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Increase seen in tick-borne illness

DULUTH - In the winter, a fever, headache and chills probably mean the flu. But when flulike symptoms show up in the summer, you might want to check for ticks.

Deer ticks are known to transmit Lyme disease, but they also can cause human granulocytic anaplasmosis -- the second-most prevalent tick-borne illness after Lyme disease, according to Dr. Johan Bakken, an infectious disease physician in Duluth. Bakken was the first to describe the illness in 1994.

"I think it existed before but was an unrecognized infection," he said.

The first patient Bakken ever saw with this condition did not fare well and died in the early '90s. Bakken started noticing similar cases each year and, after gathering information from about eight cases, published it in the Journal of the American Medical Association.

Anaplasmosis cases have been on the rise ever since, and this year the numbers are up again in the Northland.

"Last year we saw a handful of cases through St. Luke's and this year we've seen about 20," Bakken said.

In 2009, 317 cases were reported in the state, according to the Minnesota Department of Health, a number that was up from 278 in 2008. The biggest recent jump came from 2006 to 2007 when cases spiked from 176 to 322.

Bakken doesn't know exactly what is causing the uptick in the illness but said Duluth's mild winter could be a factor as well as a more vigilant civilian population seeking treatment.

Despite the rise in cases, Bakken said it's likely many more people are affected by the disease.

"Since it's like influenza, it's probably often written off, and mild cases go untreated," he said.

The other reason confirmed cases could be underreported to the state is that often doctors treat anaplasmosis without taking the added step of confirming the diagnosis through a blood test, Bakken said.

"With that combination (of symptoms) in this part of the country, there's really nothing else it's going to be," said Dr. Kevin Stephan, an infectious disease physician at St. Mary's Medical Center. "And within 24 to 48 hours (of taking antibiotics) the person feels significantly improved."

Stephan said he doesn't have definite numbers, but his sense is that St. Mary's probably is getting twice as many calls about it as they did last year.

Most of the time, anaplasmosis is easily treated with antibiotics, but someone with a very mild case does not necessarily need to seek medical treatment, Stephan said. However, he encouraged anyone feeling ill to see a physician.

"We've had people get very sick from anaplasmosis," he said.

Once bitten by a deer tick, anaplasmosis incubates in the body for about a week before people start to develop symptoms. Symptoms include a high fever, shaking, chills that don't stop, a splitting headache and very bad muscle aches in almost all muscle areas, Bakken said.

If untreated, the illness can last about seven days and leave people feeling exhausted for another week or two.

Antibiotics significantly speed up the recovery.

Prevention, of course, is the best way to avoid tick-borne illnesses. Recommendations for avoidance include tucking pants into socks, wearing light-colored clothing in order to spot ticks easily and performing nightly tick checks in the summer.

"This time of year people just really have to be careful, Stephan said. "Put on your DEET (insect repellant)."