Q&A: With a rare tick-borne disease now in Virginia, what do you need to know?

If you think you are seeing more ticks, you are not imagining things. With the growth of the deer population come more ticks, which can spread maladies like Lyme disease and Rocky Mountain spotted fever. And now, a study has found a new and rare tick-borne illness has crossed Virginia’s borders.

The deer tick – the same insect that transmits Lyme disease – spreads the parasitic infection babesiosis. 

Since 2016, the Virginia Department of Health has confirmed 17 cases in the commonwealth, according to the study published in the Journal of Medical Entomology. Most of them were on the Eastern Shore or in Southwest Virginia.

Portrait of Dr. Jeffrey Wilson

Dr. Jeffrey Wilson, an allergist and immunologist, says doctors in Virginia should begin testing for babesiosis when treating patients with tick bites. (Contributed photo)

Dr. Jeffrey Wilson, a University of Virginia allergist and immunologist, says that while that number is low, doctors should start testing for babesiosis when treating patients in the state with tick bites.

He answered UVA Today’s questions about the disease, how it affects people and how to stay safe this summer.

Q. What are the symptoms of babesiosis, and how will it affect people in Virginia?

A. It can be a wide range. It is my understanding that people can definitely acquire babesiosis from a tick bite and be asymptomatic. So, in some ways, that’s probably the most likely outcome.

But then there are the people who get a tick bite and develop symptoms. It’s flu-like, just in simple terms, but you can have an objective fever. You can get the aches and the chills and the headaches. That’s probably going to be the most common outcome.

But then, in more rare cases, it can be severe. Babesiosis can (have) a bad outcome, particularly in people who are higher risk: people who are immunodeficient, people who have had their spleens taken out for some reason, people who have malignancy and may be on chemotherapy; basically, people who are immunocompromised. Then it can be bad. It can be life-threatening.

Q. How can people protect themselves?

A. Awareness (is) a big part. And certainly if you’re going to be out in a place in Virginia or anywhere in tick country … taking the precautions. The spray that I talk about in the clinic is permethrin. I think permethrin’s got the best data for tick mitigation.

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Permethrin doesn’t go on your skin; it goes on your clothes and your shoes. It’s also got some other advantages. You don’t have to spray it each time. You can really douse your outdoor clothing and shoes in this stuff. Soak it down really good, let things dry and then you can wear it for weeks. You can even do a few launderings before you have to reapply.

Of course, that only works if you’re actually wearing pants and long sleeves. And of course, in places like Virginia, it gets hot and we’re wearing shorts, things like DEET and picaridin, they can also help.

Q. Do you have any other safety tips?

A. I’m mindful of ticks, but I still get them, so I know it’s hard. But when we’re hiking, sticking to the center of the trail and not going off into the high grass is good. Check for ticks when you get home and shower.

Q. Once bitten, how long does it take for the transmission of disease?

A. My understanding is that transmission of babesiosis is not rapid. So, if you get a tick on you but it’s only on you for a little bit – which could be a few hours or half a day – I don’t think that’s long enough to transmit. I think transmission is probably upwards of 36 hours.

Q. How does the discovery of babesiosis in Virginia affect how doctors should treat people with tick bites?

A. In a place like Virginia, providers are used to a situation where if somebody got a tick bite and there’s any concern for any infection, typically all you need to do is put them on a course of antibiotics, and most often that’s doxycycline. That is convenient because that takes care of Lyme disease and Rocky Mountain spotted fever and basically almost all of the big tick-acquired bacterial diseases.

This is why babesiosis is in some ways more newsworthy. Babesia (the parasite that causes babesiosis) is a protozoan; it is not a bacterium. It doesn’t respond to doxycycline. That would take a different kind of medication.

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Jane Kelly

University News Senior Associate Office of University Communications