fever, malaise, headache, nausea, vomiting, diarrhea and respiratory symptoms such as a cough). Symptoms tend to be more severe in those that are immunosuppressed and the elderly.

Finally, the number of the tickborne parasitic disease, babesiosis, cases increased slightly from 2013 to 2014. In 2014, 42 cases were reported, while 36 cases were seen in 2013.

Babesiosis is a parasitic disease of the red blood cells which can be found worldwide: however, most documented cases have been found in the United States. Most human infections are attributed to the species, Babesia microti, while other species are less often seen in zoonotic infections.

The parasite is typically transmitted through a tick bite, Ixodes scapularis in the U.S., from late spring to early fall. It can also be transmitted through blood transfusions and this is not restricted by geographical regions.

Babesia life cycle/CDC
Babesia life cycle/CDC

Depending on host factors (people without a spleen, immunocompromised) the disease can range from asymptomatic to life threatening.

Symptoms if present typically appear as non-specific flu like symptoms, fever, chills, body aches, and hemolytic anemia.

The danger for donated blood is that even asymptomatic people may have low-level amount of Babesia in the bloodstream from months to longer than a year making blood transfusion infections an issue. Tests for screening blood donors for Babesia are not available.

After getting infected, the presence of symptoms is variable depending on the host and parasite factors. Typically after tick borne transmission symptoms appear in one to three weeks and it may be weeks to months post blood transfusion.

The Maine CDC reminds health care providers to be aware of the risk and prevalence of tickborne diseases and consider then in their diagnosis.

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