Health officials in Sullivan County, in the southern part of New York State bordering Pennsylvania, are reporting an increase in the tick-borne disease, anaplasmosis.
“While Lyme Disease remains the prevalent tick-transmitted disease in the County, we are seeing a dramatic rise in the number of cases of anaplasmosis, another tick-borne illness,” notes Public Health Director Nancy McGraw. “In all of 2019, Sullivan County had 653 cases of Lyme and 32 cases of anaplasmosis. In the first half of 2021, there have already been 322 cases of Lyme and 32 cases of anaplasmosis.”
Anaplasmosis is caused by the bacterium 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 name of the disease implies, it’s an infection of the white blood cells.
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.
“But while Lyme Disease can sometimes cause the characteristic ‘bullseye’ rash, anaplasmosis does not cause any rash whatsoever,” explains Public Health Educator Jill Hubert-Simon, well-known as the County’s “Tick Chick.”
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.
The case fatality rate (i.e. the proportion of anaplasmosis patients that reportedly died as a result of infection) has remained low, at less than 1%.
Because A. phagocytophilum infects the white blood cells and circulates in the blood stream, this pathogen may pose a risk to be transmitted through blood transfusions. Anaplasma phagocytophilum has been shown to survive for more than a week in refrigerated blood.
Doxycycline is the first line treatment for adults and children of all ages and should be initiated immediately whenever anaplasmosis is suspected.
- Wear light-colored clothing with a tight weave to spot ticks easily.
- Wear enclosed shoes, long pants and a long-sleeved shirt. Tuck pant legs into socks or boots and shirt into pants.
- Check clothes and any exposed skin frequently for ticks while outdoors.
- Consider using insect repellent on the skin.
- Consider treating clothes with permethrin.
- Stay on cleared, well-traveled trails. Walk in the center of trails. Avoid dense woods and bushy areas.
- Avoid sitting directly on the ground or on stone walls.
- Keep long hair tied back, especially when gardening.
- If possible, remove clothes prior to entering the main part of the house to prevent ticks from coming into the home. As an alternative, use a lint roller over clothes prior to coming into the home to remove any ticks which may remain on clothing and skin
- Bathe or shower as soon as possible after going indoors (preferably within two hours) to wash off and more easily find ticks that may be on you.
- Do a final, full-body tick check at the end of the day (also check children and pets), and remove ticks promptly.
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