- Associated Press - Tuesday, November 3, 2015

MONTGOMERY, Ala. (AP) - Despite what the calendar says, Evan Conrad never goes into the woods without a liberal application of insect repellent.

The Prattville outdoorsman knows that ticks are active in Alabama year round. And even though the risk of contacting the bloodsuckers may lessen during the winter months, he also knows the risk is still there.

“You spend time outdoors in Alabama, you are going to deal with ticks,” he said. “Even using bug spray, it’s not uncommon for me to find ticks crawling on me. And I’ve had to pull a few off that have bit me.”

The Alabama Department of Public Health has put out advisories about Lyme disease becoming a concern in the state. The most commonly reported vector-borne illness in the United States, according to the agency, Lyme is spread by the brown deer tick. According to the World Health Organization, vectors are “living organisms that can transmit infectious diseases between humans or from animals to humans.”

The number of confirmed Lyme disease cases in Alabama have increased during the past several years. In 2009, the total were 3 confirmed cases, compared to 2 in 2010. Then the state went on a bit of a run, with 25 cases each for 2011 and 2012. The number stayed flat in 2013 with 23 before a spike in 2014 of 64 confirmed cases. So far this year, there have been 23 cases.

Alabama has seven counties recognized as “endemic” when it comes to Lyme: Calhoun, Chambers, Jefferson, Mobile, Shelby, Russell and Tuscaloosa. A county is considered endemic when at least two confirmed cases have been acquired in the county, said Dr. Dee Jones, state veterinarian for the health department.

“What people have to realize is that we have seen increases in cases of Lyme, but we feel people should be aware, not alarmed,” he said. “Lyme gets a lot of national and media attention, but it’s not the most common tick borne disease in the state.

“We have other tick-borne diseases we see more of each year. But what works in preventing Lyme disease works with the other tick-borne diseases as well.”

Other tick-borne disease in the state include anaplasmosis, Rocky Mountain spotted fever and tularemia.

But Lyme disease seems to get the most attention. The brown deer tick carries the borrelia burgdoferi bacterium, which causes the disease. The bacteria are spread through the bite of the tick. According to the Centers for Disease Control and Prevention, Lyme disease is concentrated in the Northeast and Upper Midwest with about 96 percent of the cases nationally reported in 14 states; Connecticut, Delaware, Maine, Maryland, Massachusetts, Minnesota, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Virginia and Wisconsin.

Geography doesn’t enter into Conrad’s concerns.

“We know Lyme disease is here, it doesn’t matter if it’s as widespread as in other states,” he said. “You still need to be careful, especially if you have kids going out in the woods.”

Most tick-borne diseases manifest themselves with similar, flu-like symptoms. Most simple cases exhibit low- to mid-grade fever, muscle aches and cramps, headache and malaise, according to the CDC. More severe cases, though rare, can cause lengthy respiratory, skeletal and circulatory problems, the CDC website shows.

In most cases, a red-ringed or “bulls-eye” shaped rash develops around the area of the tick bite, Jones said. But sometimes the rash isn’t there.

“If you pull a tick off, you need to be aware for the next two to three weeks,” he said. “If you develop symptoms, you need to go to your doctor. It doesn’t matter if it’s Lyme or not. If you have a tick-borne illness, you need to seek medical attention.”

A round of antibiotics is usually enough to combat the diseases.

Tests are done to determine if a patient has been exposed to Lyme disease. Some cases not tested may be missed, due to their similarity to the flu and other sicknesses, Jones said.

“Overall I think the doctors in the state are aware of Lyme, but some cases can be missed,” he said. “It really doesn’t matter if we have 30 confirmed cases, or 25 confirmed cases. What matters is people taking the steps to prevent their exposure to Lyme and other tick-borne diseases.”

The easiest way to keep ticks away is in a spray bottle, Jones said. Use insect repellents containing 20 percent or more of DEET on exposed skin and permethrin on clothing, he said. Parents should apply products to children, avoiding the eyes, hands and mouth.

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Information from: Montgomery Advertiser, https://www.montgomeryadvertiser.com

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