They're tiny, they're hungry, and they're here.
If you think the ticks seem bad this spring, your suspicions are correct. The Detroit Lakes area, along with the rest of Minnesota, is crawling with ticks this season, and doctors and veterinarians are reporting steadily increasing cases of tick-borne diseases in people and pets.
According to one recent report in the St. Paul Pioneer Press, the delayed spring, followed by warm temperatures, "has created a perfect storm for tick season." Another report, this one in the Minneapolis Star-Tribune, cites statistics from the Centers for Disease Control and Prevention showing that Minnesota has the seventh-highest tally of tick-borne infections in the U.S., making it "an epicenter of tick-related illnesses."
Sarah Winter, a physician's assistant at Essentia Health-St. Mary's Clinic in Detroit Lakes, said Essentia clinics in the area (including Park Rapids, Walker and Menahga) saw 240 confirmed cases of tick-borne illness last year.
The Minnesota Department of Health has classified Hubbard County as a high risk area for tick-borne diseases. All the counties surrounding Hubbard are also high risk, including Otter Tail County, which until recent years was classified as moderate.
"All the numbers statewide have been increasing," said Winter. "There's been a very steady increase since 2014."
The three most common tick-related diseases in Minnesota are Lyme, anaplasmosis and babesiosis. Symptoms of these diseases include fatigue, headaches, body aches, fever, swollen lymph nodes, stiff neck and the telltale "bullseye" rash around the site of a tick bite.
If caught early, these infections can be successfully treated with antibiotics. Left untreated, tick-borne disease can lead to neurological and joint problems.
'Almost a daily occurrence'
Dr. Shane Nygard, a family medicine physician with Sanford Health Park Rapids Clinic, said he has seen no confirmed cases of Lyme disease this year, but several people have come in with tick bites, some of them with mouth parts still attached. "I have had one patient that I did the prophylactic treatment," he said, describing a single dose of antibiotic given to patients who meet criteria for a higher risk of exposure.
Meantime, Dr. Larry Leadbetter, internal medicine physician with Essentia Health Park Rapids Clinic, said Lyme disease has been the principal tick-borne threat this year, after a surge last year in anaplasmosis. "In the walk-in or urgent care," he said, "it's probably almost a daily occurrence of a case coming in" with tick bites.
Leadbetter stressed the importance of good self-care. "Each time one is out in the woods," he said, "upon returning home one should do a good body screen to exclude ticks. Try to get them off before they attach. If you get them off before they've been attached more than 72 hours, typically the transmission of Lyme disease is pretty rare."
Most tick-related cases his clinic sees are just bites, Leadbetter said. Of patients who show symptoms of tick disease, a rash is the extent of the disease. "We rarely see, but do see, arthritic conditions from the tick disease, when early diagnosis is missed or patients weren't aware of being bitten by a tick," he said. "The little nymphs can transmit the disease. You hardly even notice that they're on. It may even be perceived as a speck of dirt that they've just got to brush off, and don't realize that they've had a tick for a period of time."
Even rarer, he said, is the neurological form of Lyme disease. "We've had it here," Leadbetter admitted. "But I think the awareness of this illness in the area helps with the prevention of that developing for people in the long term."
He also noted that anaplasmosis and babesiosis tend to make people feel sicker sooner, "so the body already gives a signal that something is wrong and needs to be checked on and treated."
Concern for animal friends
The situation is similar for pets. Though there are some differences, dogs and cats are generally susceptible to the same tick-borne illnesses as people and show many of the same sorts of symptoms. And like us, treatment most commonly involves antibiotics.
Unlike people, dogs can receive a vaccine to prevent Lyme infection; the vaccine is not foolproof, however, and it does not protect against any other tick-related illnesses.
Local veterinarians say they're seeing a lot of ticks on their patients this spring.
"We are seeing a lot more ticks this year than we normally do," said Dr. Barbara Lester with Isaacson Veterinary Hospital in Park Rapids. "We run a screening test, and it's rare that I get a negative dog in this area. Most of the dogs have some sort of tick disease."
"A lot of dogs come in that can't walk," she said. "The owners thought they broke their leg or got hit by a car - they're that sore from tick disease making their joints swollen. They come in with really high fevers, not eating. There are a few dogs where Lyme disease attacks the kidneys, and we'll have dogs not survive at young ages."
Treatments include a type of aspirin specially formulated for dogs. Lester warned that human Tylenol and aspirin are toxic to dogs because of the way their metabolism works.
Lester advised using flea and tick products year-round, because ticks can be active any time the weather is above 30 degrees Fahrenheit. "The edible ones tend to work the best," she added. "Then they've eaten the product and it's in their bloodstream, and it kills these ticks hopefully fast enough to prevent the disease."
She noted some infections, like anaplasmosis, transmit very quickly from tick to dog - possibly too quickly for topical preventatives to do any good.
"We've been seeing anaplasmosis in dogs of all ages, even on very good preventatives, because it's been so thick," said Dr. Megan Larson with Ark Animal Hospital in Park Rapids. "We see them with severe high fevers, vomiting and not feeling well. A lot of times, they've been able to be treated quite readily. They usually respond in 24 to 48 hours."
'Canary in the mine'
Dr. Amanda Bergin with Town & Country Animal Clinic in Park Rapids noted that ticks are becoming increasingly resistant to over-the-counter flea-tick preventatives.
Lester said the tick problem seems worse this year. "We've seen dogs just covered in them. If that's the case, and they're not using a flea and tick preventative, we will have higher numbers of tick diseases showing up in our pets," she said.
"It has been really thick this year," Larson agreed. "Of course, it was a later season, because our spring was so late. So, we are seeing a very thick tick population now in June, and we expect to see it very thick in July. Usually it drops a bit in July and mid-August, but we have a feeling that it's going to be very thick throughout the year."
Larson said people tend to expect ticks to be less of a problem in the fall, but with warmer fall weather that can mean dogs can be bitten in November and start showing symptoms in December. "So, the recommendation is to thoroughly treat all the way through November, until the hard freeze," she said.
"They're out longer," Bergin said about the ticks. "There are more of them."
The prevalence of tick-borne illnesses in area dogs and cats should alert their human friends to the risk they also face, said Bergin.
"Our pets are our canary in the mine," she said, "indicators of how this disease can be more prevalent in people."
Ick, a tick!
Don't panic if you find a tick on yourself or your pet. Ticks only transmit diseases as they feed, and must be attached to the skin for a minimum of 24 hours to spread any kind of infection. Not all ticks are infected, and only infected ticks can spread disease.
According to the Minnesota Department of Health, tiny nymph deer ticks and adult female deer ticks, which are red and dark brown, are the types of ticks you need to worry about. Male deer ticks, deer tick larva, and wood ticks do not transmit Lyme or the other diseases of most concern in Minnesota.
To help prevent being infected, spray your clothes with the tick-repellent insecticide permethrin before going into woods or tall grasses. Wear lighter colored clothes to make it easier to spot ticks, and tuck your pant legs into your socks. When you go back indoors, look yourself over thoroughly - including behind your ears and knees, in your hair and in your belly button - and remove any ticks you find.
Likewise, check your pets for ticks after every trip outdoors. Talk with your veterinarian about how to best protect your pets against ticks.
If you do find a tick burrowed into your skin or the skin of your pet, use tweezers to grasp the tick close to its mouth and gently and slowly pull the tick straight out. Wash the area and apply an antiseptic, and watch for signs and symptoms of illness.
For more information about tick-borne diseases, visit the Minnesota Department of Health's website.