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First Missouri death this year from tick-borne disease reported

A 74-year-old St. Louis man died last Friday from a tick-borne disease known as ehrlichiosis, becoming the first fatality of the year linked to a disease transmitted by ticks.
The Missouri Department of Health and Senior Services reported the man’s family said he found an attached tick after returning from a fishing trip to northeast Missouri. The illness progressed rapidly and didn’t improve despite hospitalization and antibiotic treatment.
An 80-yea-old St. Louis woman was hospitalized in April from the same disease, according to the MDHSS, and is now recovering at home. Ehrlichiosis is similar to Rocky Mountain spotted fever and can cause symptoms ranging from a mild flu-like infection to a serious illness, with potentially life-threatening complications including kidney failure and breathing difficulties.
The DHSS reports the tick is responsible for more human disease than any other insect, and are very effective at transmitting diseases because they take blood from a large variety of large and small mammals, reptiles and even birds.
“In terms of the numbers of calls I get, they’re definitely worse than normal,” said MU professor of entomology Richard Houseman. “The tick population explosion has a lot to do with the abundance of habitat and hosts. The burgeoning population of about four million deer in the state, the urban deer population and the back-to-nature creation of natural areas even at home are the culprits.”
The complaints regarding the number of ticks started coming in during March, a month earlier than the official start of tick ‘season,’ which has been the month of April. Lois Kendall, a spokeswoman for St. Anthony’s Medical Center in St. Louis reported more calls of multiple ticks, inflamed or infected tick bites and more people appearing at the hospital’s satellite urgent care centers.
If the past two years of state statistics of tick-borne illnesses in Missouri offers any indicators, it should be that it’s only going to increase this year. Conditions are ripe for tick populations, with an abundance of hosts for them to feed on and to travel on, even in urban areas. Deer, mice, rabbits, and other hosts, plus mild winters equals more ticks. Ground temperatures must drop to 26 degrees for 72 hours, reaching 18 inches into the soil for an effective winter-kill of the ticks.
The number of tick-borne illnesses in Missouri rose to 668 in 2008 – up nearly 100 cases from 2007. State health department officials have documented a 300 percent increase in tick-borne disease in Missouri since 2003. MHDSS reported 56 cases of erhlichiosis as of July 2007, more than double the total number of cases reported in 2006.
The four most commonly reported tick-borne diseases in Missouri are Rocky Mountain spotted fever, ehrlichiosis, tularemia, and a Lyme-like disease called STAR (southern tick associated rash).
Most ticks are not infected with the different types of bacteria that cause the diseases listed, but with more ticks there is a greater chance of being bitten by one that is infected. Most bites respond to antibiotics.
Ticks can be kept out of the yard by clearing away leaf litter, tall grass and brush, and keeping the lawn mowed reduces the chance of getting ticks while out and about in your yard.
When hiking or out in high grassy or woodsy places, walk in the center of trails. Ticks can be in the tall grasses or short foliage at the edge of the trail, and in vegetation that hang alongside.
Houseman stated ticks implement the tactic of ‘questing’ to locate their hosts. DHSS says ticks do not jump, fall or fly and are generally found within three feet of the ground. They are most active during the cool morning or evening when the humidity rises. To find the host, a tick climbs to the tips of vegetation and extend their front legs out away from their bodies in order to hook the host as it brushes past.
So, knowing ticks are perched and waiting for a proper passer-by, wearing light colored clothing is a big help in spotting them as they start their march to find a place to attach. Keeping them on the outside of clothing is important. Wear a long-sleeved shirt and tuck pant legs into socks, or even tape pant legs into socks.
Tick ‘questing’ is aided by the carbon dioxide we exhale, as well as movement and heat, which assists ticks in finding their host. It is important to use an insect repellant that contains DEET on skin because it interferes with the tick’s ability to zero in. Using permethrin on clothing kills ticks, mosquitoes and even chiggers, and it remains on clothing through several washings.
When returning to a vehicle, quickly check clothing, boots, and so forth for any of the migrating insects, paying particular attention to the head, neck and underarm areas.
If an attached tick is found remove it, using tweezers. Do not squeeze it. Grab the tick at the front of its body and ‘head,’ pull straight back and disinfect the area with soap and water. Finding a tick after it has already attached need not be alarming, as it has to be biting the skin for at least four to six hours, according to Dr. Howard Pue, Missouri State Pubic Health veterinarian.
If you do find an attached tick circle the date on a calendar and monitor the symptoms for the next several days, and up to two weeks.
If symptoms such as fever, severe headache, sometimes with chills, body aches, nausea, vomiting or diarrhea appear following exposure to ticks, contact a healthcare provider. Symptoms usually appear five to ten days after the bite. Rashes, or pus-filled wounds, that can occur with tick-borne diseases usually do so after a person has been ill for four or five days.

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