United States: After the arrival and settlement of the black-legged tick in Ohio, the rate of Lyme disease corresponded to this increase and has posed a high health impact on people in Ohio. While primary and secondary, Lyme diseases are preventable and totally curable, late stage untreated ones can progress and present severe chronic health impacts.
Advisory by Ohio’s medical practitioners
Specifically, tickborne illnesses, especially Lyme disease, should be considered additionally in the assessment of patients with fever or fever accompanied by rash. Numerous tickborne diseases show clinical presentation in the form of pyrexia, cephalalgia, lassitude, and myalgia, as the Ohio Department of Health highlights. Skin rashes in certain tickborne diseases may be present, but the rashes may not look the same in every affected individual.
It is imperative to acquaint oneself with the laboratory diagnostics available for tickborne diseases.
Lyme Disease:
The diagnostic protocol comprises a two-step process, utilizable with a single blood specimen:
- Step One: Conduct an immunoassay antibody test to detect IgM and/or IgG antibodies to Borrelia burgdorferi. A negative result negates the necessity for further testing.
- Step Two: If the initial result is positive, indeterminate, or equivocal, proceed with an IgM and/or IgG Western blot assay.
– The IgM Western blot typically turns positive within a few days to weeks post-illness onset.
– The IgG Western blot is expected to yield positive results approximately four weeks following the onset of symptoms.
Anaplasmosis, Ehrlichiosis, and Spotted Fever Group Rickettsiosis:
– Perform PCR on whole blood samples during the acute phase of the illness or conduct IFA testing on paired serum samples collected during the acute and convalescent stages (two to four weeks apart).
Note: Serologic sensitivity in the early stages of infection is suboptimal. If initial serologic tests are negative in patients with potential early-stage infection, repeat serology three to four weeks later to check for seroconversion, as per the Ohio Department of Health.
Babesiosis:
– Diagnosis can be established by examining thick and thin blood smears stained with Giemsa or through IFA testing.
Powassan Virus:
– Contact the ODH Zoonotic Disease Program at 614-995-5599 to arrange for testing by the CDC.
– Immediately report suspected tickborne infections to the local health department of the patient’s residence.
Therapeutic Approaches for Tickborne Diseases
In suspected anaplasmosis, ehrlichiosis, Lyme disease, or spotted fever group rickettsiosis, it essential to start doxycycline treatment in all patients even the children. Start therapy prior to obtaining a diagnostic work-up since anaplasmosis, ehrlichiosis, and spotted fever group rickettsioses are conditions with potential fatality.
For babesiosis, anti-parasite therapy should include Atovaquone together with either azithromycin or clindamycin together with quinine.
Powassan has no antiviral cure as of now; therefore, management is moving toward
supportive care.
Thus, the obtained results allow suggesting that Ohio clinicians should be more cautious about the given pathogen types and apply the specific diagnostic and therapeutic approaches to minimize the effectiveness of such diseases and protect public health.