Cases of Lyme disease and other tick-borne illnesses are rising sharply across the United States, and health experts say warmer temperatures and expanding tick habitats may be contributing to the increase.
Dr. Kavita Aggarwal of Optum Medical Care said data from the Centers for Disease Control and Prevention shows Lyme disease cases have surged in recent years.
“In 2021, there are about 20,000 cases over the expanse of America,” Aggarwal said. “And then in 2023, almost 90,000 cases. So it’s really quite astounding.”
Aggarwal said climate change may be helping ticks survive year-round and expand beyond traditional hotspots in the Northeast.
“The ticks are not dying. They are living year around,” she said. “And they’re actually expanding where they’re living. So that’s not just a disease or an issue of the Northeast, but it’s expanding westward including the Midwest and beyond.”
While Lyme disease remains the most recognized tick-borne illness, Aggarwal said ticks can carry several other infections, including ehrlichiosis, anaplasmosis and babesiosis.
“The three of these present typically very similar symptoms — fevers, chills, malaise, headache, nausea, arthralgias, myalgias,” she said. “The difference between ehrlichiosis and anaplasmosis compared to Lyme is that the blood work would be a little different.”
Babesiosis, she said, can be especially serious because it is caused by a parasite that behaves similarly to malaria.
“That one is a little bit more serious, can sometimes lead to hospitalization and requires treatment with multiple different antibiotics,” Aggarwal said.
Health officials are also monitoring cases of alpha-gal syndrome, a tick-related condition that can trigger allergic reactions to red meat.
“If a person is exposed to this protein introduced by a tick bite and they are sensitive to it, then they can get allergic reaction response as well,” Aggarwal said. “So it presents not like Lyme disease but more like an allergic reaction, hives, swelling, shortness of breath, like an anaphylactic episode.”
Symptoms of Lyme disease often begin about two weeks after a bite and may include fever, chills, headache, fatigue and muscle aches. Although the classic bull’s-eye rash is commonly associated with Lyme disease, Aggarwal said it appears only in a fraction of cases.
“Only one-third of tick bites are actually even noted,” she said. “Two-thirds of tick bites go unnoticed.”
If a tick is found attached to the skin, Aggarwal recommends removing it immediately with clean tweezers.
“You want to place the tweezer as close to your skin and as close to the part from the tick that’s in your body and your skin and extract the tick from there,” she said.
Children and older adults are among the groups most vulnerable to severe illness or emergency room visits related to tick bites, according to Aggarwal.
“If you have children, they’re at camp, they’re in the playground, especially the summer months, make it a habit to do a tick check when they come inside,” she said.
To reduce the risk of bites, Aggarwal recommends wearing long sleeves and pants, using insect repellents containing DEET or permethrin-treated clothing, and staying in the center of hiking trails.
“Those ticks are at the edge waiting for a passerby to come by to jump onto,” she said.
After spending time outdoors, Aggarwal advises putting clothing in a hot dryer for at least 10 minutes and showering promptly to wash off unattached ticks and check for bites.
“You also want to pay attention to the areas that they like to go to,” she said, including underarms, behind the knees, around the waist and along the hairline.
Despite the risks, Aggarwal encouraged people to continue enjoying outdoor activities.
“Please enjoy the beautiful Hudson Valley,” she said. “It’s gorgeous. We should enjoy it. We should not be limited. But as long as we’re safe, then we’ll be fine.”
Image: This undated photo provided by the U.S. Centers for Disease Control and Prevention shows a blacklegged tick, also known as a deer tick. (CDC via AP, File)