Reported cases of a tick-borne disease are swelling in Maine this year, but it’s not Lyme disease.
Cases of anaplasmosis, an illness with flu-like symptoms that are similar to Lyme but typically more severe, have jumped from 52 a year in Maine five years ago to 433 this year, through Oct. 24, according to the Maine Center for Disease Control and Prevention. Of this year’s 433 cases, 113 were hospitalized, according to Maine CDC statistics.
The deer tick, the same tick that’s a carrier for the bacteria that cause Lyme disease, is also a carrier for anaplasmosis.
Lyme – of which there have been more than 1,000 cases per year in Maine since 2011 – has established a long-term presence inMaine the state, but anaplasmosis has remained under the radar.
Anaplasmosis cases are also rising in other New England states: Massachusetts had 828 cases in 2016 compared to about 200 in 2012, while New Hampshire, Vermont and Rhode Island are also reporting increases. Lyme cases remain strong in Maine, but the 1,039 cases through September of this year are below five-year averages. Another tick-borne disease, babesiosis, is also increasing, but still at much lower rates than Lyme or anaplasmosis, with 93 cases through September.
Anaplasmosis symptoms are flu-like and can include fever, chills, fatigue and joint pain. About 25-30 percent of all anaplasmosis cases result in hospitalizations, compared to about 5 percent of Lyme cases.
Mark Elwin, 52, of Walpole – a village in South Bristol – said anaplasmosis sent him to the hospital in 2015, and he’s been infected since then.
“I was miserable. I could barely roll over in bed it hurt so much,” Elwin said of the symptoms that led him to the hospital.
Mainers are more at risk of anaplasmosis, experts say, for a number of reasons.
Part of the issue is greater awareness and more testing by people who fall ill. But also, more deer ticks are infected with anaplasmosis and passing the bacteria on to humans, said Chuck Lubelczyk, a field biologist with the Maine Medical Center Research Institute in Scarborough.
“It certainly is spreading,” Lubelczyk said.
Several years ago, in southern Maine 5 percent or fewer of ticks that were tested had anaplasmosis, he said. Now, it’s doubled, and about 10 percent of the ticks are infected with anaplasmosis.
In the midcoast and points north, it was extremely rare for a deer tick to have anaplasmosis bacteria. A few percent of the tested ticks along the midcoast now have it, about the same rates as southern Maine five to seven years ago, Lubelczyk said.
In comparison, more than 50 percent of deer ticks – sometimes more than 65 percent – carry Lyme disease in Maine.
Lubelczyk said ticks seem to be out earlier and longer than previously, emerging earlier in the spring and lingering into the fall, and he sees more nymph-stage ticks, which are small and difficult to detect.
“We may be having two different tick populations, one that arrives earlier and another that arrives later. It’s not clear yet,” he said.
Sara Robinson, a Maine CDC epidemiologist, said anaplasmosis is more difficult to detect than Lyme, as anaplasmosis does not have the “bull’s-eye” rash that appears in some infected with Lyme, signaling that they have the disease.
Robinson said the best way to tell is if you’re feeling like you have the flu outside of flu season, which is typically October to May.
“If you feel like you’re getting the flu in the summer, call your doctor,” Robinson said.
LIVING IN THEIR HABITAT
Elwin, who went to the hospital with anaplasmosis in 2015, said the infection sent his life spiraling downward.
“It’s been devastating,” said Elwin, whose home is in the woods, surrounded by towering pines and birch trees, a natural habitat for ticks.
Elwin said he first started feeling fatigued and getting flu-like symptoms on a Friday in mid-September 2015. By the weekend he could barely move, with symptoms that included fever, chills, sweating, and aches and pains.
“I was lying in bed all day because of the pain in my shoulders, arms and head,” he said. “Everything hurt.”
He went to his primary care doctor on Monday, where he tested positive for anaplasmosis, and was given antibiotics. He spent a few hours at Miles Memorial Hospital’s emergency department later that week after he felt dehydrated. He was given fluids and sent home. Later, he also tested positive for Lyme.
Elwin said he didn’t know he had been bitten by a tick.
Elwin said ever since his anaplasmosis diagnosis, he’s felt terrible and been unable to work full time at carpentry, which was how he made his living. He is still trying to do carpentry as a hobby but finds activities beyond reading difficult. Elwin also tested positive for anaplasmosis in October 2016, according to medical records he provided to the Press Herald.
“I’ve read all the Greek tragedies. I never knew I wanted to do that, but now I have,” Elwin said.
Dr. Heidi Heap-Chester, Elwin’s primary care doctor, said Elwin has tested positive for “multiple tick-borne diseases.”
“Anaplasmosis is becoming more frequent in Maine and particularly emergency room and urgent care sites need to be aware that a ‘summer flu’ in an endemic area is anaplasmosis until proven otherwise,” Heap-Chester said.
Anaplasmosis responds well to antibiotic treatment if caught early, but it’s difficult to catch early.
Prevention is also key. Wear long clothing and repellents when in tick habitat, such as the woods, and when picking up dead wood or leaves. Check often for ticks, which are difficult to see. Lubelczyk said one of the more common ways to pick up a tick is from your pet. The tick that’s on your pet can drop off after feeding and crawl on you.
People who do find a tick on them should remove it immediately and have it tested. In most cases, ticks need to be attached to a human for 36 hours before diseases can be transmitted.
Mark Elwin poses for a portrait near his home in Walpole. He was hospitalized for tick-borne anaplasmosis in 2015. Still unable to work, he says of his downward spiral, “It’s been devastating.” Experts recommend wearing long clothing and checking for ticks often. (Brianna Soukup/Portland Press Herald)