Ticked off: Bloodsuckers are bad news

There are many different types of ticks.

"Tick-tock of the lonely clock." "The old ticker is still working though my spouse is going to give me a heart attack!" "Don't tick me off; I'm off my antidepressant." "Your breath smells; here's a Tic-Tac." "Everyone now and then gets a little tic under the eye so it quivers like Katherine Hepburn's."

But the grossest tick is the one you find stuck to your body, sucking your blood. Do ticks serve any purpose in the environment?

When John Denver sang "Rocky Mountain High," I wondered if he ever considered changing the lyrics to "Rocky Mountain High from a Tick-Borne Fever."

Rocky Mountain Spotted Fever (RMSF) is all over North America– and North Carolina has about 35 percent of the cases. The dog tick is the main carrier.

That means that about five to seven days after Lassie's tick bites you, RMSF presents you with fever, a headache that makes you wish you were Marie Antoinette, nausea, and joint and muscle pain. The rash actually doesn't appear until three to five more days.

Lyme Disease is better known, though it's mostly located in the Northeast. It's the deer tick, Ixodes, that carry these little blighters, and the classic bull's-eye rash occurs seven to 14 days after a bite. However, it's believed that 10-35 percent of the time the bulls-eye doesn't appear.

Initially, an infected person might feel totally wiped out and experience joint and muscle aches and enlarged lymph nodes. If Lyme is not treated, chronic arthritis can develop, and in some cases neurological and heart damage. Getting a blood test for Lyme is usually worthless during the first phase, a fact which infuriates most patients.

What most people in Virginia don't know is that the most common tick-borne illness in this state is Ehrlichiae (er-lick-e-ah). The Lone Star tick is the main tick that carries Ehrlichiae, even though it sounds like it's from Texas.

People with Ehrlichiosis develop flu symptoms in the spring and summer when ticks are out having a good ole time. About a week after infection, a fever starts, accompanied by body aches, headaches, fatigue, and sometimes vomiting. Most people with Ehrlichiosis, unlike RMSF, don't develop a rash (which is why it's sometimes called Rocky Mountain Spotless Fever). Neck pains and neurological disorders can occur as well.

Most people with Ehrlichiosis just tough it out and blame their symptoms on work or their in-laws. Usually it goes away in 2-4 weeks, but it can persist for up to two months. Others– in particular, older people and those with HIV– end up in the hospital with high liver enzymes, anemia, slowing of the kidneys, and a drop in their immune cells. Platelets can drop, so easy bleeding can occur.

Unfortunately, Ehrlichiosis, like RMSF, can be fatal. Seizures, coma, congestive heart failure, and kidney and respiratory failure can result from Ehrlichiae. The good news is Ehrlichiosis, like RMSF and Lyme, is treatable with antibiotics.

And just when you thought it was safe to get out your Mint Juleps this summer, another southern tick-borne illness is out there. Vincent van Gogh painted "Starry, Starry Night" but the Lone Star tick can give you a STARI night, Southern Tick-Associated Rash Illness.

STARI causes a bulls-eye rash like Lyme, but the blood tests are negative for Lyme, RSMF, and Ehrlichiae. Again, headache, body aches, fatigue, and sometime nausea occur in STARI. Antibiotics, anyone?

Make sure your dog is brushed off every day and given tick medication. If you go into grassy, bushy areas, watch out for ticks. Wear bug repellent­ it works! I like OFF which has Deet, though it makes me smell "OFF-full."

Got a medical question? Dr. Hook would like to hear from you!