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Rare tick-borne illness leads to death in state

July 24, 2018

Indiana recently had a fatal case of a rare tick-borne illness, and state health officials now are warning residents to take precautions against tick bites because mid-July is the height of tick season.

The death came from ehrlichiosis in an elderly patient, state health officials said in a news release Monday. They said they could not identify the patient’s county of residence. 

“Deaths from ehrlichiosis are rare in Indiana, with only four deaths reported in the last five years,″ the release states.

Ehrlichiosis is carried by bacteria transferred to people through a bite from the lone star tick, said David Fleiss, director of vector control for the Fort Wayne Allen County Department of Health.

The species is rarely seen in Allen County, he said, as are other species of disease-causing ticks: the Lyme disease-causing black-legged tick, the American dog tick and the brown tick.

Rocky Mountain Spotted Fever is primarily carried by the American dog tick; brown ticks also can carry Rocky Mountain Spotted Fever, although cases are rare, Fleiss said.

Allen County this year has fewer than five reported cases of all three diseases, Fleiss said. In his approximately 20 years with the health department, he said, he has seen only one case of ehrlichiosis, and it may have been contracted elsewhere.

According to State Health Department statistics, in the five years ending in 2016, only two tick-related illnesses have been reported in the Fort Wayne area, one each in Adams County and Noble County.

The bulk of cases are in far southern Indiana and northwest Indiana. Fleiss said he does not know of any fatal cases of tick-borne diseases in Allen County.  

Ehrlichiosis can be so mild it goes away without treatment, but it also can be severe or life-threatening in older adults and those with compromised immune systems, according to the American Lyme Disease Foundation, which studies and tracks diseases caused by ticks.

According to the foundation, flu-like symptoms : headaches, fever, muscle aches, chills and fatigue : are most often reported, although some people may experience nausea and vomiting, confusion, joint pain or a rash.

Unlike Lyme disease, the rash is not associated with the area of the tick bite. Symptoms generally show up about a week after the bite. 

In Indiana, “Cases of tick-borne disease tend to peak in July,” said Jennifer Brown,  public health veterinarian at the State Department of Health.

Lone star ticks are primarily in southern and eastern states, but their range includes all of Indiana, according to the federal Centers for Disease Control and Prevention. They are “aggressive biters,” according to the CDC.

Females are distinguished by a white dot in the center of their back, a marking that may not be star-shaped but gives rise to the species’ name. Males have a black, web-like marbling on their back. Females and less than full-grown nymphs are the most frequent biters.

In May, an Indiana University study conducted by Project Vector Shield found an increased number of black-legged ticks in southern Indiana, leading researchers to suspect a rise in Lyme disease might follow this year.  

State health officials Monday reported the number of tick-caused illnesses statewide, more than 100, has been rising since this year’s earlier months.

However, the number of illnesses is not much different from last year’s, when about 250 were reported through Dec. 31.

IU researchers reported more lone star ticks may arrive in upcoming years because most new vector-spread diseases come from the South because of rising global temperatures. The number of lone star ticks had expanded rapidly in the last 20 years, they said.

Ehrlichiosis has an odd side effect in some cases : a severe allergic reaction to red meat, the IU researchers point out.

If someone becomes ill with tick-borne illness symptoms after spending time outdoors, he or she should seek prompt medical attention, health officials said. Most tick-borne illnesses can be treated successfully with antibiotics, they said.

“Call your health care provider right away if you develop a flu-like illness or a rash during the summer months,” Brown advised.    

rsalter@jg.net

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