Toronto Star
Jul. 5, 01:00 EDT

A tiny, ticking time bomb

Ticks are so minuscule they can easily go unnoticed, but their bites can make you seriously ill

Helen Branswell
Canadian Press

It's time to talk about the lowly tick.

Unlovely, unnoticed, definitely unwanted, Ixodes scapularis rarely figures prominently in our thoughts.

Sure, the Lyme disease delivery boy got a lot of attention in the 1980s, when the hitherto unknown malady with its distinctive bull's-eye rash barrelled into the North American consciousness.

But the media and their public are fickle beasts. With anthrax-laced envelopes and West Nile-bearing mosquitoes competing for attention, what's a poor tick to do?

Spreading previously unseen diseases into Canada seems a promising start.

Infecting people with combinations of Lyme disease and one or two other diseases at the same time also seems noteworthy.

Infecting people with diseases that make their way into the blood supply and sicken others via tainted transfusions probably merits renewed attention.

Deer ticks (also known as black-legged ticks) have done all that in Canada in the past couple of years. And with Environment Canada predicting this year's unusually warm winter will lead to an increase in deer tick populations-- and a spread of the turf held by infected deer ticks-- it seems like an appropriate time to reconsider the tick.

David Crane, for one, has a healthy respect for the tick's ability to turn a summer stroll into a medical nightmare.

Crane, business columnist for the Toronto Star, used to own a home on Nantucket. The island off the coast of Massachusetts-- in fact the entire state-- is a hot zone for ticks that carry Lyme disease.

(Not all ticks carry the disease. Trouble spots include but aren't limited to Connecticut, New York state-- especially Long Island-- and Michigan. Parts of southern Ontario, along Lake Erie, are home to infected tick populations as are regions of the Fraser delta, the Gulf Islands and Vancouver Island in British Columbia.)

Crane knew about the problem and was tick conscious.

"We made it a habit, especially in the spring, never to go into tall grass and stuff like that. You don't take short cuts to get to the beach," he says. "You follow the established trail."

But ticks are tricky. Young ticks, known as nymphs, are minuscule and easy to miss. They are also voracious blood suckers. Even though the Cranes were used to doing tick checks, he was bitten a few summers back.

Several weeks later, Crane was admitted to hospital in Toronto with alternating chills and sweats. Blood tests showed his red blood cells were being destroyed. Doctors were divided over what to blame-- leukemia? malaria?-- but concurred on one point.

"He was really sick," says Dr. Kevin Kain, director of travel and tropical medicine at Toronto General Hospital. "He looked like he had leukemia or something catastrophic."

It turned out the tick that bit Crane was infected with both Lyme disease and babesiosis, a disease that had never before been diagnosed in Canada. Untreated, babesiosis can be fatal. In combination, it is at the very least pretty nasty.

Fortunately for Crane, both diseases respond well to antibiotics.

Kain and some colleagues reported Canada's first known case of babesiosis in the Canadian Medical Association Journal.

At the time, they hypothesized that if Crane, while infected, had been bitten by another tick, he could have begun the process of spreading babesiosis among ticks in Canada.

They also theorized that if Crane had given blood while infected, people who got the blood products made from his donation could have developed babesiosis.

"And within a year-- bingo! We had our first case of babesiosis by blood transfusion," Kain says.

The donor wasn't Crane. A man who had been camping around Cape Cod had been bitten but had never developed symptoms-- some people with strong immune systems don't. Unaware that he was carrying the bug in his blood system, he gave blood six months later. The woman who got it wasn't as healthy; she came down with babesiosis.

"It's like any infection-- in some people, really bad story, in other people, minor symptoms," Kain explains.

Ticks can also convey Ehrlichiosis, a disease that resembles Rocky Mountain spotted fever, a potentially fatal disease-- also spread by ticks -- that causes fevers, chills and muscle aches and which can lead to encephalitis, an inflammation of the brain. Only infected ticks spread diseases.

The really impressive thing about ticks is that they can be infected with several diseases, and give each to its victims.

"One of any of them can make you sick. Multiples tend to make you sicker," Kain warns.

So maybe it makes sense to keep your eyes out for ticks, especially if you are visiting wilderness areas where Lyme disease has been reported.

"If you're out in the country, you really do have to check each other over to make sure you haven't got a tick sticking to you," Crane says.

"If you're going to stay in somebody's cottage or these kinds of things, you should go onto the Web and get a basic primer on Lyme disease and ticks, because it's not a pleasant disease." Return to: Links