Have you heard of a strange tick-borne fever? - Let's learn about Ehrlichiosis!

You've probably seen a small tick attached to your body while walking in the woods or playing in the grass in your garden. At that time, we think, "Oh, this little creature, what can I do?" and we just throw it away, right? But did you know that these little ticks can transmit diseases that we don't even think about, sometimes even life-threatening ? Well, today we're going to talk about a tick-borne disease that has a strange name, but can be dangerous if not taken care of properly, called Ehrlichiosis .

What is Ehrlichiosis? Simply put...

Simply put, Ehrlichiosis is a disease caused by a type of bacteria . It is caused by the bacteria `Ehrlichia chaffeensis`, `E. ewingii` or `E. muris eauclairensis`. This bacteria enters the body when an infected tick bites . Just like dengue is transmitted by a mosquito. There are two types of ticks that are mainly responsible for this, namely the `lone star tick` and the `blacklegged tick`.

This disease may start out as a very common cold or flu . So we may not pay much attention to it. However, if not treated quickly, it can become serious and life-threatening . Sometimes this disease is also called `human monocytic ehrlichiosis (HME)`.

Is this like Lyme disease?

You've probably heard of Lyme disease. It's also a tick-borne disease. Although both diseases are transmitted by ticks, there are slight differences in the symptoms . But the most important thing to remember is that Ehrlichiosis can be more serious than Lyme disease if not treated promptly .

Is Ehrlichia bacteria really dangerous?

Yes, this Ehrlichia infection can be dangerous if left untreated . Just think, about 60 out of 100 people who develop this disease will have to be hospitalized . Also, according to reports, about one out of 100 people who develop this disease may die . So this is not a good disease to think about lightly.

Who is more likely to develop Ehrlichiosis?

In fact, anyone who is bitten by a tick can get this disease. Ticks are usually found in tall grassy areas, in wooded areas. These ticks can even be found on the bodies of our pets .

However, some people are at higher risk of developing a more severe form of the disease if they develop it. These are:

• People over 50 years old.
• People with weakened immune systems. For example, people with HIV, cancer patients, or those taking medications that suppress the immune system.
• People with chronic diseases like diabetes mellitus, or connective tissue disorders.

Although there is little clear data on the prevalence of this disease in Sri Lanka, it is common in some countries of the world, especially in some parts of America. Most of the time, this disease is reported more during the summer months, that is, in the months of May, June, July and September . This is because during that time, people spend more time outdoors, and ticks are also more abundant during that time.

How does Ehrlichiosis affect our bodies?

The Ehrlichia bacteria that cause Ehrlichiosis enter our bloodstream after a tick bite. The bacteria then directly attack white blood cells, which are a very important part of our immune system . Think of them as the body's sentinels. They help us fight off germs and protect us from disease. The bacteria invade and eventually destroy these white blood cells. This reduces our body's ability to fight disease.

What are the symptoms of Ehrlichiosis?

Symptoms of this disease begin to appear between 5 and 14 days after a tick bite. Symptoms often appear suddenly . Symptoms such as fever and chills come first.

Symptoms that may appear in the early days:

• Fever is coming.
• The body becomes cold ( feeling cold ).
• I have a headache .
• Body aches, muscles hurt .
• I feel very tired .

After a few days, other symptoms may appear:

• Skin rash. This can appear as red spots or small dots. This rash is more common in young children than in adults.
• You may cough .
• Nausea and vomiting may occur.
• You may get a stomach ache .
• Memory and attention problems, and confusion may occur.

Important: If you experience one or more of these symptoms, especially if you have been in an area where ticks may be present, see a doctor immediately.

How do doctors diagnose this disease? (Diagnosis)

To find out for sure if you have ehrlichiosis, a doctor will examine you. They will ask you about your symptoms and your health history.It is very important to tell your doctor if you have recently (within the past three weeks) walked in a wooded area or in tall grass where ticks may be present. Even if you do not remember being bitten by a tick, you should tell your doctor if you have been in such an area. This information, along with blood tests, will help your doctor decide whether or not you need treatment for ehrlichiosis.

What tests are performed?

Mainly blood tests are done.

• A small needle is inserted into a vein in your arm and a blood sample is taken.
• The lab will do a complete blood count on this blood sample. They will also look for signs of the bacteria that cause Ehrlichiosis. Sometimes they will also try to grow the bacteria (culture).
• However, it can take several weeks for this bacteria to grow. So, even before the lab report comes in, your doctor may decide to start treatment based on your symptoms and other information . A quick blood count can give you an idea of ​​whether you might have an infection.

How is this treated?

