Ticks can transmit a new Lyme-like disease

Howard LeWine, M.D.

Chief Medical Editor, Harvard Health Publishing

There are several good reasons to keep ticks off your body. One is that they are creepy and suck your blood. Another is that they can transmit 14 different diseases—not just Lyme disease. A report published online this week in the journal Annals of Internal Medicine describes the newest tick-borne disease in North America, which is caused by a bacterium known as Borrelia miyamotoi.

The microbe was first identified in Japan in 1995. The first report of it infecting humans came from Russia in 2011. Cases began appearing in the northeastern United States in 2013.

Borrelia miyamotoi is a spiral-shaped bacterium that is related to the one that causes Lyme disease, another tick-borne infection. Infection with Borrelia miyamotoi often causes a recurring fever, as well as headache, muscle aches, and chills. It does not usually cause the “bull’s-eye” rash seen in some people with Lyme disease.

According to the Annals report, nearly one-quarter of people diagnosed with Borrelia miyamotoi disease are so sick they need to be hospitalized. The best therapy so far is the oral antibiotic doxycycline. That’s good news, because doxycycline is also an effective treatment against the bacteria that cause Lyme disease and anaplasmosis, another tick-borne disease.

On the increase?

Experts aren’t sure how common Borrelia miyamotoi disease is. In the Annals report, lead author Dr. Philip Molloy of Imugen, a clinical laboratory in Norwood, MA, and his colleagues found evidence of the bacterium in 0.8% of the blood samples they tested for possible tick-borne infection. Other tick-borne diseases were two or three times more common than that.

The disease isn’t yet on many doctors’ radar. When they see someone with symptoms that suggest Lyme disease, they may have the person tested for that disease, but the test will come back negative. It’s also likely that some people who develop Borrelia miyamotoi disease never see a doctor, and write it off as the flu.

Prevention is best

Borrelia miyamotoi lives in deer ticks. These small, hard-bodied ticks also spread Lyme disease (which is caused by a related bacterium, Borrelia burgdorferi). The best way to avoid getting either of these diseases, or any of the others spread by ticks, is to keep ticks off your body and check yourself for ticks after you’ve been walking through grassy areas, where ticks are likely to live.

The types of ticks and the diseases they cause vary throughout the country. Get familiar with which ones are more likely to be present where you live.

Here are eight tips for protecting yourself from ticks:

Wear light-colored clothing. Light colors make ticks easier to spot, especially the tiny deer ticks.

Tuck your pant legs into your socks. It’s not a flattering look. But tucking your pants into your socks does create a physical barrier against ticks.

Use insect repellent. DEET, the active ingredient in many insect repellents, is somewhat effective against ticks at normal concentrations. It may take a heavier concentration of DEET — between 30% and 40% — to really keep them away. Permethrin is a stronger chemical that kills ticks as well as repels them. Products containing permethrin should be sprayed on clothes, not on the skin.

Stay in the middle of the path. Ticks can’t fly or jump. So they can only get on you if you come into contact with the kind of environment they live in. They prefer moist, often shady, wooded areas, with plenty of leaves, low-lying plants, and shrubs.

Inspect yourself and your children, especially the legs and groin. Most ticks probably get picked up on the lower legs and then climb upward in search of dinner. The shower is a good place to conduct a tick check. Feel for any new bumps on soaped-up skin.

Put your clothes in the dryer. Deer ticks can survive a hot-water wash, but an hour in a dryer will kill them.

Think sunny. Ticks don’t do well in dry, open areas. Set lawn furniture and playground equipment back from the edge of wooded, shady areas. If you’re picnicking, look for a patch of well-tended lawn or some open ground.

Protect your dog, too. Deer ticks will latch onto dogs as well as humans. Groom your dog daily and check it for ticks. A variety of sprays, collars, and topical products are available to kill or repel ticks. Vaccines are also available for dogs.

Tick first aid

A tick usually has to stay attached to your skin for about 24 hours for Borrelia miyamotoi or another tick-borne microbe to get into your bloodstream.

If you find a tick attached to your skin, remove it right away, but carefully and gently. Use tweezers to grab the tick as close to the skin as possible. You can also use a needle to very gently pry it off.

If the tick is swollen, it may have been attached for a while. Contact your doctor. He or she may recommend a dose of antibiotic, especially if tick-borne diseases are common where you are.


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  7. Jeff Levy

    One important point: Studies have shown that Borrelia can be transmitted by a tick in less than 6 hours, not 24 hours as stated here. In addition, the Powassan virus can be transmitted by a tick bite in 15 minutes.

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