Mobile Register, AL

[Franky]

Some interesting info from the Mobile Register.

While the risk of Lyme disease in lower Alabama remains a debated topic among health professionals, another dangerous type of tick-borne illness poses a real threat to local residents, according to physicians and scientists.

Tick-borne rickettsial diseases, including Rocky Mountain spotted fever and ehrlichioses, are increasing in states such as Alabama, where development is pushing more people into previously wooded areas, said Dr. David Wood, a microbiologist at the University of South Alabama and an expert in rickettsial diseases.

“Tick-borne diseases have increased over the last few years,” Wood said. “We’re cutting down a lot of places, moving houses into wooded areas that used to be forest, but the deer are still around; the vectors are still around.”

Rickettsial diseases are unique because their bacteria grow inside a cell, unlike most diseases, in which growths occur on the cell, said Wood.

They’re difficult to diagnose because early symptoms are similar to many other illnesses, but left untreated the diseases can cause serious illness and death.

“They’re probably more prominent than we really know, because a lot of times, these diseases, people have them but are not really diagnosed properly,” Wood said. “The problem is diagnosing it correctly and giving the right antibiotic.”

In response to an increase in cases, the Centers for Disease Control and Prevention featured rickettsial diseases in a March edition of its Morbidity and Mortality Weekly Report.

The article included guidelines for physicians on properly diagnosing a patient, stating that 60 to 75 percent of those with a tick-borne disease often receive an alternate diagnosis.

Getting a correct diagnosis as soon as possible is critical to treatment, since antibiotic therapy is most effective in the early stages.

Symptoms usually begin about 10 days after the tick bite, Wood said. Common symptoms at that stage include fever, chills and headache.

A headache is almost always reported by adults, and can be severe, the CDC reports.

Those infected with Rocky Mountain spotted fever often develop a rash, but that usually occurs after seeking medical attention for another illness.

Rocky Mountain spotted fever frequently becomes a serious illness, according to the CDC, and patients usually require hospitalization.

Long-term health effects can include partial paralysis of the lower extremities and gangrene infections that require amputation. The disease can also lead to blindness, speech disorders and loss of movement and bowel or bladder control.

Ehrlichioses can lead to serious illness and death as well, but at lower rates than Rocky Mountain spotted fever.

“They’re very severe diseases,” Wood said. “Rickettsial diseases have probably caused some of the worst bacteria in humans. The organism can infect so many different cells of the body.”

As much as 20 percent of untreated Rocky Mountain fever cases and 5 percent of treated cases become fatal, making it the most commonly fatal rickettsial disease in the United States, the CDC stated.

Dr. Steven Alsip, an infectious disease specialist in Mobile, said Rocky Mountain fever cases are not uncommon in his practice, especially in people who have recently returned from a trip to the North Carolina mountains.

North Carolina had 625 cases of the disease in 2005, more than three times the number of the next-highest state, Oklahoma, and nearly half of all cases nationwide, according to the CDC.

“We’ve got a lot of folks who come back from their vacation and have it or are scared they have it,” Alsip said.

Alabamians don’t have to travel to be at risk, however. Seventy-two cases of the disease were reported in Alabama in 2005, the CDC reported, and Wood says there were likely even more.

“I think it’s estimated that we’re probably underestimating these diseases by at least fourfold,” Wood said. “If that is the case, then tick-borne rickettsial diseases would be high on the list of life-threatening disease in our country.”