Ehrlichiosis is treated with antibiotics . These medications are usually taken for five to seven days. This means that you should take the medication for at least three more days after your fever has completely gone down and your other symptoms have improved.

It is important to start treatment early. Treatment is most effective when started as soon as symptoms appear. If left too late, ehrlichiosis can lead to serious complications and even hospitalization.

How to manage symptoms at home?

If your symptoms are not severe, your doctor may tell you to take over-the-counter drugs to control your symptoms. However, it is best to consult your doctor before taking any medication.

After starting antibiotics, you should start to feel better within 24 to 48 hours , especially if you start treatment early. However, do not stop taking the medication before the prescribed time. Doing so may cause the infection to come back. If you do not feel better after a few days, see your doctor again.

How can you avoid Ehrlichiosis? (How to reduce the risk)

The best way to protect yourself from this disease is to avoid being bitten by ticks . There are several things you can do to do this:

• Keep the grass in your garden cut short , no more than 5 inches tall.
• If walking in forested areas, only follow clear paths (on clear trails) .
• A spray containing `DEET` , an insect repellent that prevents ticks.Use. Or use another insect repellent approved by a doctor.
• When going into the woods or tall grass , wear clothing that covers as much of your body as possible . Such as long pants and long-sleeved shirts. If you are someone who often spends time in areas where ticks are present, you may want to buy special clothing that protects against ticks.
• After coming back from being outside , check your entire body for ticks . Have someone check areas that are hard to see (head, back) for ticks.
• Ask your veterinarian about the best way to protect your pets from ticks . Check them regularly for ticks, especially after coming home from the outdoors.
• If you find a tick attached to your body, follow these instructions on how to remove it safely (we'll talk about this in a separate article).

What happens if I get Ehrlichiosis? Will I recover?

If treated quickly, most people make a full recovery . Depending on your condition, you may need to stay in the hospital for treatment.

Possible complications of Ehrlichiosis:

If not treated promptly, some people can develop serious, even life-threatening complications. Some of these include:

• `Disseminated intravascular coagulation (DIC):` This is a very dangerous condition in which blood clots form inside the veins and at the same time, bleeding starts to occur in some areas.
• Acute respiratory distress syndrome (ARDS) or breathing difficulty: A condition in which the lungs do not function properly, making it very difficult to breathe.
• Renal failure / acute kidney injury : The kidneys are unable to properly filter waste products from the body.
• Bleeding inside the body (Hemorrhaging) .
• Sepsis : A severe infection in which germs enter the bloodstream and spread throughout the body.
• Inflammation of the brain and the membranes covering it (Meningoencephalitis) .
• Heart failure .
• Seizures .
• Coma state `(Coma)` .

These complications are scary to hear about. But remember, these often only occur if treatment is delayed . That's why early treatment is so important.

What time should I see the doctor?

If you have been bitten by a tick, or have been in an area where ticks are present, and then develop symptoms of ehrlichiosis, such as fever and body aches, see a doctor immediately .

There is no need to see a doctor immediately after a tick bite, unless you have symptoms. Taking antibiotics without being sick will not prevent Ehrlichiosis. However, be aware of the symptoms.

To an emergency roomIn what situations should you go to (ETU)?

If you have any of the following symptoms, go to the nearest emergency room immediately:

• A fever of more than 103 degrees F (39.4 C).
• If you cough and bleed.
• If it is very difficult to breathe.
• If you are talking nonsense, if you can't concentrate, if you are showing mental changes.
• If you have a severe stomach ache.
• If a seizure occurs.

Do our pets also get this disease?

Yes, dogs can get Ehrlichiosis, and it can be dangerous for them if left untreated . Sometimes it can become a chronic disease and even lead to death. If you have concerns about your pet's condition, talk to your veterinarian.

The most important things we need to remember (Take-Home Message)

We all need to remember that ticks are not just annoying creatures that cling to our bodies and suck our blood, but they can also transmit dangerous diseases like Ehrlichiosis .

If you live in a forested, grassy area, take every precaution to protect yourself from ticks. If you see a tick on your body, remove it immediately.

• Don't take symptoms like fever, body aches, severe headaches, and skin rashes lightly , especially after being in an environment where ticks are present.
• Seek medical advice immediately . If treatment is started early, you can fully recover from this disease.
• Take the antibiotics prescribed by your doctor for the full duration . Do not stop taking the medication as soon as you feel better.

Take care of your health and that of your family! Being aware of these diseases will go a long way in protecting yourself from them.

` Ehrlichiosis, ticks, tick fever, bacterial infection, fever, skin lesions, prevention