Syracuse, NY – For the first five years of his tenure at Upstate Medical University, Dr. Kris Paolino rarely treated cases of a tick-borne disease called anaplasmosis, or anaplasma.
“I saw maybe one or two cases of anaplasma, maybe three in a bad year,” Paolino said.
Now, the bad year has gotten worse.
“I must have seen at least two dozen cases myself just last year alone, and that doesn’t count the cases that other providers are seeing.” Paolino said.
Anaplasma, a bacterial disease, is one of two tick-borne diseases rapidly spreading in Upstate New York. The other is babesia, caused by a parasite similar to malaria.
“Of all the tick-borne illnesses, babesia and anaplasma are really the two that are scary,” Paolino said. “They can get really severe and they can kill people if not picked up on early enough.”
As warm weather approaches and Upstate New York residents venture into woods and trails, ticks are waiting. And every year, gardeners and hikers are not only more likely to get a tick bite, but are also more likely to get sick from one. We’re already on guard against Lyme disease, the disease most commonly transmitted by ticks.
But we – parents, gardeners, camp counselors and doctors – have much more to learn about ticks and the sickness they can cause.
These two other diseases are on the rise. Like Lyme, they come with high fevers and aches; unlike Lyme, they bring no tell-tale bull’s-eye rash.
And also like Lyme, both emerging diseases can be treated — if they’re diagnosed soon enough.
Upstate’s free tick-testing lab, established in early 2019, has tracked both the number of ticks mailed in and the percentage of those ticks that carry pathogens – the viruses, bacteria or parasites that cause human disease.
The lab began taking in and testing ticks from the public in April 2019. In its first two years, the lab tested about 9,000 ticks, and has received that many in just the past year alone.
Lab director Saravanan Thangamani says some of that increase could be simply that the program has become more widely known. He notes, though, that some people send in ticks every year, and they have been sending more per person than before.
“That is an indication that ticks are actually increasing in numbers as well,” Thangamani said.
The percentage of ticks carrying disease has also increased. Since the program’s first year, from spring 2019 to spring 2020, the share of ticks carrying the bacterium that causes Lyme disease has increased from 29.3% to 32.3%.
There have been much bigger percentage jumps for other diseases. The percentage of ticks carrying anaplasma has nearly tripled, from 2.5% to 7.3%, according to the lab’s website. Babesia saw a similar trajectory, from 2.9% to 12.8% over the same period.
Thangamani said ticks are already streaming in this spring, and with the new data this year, the lab will be able to say with more confidence what the trends are over time.
“By the end of this spring, we’ll have a very good idea of the real change in pathogen prevalence,” Thangamani said.
The ticks come in from around the state. Most of the ticks carrying babesia were sent in from the Hudson Valley, and Thangamani said he’s reaching out to hospitals and clinics there to see if they’re seeing an increase in patients with the disease. Thangamani said the disease is likely to spread throughout Upstate New York just as Lyme disease has.
So far, Paolino said, he’s only seen a handful of cases of babesia at Upstate. He said that’s likely to change in the future.
“We’re going to see more cases because the more of the parasite that’s in the area, the more ticks that are infected, the more likely we’re going to see people just not realize they got bit, and then they’re going to come down with it,” he said.
The babesia parasite infects red blood cells. The symptoms are similar to other tick-borne diseases: fever, chills, aches and fatigue. While many people have no symptoms, babesia can be a life-threatening illness for people with weak immune systems or who have serious underlying conditions such as liver or kidney disease, according to the Centers for Disease Control and Prevention.
Anaplasma, babesia and Lyme disease are all spread by the most common tick species in New York, the black-legged, or deer, tick. That tick can also carry several other diseases.
Adult female ticks who didn’t feed last winter are hungry now. Females will lay eggs in late May, and by June and July the most dangerous stage of ticks, the nymphs, will be out in abundance.
Nymphs cause an estimated 80% of cases of Lyme disease cases, because they are most active when people are, and because they are tiny and hard to see on the body. A tick nymph is the size of a poppy seed.
Anaplasma symptoms are similar to Lyme, and the two diseases are generally treated with the same antibiotics. Early symptoms for both include fever, chills and muscle aches. About 70% of people infected with the Lyme bacterium develop a spreading red rash, a telltale sign that can lead to earlier treatment. There is no rash with either anaplasma or babesia.
Lyme and anaplasma can be treated with doxycycline and other antibiotics.
Babesia is more insidious. The common drugs that treat Lyme and anaplasmosis don’t work against the disease. Treatments for babesia include quinine, an anti-malarial drug.
Patients have to be properly diagnosed first, of course, and that doesn’t always happen because medical providers are unfamiliar with relatively uncommon diseases like anaplasma and babesia, Paolino said.
“If (doctors) aren’t thinking, ‘I’m in the middle of tick season and we have lots of these tick-borne diseases around here,’ they’re not necessarily going to think of them when they see a patient admitted into the emergency room with a high fever,” he said.
How to remove a tick: