Nature's Dirty Syringe: The Lowly Tick

Whenever people think about ticks they think about Lyme disease. Of course, the

annual number of cases of Lyme disease suggests that we're not thinking often enough

about ticks. Preventing tick bites is important because the creepy, crawling tick is

Mother Nature's dirty syringe. There's no telling what you might get from its silent jab.

Take the deer tick (Ixodes scapularis), for example. This dot-sized biter can

transmit Borrelia burgdorferi, the Lyme disease bacterium. Lyme disease is common in

Maryland. There have been 382 cases so far this year. It turns out, however, the tiny

deer tick is a biological bus on which many other microbes ride.

One of those other passengers is Babesia. It causes fever, chills, fatigue and

anemia. Babesiosis can be fatal. It is a malaria-like parasite that invades red blood cells.

Babesiosis is treated with an antibiotic and the anti-malarial drug quinine or atovaquone.

Another tick-borne microbe is Anaplasma. First described in the U.S. in 1994,

these bacteria invade white blood cells to cause a disease known as Human Granulocytic

Anaplasmosis (HGA). Anaplasma causes fever, headache, malaise and muscle aches.

Some people may have mild symptoms or none at all. For others, symptoms may be

severe and the outcome fatal. Fortunately, HGA responds well to common antibiotics.

Bacteria called Bartonella also have been found in some Ixodes ticks. Normally

associated with an infection called Cat Scratch Disease, Bartonella also may be

transmitted to people by ticks.

A few years ago, researchers found another Borrelia bacterium lurking in deer

ticks in four East Coast states (Tested Maryland ticks didn’t have this microbe.) This

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new Borrelia is related to the Lyme Borrelia, but it’s not clear yet if it causes any

noticeable illnesses in humans.

Can one little deer tick carry all these different microbes? That’s hard to say, but

some of them do harbor more than one pathogen at a time, and they can transmit more

than one to us. The most commonly seen co-infections in the eastern U.S. are Lyme

disease and Babesiosis. These mixed infections tended to be more serious than just Lyme

disease or Babesiosis alone.

A study of ticks collected in northern New Jersey found two percent of them were

infected with Lyme and Babesia. About a third of the ticks were carrying just Lyme, and

about eight percent had just Babesia. Interestingly, 54% had none of the four tested

pathogens: Lyme, Babesia, Bartonella and HGA. Less than one percent of the ticks

carried three pathogens. The odds of escaping a tick bite without a subsequent infection

seem pretty good. Of course, there are other ticks and still other microbes.

On Maryland’s Gibson Island, a study of 1550 ticks collected by island residents

found only three percent of the ticks were Lyme-carrying deer ticks. The rest were the

aggressive, irritating Lone Star tick (Amblyomma americanum). This persistent biter may

not give you Lyme, but it might give you a “Lyme-like” microbe called Borrelia

lonestari, or a rash called Southern Tick-Associated Rash Illness (STARI).

It may also give you Human Monocytic Ehrlichiosis (HME). The disease is

caused by Ehrlichia chaffeensis, a bacterium that invades white blood cells to cause

fever, nausea, headache and fatigue. Like HGA, it can be fatal, but typically responds to

common antibiotics.

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 Not surprisingly, there are other ticks in Maryland and other parts of the country

spreading other diseases, including Rocky Mountain Spotted Fever, Colorado Tick Fever,

tularemia, typhus, hemorrhagic fever, and viral encephalitis.

If all these ticks and diseases are confusing, imagine how your doctor feels when

you walk in at the end of the summer complaining about flu-like symptoms, a rash that

disappeared and vague memories of ticks at your out-of-state camp site. Image all the

possible combinations of ticks, microbes, symptoms, diagnostic tests and drug treatments

the doctor has to consider before you walk back out the door.

Someday, research may end some of doctor’s guesswork. Efforts are underway to

develop a tick vaccine; not against all those tick-borne microbes, but against the tick

itself. Such a vaccine already exists for cattle. Researchers at the University of Rhode

Island are looking to use components of tick saliva to make a vaccine. Tick saliva is rich

in proteins that suppress our immune responses and blood coagulation while the tick

feeds. One or more of those proteins may someday become the components of a vaccine

to keep ticks from successfully transmitting infections to us.

Until then, we’re going have to rely on repellents, tick checks, and the proper

removal of embedded ticks. For more information on ticks see:

www.cdc.gov/ncidod/dvrd/rmsf/Prevention.htm.

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