Ticks win in fight over budget

Staff WriterJune 29, 2011 

  • Don't panic, says Marcée Toliver, former state tick specialist, because the probability of getting sick is small. Remove the tick with tweezers as soon as you find it. Don't wait to visit a doctor before removing a tick, because the longer a tick is attached, the higher the risk of it transmitting a disease.

    If you feel ill or notice a rash, make sure to see your doctor. Tick-borne diseases are almost always cured by prompt antibiotic treatment.

    For more information, visit www.cdc.gov/ticks/diseases/.

  • Lyme disease, in its early stages, usually begins with a rash shaped like a bull's eye and flulike symptoms. If left untreated, it can damage the heart, joints and nervous system. North Carolina recorded 63 cases in 2010.

    Southern tick-associated rash illness (STARI) resembles Lyme disease but seems to be caused by different bacteria. It can be transmitted by the lone star tick, the most common tick in North Carolina. There is no clinical test, so there is no way to formally track the number of people infected each year.

    Rocky Mountain spotted fever often begins with a sudden headache and fever. Most patients develop the spotted rash that gives it its name a few days after first feeling ill. It can be fatal if left untreated. North Carolina recorded 278 cases in 2010.

    Rickettsia parkeri causes symptoms similar to Rocky Mountain spotted fever, but milder. Clinical tests cannot distinguish between the two diseases in humans.

    Ehrlichiosis begins with flulike symptoms. A few patients develop a rash, but not most. North Carolina recorded 89 cases in 2010.

The recent state budget cuts have discontinued funding for the only state effort to measure tick-borne disease risks by directly studying ticks.

Other state efforts rely on reports of illness after people have already become infected.

Ticks in North Carolina can carry a host of diseases, some of which can be fatal.

The cuts of about $500,000 will shut down the Public Health Pest Management section in the state Department of Environment and Natural Resources. Beyond studying tick populations, the five environmental health specialists who worked for the pest management program also educated residents about the risks of tick bites and the best ways to protect themselves.

In terms of dollars, the program is a tiny casualty of the legislature's $2.5 billion cuts in state spending for the coming year. But the program's closing is "tragic for the state," says Dr. Marcia E. Herman-Giddens, president of the Tick-Borne Infections Council of North Carolina, a nonprofit organization that advocates for tick disease control and education. "They were the only resource the public had."

Three programs funded at the county level will survive, in Chatham, New Hanover and Brunswick counties. Only the two coastal programs will continue to study tick populations.

But the county efforts can't fill the void left by the closing state program. "It's a question of scale," says Marcée Toliver, who was the tick specialist with Public Health Pest Management.

Almost 500 cases of tick-borne disease were reported to state public health officials in 2010, but the true number of infected people is probably in the thousands, according to Herman-Giddens.

Not all cases of illness are reported, Herman-Giddens says, and the state records statistics for only three diseases - Rocky Mountain spotted fever, Lyme disease, and Ehrlichiosis.

Rocky Mountain spotted fever - more common in North Carolina than almost anywhere else in the country - can be fatal. Lyme disease has been associated with long-term disability in patients who don't receive prompt treatment. Ehrlichiosis can cause vascular problems or even death if left untreated.

Promising research

Beyond tracking the danger from known threats in North Carolina, Toliver and her colleagues also identified new threats.

Their tick studies recently uncovered a Lyme-carrying tick that may be new to the state, according to Dr. Barry Engber, a medical entomologist with Public Health Pest Management.

The new tick, Ixodes affinis - which doesn't have a common name - is a relative of the tick best known for carrying Lyme disease, the deer tick.

"It went from being unknown in North Carolina and now having been found in nearly every county east of Raleigh," Engber said.

Lyme-infected Ixodes affinis ticks aren't the only disease-carrying ticks that are becoming more common in North Carolina, according to Toliver and Engber. The Gulf Coast tick - originally hailing from the U.S. Gulf Coast, as its name suggests - has been showing up more in their surveys.

Gulf Coast ticks can carry bacteria called Rickettsia parkeri, which causes an illness similar to Rocky Mountain spotted fever.

Unlike with Rocky Mountain spotted fever, where only 1 percent or 2 percent of the dog ticks that carry it are infected, Engber says that as many as 40 percent of Gulf Coast ticks carry Rickettsia parkeri in some locations. "It's just incredible, for it to have that high of an infection rate," he said.

A high infection rate amongst ticks translates to a greater risk that those bitten by a tick will fall ill.

With the end of the state's program, however, no one will be consistently monitoring the risk from disease-carrying ticks.

"It'll make it more difficult to control tick-borne diseases," says John Dorney, president of the N.C. Lyme Disease Foundation, a nonprofit patient advocacy and education group.

Herman-Giddens agrees. "It leaves us in a really bad place," she said.

helen.chappell@newsobserver.com or 919-829-8983

News & Observer is pleased to provide this opportunity to share information, experiences and observations about what's in the news. Some of the comments may be reprinted elsewhere in the site or in the newspaper. We encourage lively, open debate on the issues of the day, and ask that you refrain from profanity, hate speech, personal comments and remarks that are off point. Thank you for taking the time to offer your thoughts.

Commenting FAQs | Terms of Service