I mean spirochetes, of course. They cause a legion of human maladies ranging from Leptospirosis to Syphilis to Lyme disease and Relapsing Fever – not to mention periodontal disease. This bacterial phylum has numerous members that are transmitted by hard and soft ticks. Syphilis is not one of them, I am sure you know. Syphilis is an STI transmitted by doing the Hokey Pokey, and that’s what it’s all about.
I got a Texas Dept. of Health notice the other day advising that Soft Tick Relapsing Fever (STRF) was on the rise in Texas. This is a disease caused by a Borrelia species – Borrelia are a number of genera in the spirochete phylum. I’ve never seen a case of STRF, but I did see one case of Borrelia recurrentis (Relapsing Fever) back in my days as a solo Internal Medicine doc. The patient was a college student who was an avid spelunker. He was suffering from a mysterious febrile illness that gave him fever and chills lasting several days, then resolving only to return a week later. I hate it when that happens. The actual diagnosis was made by a sharp-eyed laboratory worker who, while examining a routine blood smear, noticed the little corkscrew boogers on the microscope slide. She was one of my favorite lab staff – alert, very bright, and funny too.
As for syphilis, I diagnosed a single case during those years – secondary syphilis masquerading as Lupus. Syphilis has a long history of being called The Great Imitator. That patient was cured with penicillin, but only after experiencing a serum-sickness type reaction during treatment. I hate that too when that happens.
A week or two after the Department of Health notice about STRF, I received a Medscape alert about Tick-borne viral encephalitis making its way through Europe. Here it is:
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Growing Research Indicates Prevalence Of Tick-Borne Illnesses Rising Due To Climate Change
The AP (7/25, Teirstein) says, “In 2022, doctors recorded the first confirmed case of tick-borne encephalitis virus acquired in the United Kingdom.” The past three decades have seen the country become about “1 degree Celsius warmer (1.8 degrees Fahrenheit) on average compared to the historical norm.” Analyses have revealed that a number of “tick-borne illnesses are becoming more prevalent because of climate change. Public health officials are particularly concerned about TBE, which is deadlier than more well-known tick diseases such as Lyme, due to the way it has quickly jumped from country to country.”
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Ticks also transmit other non-spriochetal and non-viral pathogens. Take Rocky Mtn Spotted Fever (a rickettsial disease), Ehrlichiosis, Southern tick-associated rash (STAR) illness, and rabbit fever (Tularemia) for example. Most of these tick-borne bacterial infections are treated with a long course of doxycycline. Of course, that antibiotic doesn’t do diddly for tick-borne encephalitis. Sigh.
My best advice, if you are a nature child who enjoys hiking in the open and wooded spaces (I know some of you do) is to wear constricting sleeves and pant legs to thwart the access of ticks to your skin. When you are done with your hike, have your hiking partner examine your skin folds, axillae, and hard-to-inspect places for ticks. Remove any that you find.
I know that this kind of total skin examination can be a bit embarrassing let alone sometimes leading to the Hokey Pokey. The worst-case scenario is that you will wind up needing doxycycline for gonorrhea or perhaps a cephalosporin for syphilis, or time for HPV or Herpes type II.
If you contract any of these, you can’t really blame them on the ticks.