Family Medicine
Question: Last week a friend’s child was diagnosed with an infection from a tick bite. She had been sick for a couple of weeks before the doctors were able to figure out what was wrong. The mother said it was ehrlichiosis. I have never heard of this. Can you tell me more about it? Will the child be OK? Answer: Ehrlichiosis is an uncommon disease that is spread primarily by tick bites. This is why we see it in the summer when ticks are more active.
It is commonly spread by the dog tick, the deer tick or the Lone Star tick.
The latter, as the name implies, is found abundantly in Texas but also as far away from the Southwestern United States as Rhode Island. The bacterium that causes ehrlichiosis belongs to the germ family known as Rickettsiae.
Other bacteria in this family cause a variety of serious diseases worldwide, including Rocky Mountain spotted fever and typhus.
The rickettsial diseases can be spread not only by tick bites, but sometimes by flea and mite bites as well. Ehrlichiosis – unlike Rocky Mountain spotted fever, which was first identified in the 1890s – is a relatively new illness that was identified and named in 1990
Ehrlichiosis can be difficult to diagnose as the symptoms resemble the flu – fever, chills, headache, malaise, and muscle aches. Sometimes there is a rash that looks like heat rash and is itchy. These symptoms follow a tick bite by about seven to nine days. Oftentimes, due to the time lapse, the tick bite is forgotten by the victim and not mentioned to the doctor. Some experts believe that many cases go undetected because the symptoms are so mild that no medical attention is sought and the person recovers without medical intervention. Frequently, though, the flu-like symptoms continue to last for several days and the sufferer seeks a doctor’s help.
When the person sees the doctor, he or she may become suspicious of ehrlichiosis after blood tests show a depressed blood count and elevated liver function. This may prompt a more precise specific antibody test that can detect the rickettsial bacteria.
Once the diagnosis is made, the infection is easily treated with antibiotics. The patient begins to feel better almost immediately after starting antibiotics, but full recovery can take about three weeks
Prevention is always the best treatment. You can prevent tick bites by using an insect repellent and wearing long pants and long sleeves when out in the woods. It’s often a good idea to tuck the bottom of your pants into your socks so that ticks can’t just crawl up your socks and onto your legs. Regardless of the protection you take, it’s always a good idea to check yourself for ticks after you have been out in dense brush and long grass.
Also, check your pets for ticks as they can carry them into the house. Use tick repellant on your animals. If you get bitten by a tick, remove it promptly. It takes 24 hours of the tick being attached to your body for the infection to pass from the tick to you – so prompt removal is very helpful. If you do remove a tick, make a note of the time and date in case you become ill with flu like symptoms within two weeks of the bite.
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Editor’s note: Family Medicine(r) is a weekly column. To submit questions, write to Martha A. Simpson, D.O., M.B.A., Ohio University College of Osteopathic Medicine, P.O. Box 110, Athens, Ohio 45701, or via e-mail to readerquestions@familymedicinenews.org. Medical information in this column is provided as an educational service only.
It does not replace the judgment of your personal physician, who should be relied on to diagnose and recommend treatment for any medical conditions.
Past columns are available online at www.familymedicinenews.org.