If a person spends a lot of time outdoors in areas where ticks are common and develops summer flu-like illnesses, the possibility that it is due to tick-borne diseases such as Lyme disease should always be considered .

However, this summer, the global presence of COVID-19 presents a whole new set of challenges in being able to correctly diagnose Lyme disease and other tick-borne diseases.

Lyme disease shares several symptoms with COVID-19, including fever, pain, and chills . Anyone who mistakes Lyme disease for COVID-19 could unknowingly be delaying necessary medical treatment, and that can lead to serious and potentially debilitating symptoms.

Not getting medical treatment for Lyme disease as soon as possible can be dangerous.

As we move from spring to summer and the peak period of tick activity in much of the Northern Hemisphere, the time we spend outdoors will increase, as will the risk of contracting tick-borne diseases .

In some cases, there are key symptoms of a tick-borne disease that can help make a diagnosis. For example, early Lyme disease, which is caused by the bite of an infected blacklegged tick , is commonly associated with a spreading “bullseye rash”. Seventy percent to 80% of patients present with this symptom.

However, other symptoms of Lyme disease – fever, headaches and body aches, and fatigue – are less distinctive and can easily be mistaken for other illnesses, including COVID-19. This can make it difficult to diagnose a patient who has not noticed a rash or did not know that they were bitten by a tick. 

As a result, cases of Lyme disease can be misdiagnosed. Generally, if identified and treated quickly, using antibiotics for two to four weeks can kill Borrelia burgdorferi . What is the species of spirochete bacteria that causes Lyme disease.

But any delay in treating Lyme disease can lead to more severe and persistent symptoms. If Lyme disease is not treated, neurological and cognitive problems and potentially fatal heart problems could develop.

Lyme disease isn’t the only problem ticks bring

Ticks throughout North America can spread a wide range of diseases . Many of which also present with flu-like symptoms, which can lead to misdiagnosis. Especially when these diseases are not especially common in the general population.

Spotted fevers are another group of tick-borne diseases. The most serious of these is Rocky Mountain spotted fever , which can be fatal. Spotted fevers, as the name suggests, are often associated with a rash. 

But the rash may not show up until after a fever and other flu-like symptoms, putting it at the same risk of mistaking it for COVID-19. Like Lyme disease, spotted fevers can be treated with antibiotics, and early treatment can prevent more serious infections. So it is essential that there is a quick and accurate diagnosis.

Is COVID-19 increasing the chances of getting tick bites?

Recent reports from around the world suggest that wildlife has gotten bolder this spring. Wandering through the suburbs and cities in which the traffic of people and vehicles has been reduced due to COVID-19.

It is not clear if this phenomenon is being driven by changes in animal behavior or is simply caused by humans spending more time in their homes. But changes in wildlife behavior and habitat use could have an impact on tick-borne diseases. 

For example, white-tailed deer are important hosts for multiple species of ticks that bite humans in eastern North America. Including black legged ticks. And more deer around our homes and neighborhoods could lead to more ticks that can bite humans.

Ticks do not travel very far on their own, the maximum distance being around 30 cm per day for some species. But they can disperse tens of kilometers or more if they travel by a highly mobile host such as a deer, a coyote or a bird. 

Therefore, wildlife exploring our neighborhoods while we are indoors may be leaving behind ticks that carry pathogens. Or that they could acquire an infection through the more common wildlife already close to our homes.

Take your precautions

Being cautious is a key component in preventing and treating tick-borne diseases. People should be aware of activities that could expose them to ticks . In addition, doctors should always consider the possibility of a tick-borne disease. Especially given the possible overlap of symptoms with COVID-19.

As with COVID-19, mitigation can substantially reduce the risk of tick-borne diseases. Wear long-sleeved shirts and long pants and use a repellent when you are inside the tick habitat, and check for any ticks when you get home.

It’s important to be on the lookout for ticks when spending time outdoors, however fear of ticks shouldn’t be an impediment for people to enjoy nature either.

By Dr. Eric Jackson

Dr. Eric Jackson provides primary Internal Medicine care for men and women and treats patients with bone and mineral diseases, diabetes, heart conditions, and other chronic illnesses.He is a Washington University Bone Health Program physician and is a certified Bone Densitometrist. Dr. Avery is consistently recognized in "The Best Doctors in America" list.

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