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Ticks, illnesses unusually high early in season

. -- It's still early in the tick season, but health officials are worried that the tiny bugs could spread a lot of sickness this year. Missouri and Illinois already have reported more ticks or illnesses from tick bites than there were last year at this time. 

A girl from northeastern Missouri died May 23 of an infection with a tick-carried disease called ehrlichiosis. The girl was one of three children hospitalized with the disease at St. Louis Children's Hospital last month. She died despite 10 days of intensive care. Deaths from the tick disease are not common, health officials say. 

Two children were treated for tularemia at Children's Hospital and Rocky Mountain spotted fever is suspected in another three children. Both diseases are carried by ticks. 

The number of cases is par for the course later in the summer, but unusual so early in tick season, said Dr. Ericka Hayes, a pediatric infectious disease specialist at the hospital. Officials from the Missouri Department of Health and Senior Services issued a statement Wednesday telling people to take precautions against tick bites. 

So far state health officials have confirmed 16 cases of ehrlichiosis and are investigating two other cases. On average, Missouri has about nine cases of the disease at this point during the year. The cases have appeared in all parts of Missouri, said Karen Yates, Vector-Borne disease program coordinator for the state health department. Cases of Rocky Mountain spotted fever have more than doubled this year. 

Missouri health officials have confirmed 54 cases of the illness this season. In an average year, only 22 cases would have been seen by this time. 

Health officials also have had reports of 10 cases of Lyme-like disease and two cases of tularemia. "I suspect given that we are seeing these numbers this early in the season, that we're going to have a lot of tick-borne illness this year," Dr. Hayes said. 

Ehrlichiosis and Rocky Mountain spotted fever can be life-threatening if not treated within four or five days of the illness's onset, Dr. Hayes said. Children and adults can be affected equally severely. The diseases are easily treated with an antibiotic called doxycycline, she said. The Lyme-like illness, sometimes called Southern tick-associated rash illness, is usually a very mild illness. 

A target-like rash at the site of the tick bite is similar to true Lyme disease, but people with the rash illness rarely develop complications like people with Lyme disease do, Dr. Hayes said. Tularemia can be transmitted by a tick bite and usually results in a mild illness with an ulcer at the bite site and swollen lymph nodes. The disease also can be transmitted by rabbits or other rodents through inhalation that can cause pneumonia, but that form is rare, Dr. Hayes said. 

Missouri is a hotbed of tick-borne diseases, Dr. Hayes said. "If you look at a map plotting the incidence of ehrlichiosis and tularemia, there's a big black spot over Missouri and Arkansas. Everywhere else is gray and white," she said. 

Symptoms of the illness usually resemble the flu with body aches, headaches, tiredness and fever, said Joyce Berkowitz, infection control practitioner at Cardinal Glennon Children's Medical Center. Sometimes people will develop bellyaches, nausea, vomiting and diarrhea. 

Rocky Mountain spotted fever usually starts with a rash, but rashes appear in less than half of people with ehrlichiosis, she said. Symptoms usually appear a few days to two weeks after being bitten by a tick. Cardinal Glennon Children's Medical Center has seen only two possible cases of tick-borne illnesses this year. 

"We usually start seeing stuff when the kids get out of school and are in vacation mode," Berkowitz said. In Illinois, veterinarians, doctors and others have reported more ticks to the Department of Public Health, but people have not fallen ill at a higher rate than usual, said spokeswoman Melaney Arnold. 

If you do get sick, tell your doctor if you've spent time outside, even if you haven't seen a tick, Dr. Hayes advises. Ticks may bite and drop off before you realize it. If you find a tick, remove it immediately. The longer a tick is attached, the more likely it is to spread disease, she said. 

Tips to avoid ticks 

􀂙If you are in a tick-infested area, walk in the center of trails to avoid overhanging grass and brush where ticks hide. 

􀂙Wear light-colored clothing so ticks are easier to spot. Wear a long-sleeved shirt, a hat and long pants. Tuck your pant legs into your socks. 

􀂙Use insect repellent containing 20 percent or more DEET. The repellent is also effective against mosquitoes. Be sure you know how to use the chemicals properly and don't use products with more than 30 percent DEET on children. Babies two months old and younger should not be exposed to DEET at all. 

􀂙Get ticks off your body immediately. To remove an attached tick, grasp it with tweezers as close to the skin as possible and pull straight out. If you don't have tweezers, use a piece of cloth or something else as a barrier between your fingers and the tick. Put the tick in a sealed plastic bag for disposal, or save it in rubbing alcohol in case you get sick and want to have it identified. Check yourself, your children and your pets for ticks after being out-doors, even in your own yard.