When it's more than just a bug bite

| Monday, August 01, 2016

By John McElligott, M.D., Land Line contributing columnist

It’s summer and bugs are biting. Here are some questions from our trucking readers. Tick bites are common threats and doctors are well-versed on those dangers. Zika is a virus that unfortunately poses many unanswered questions. We are learning more about every day. The government is investing substantial funds into protecting you. The Centers for Disease Control are publishing information as quickly as possible.

Question:
I had a tick bite hauling shrubs from the Pacific Coast. The bite was on my chest and I got a rash, fever, joint aches and fatigue about a week or so later. My neck is still stiff and I’m often dizzy. Should I be tested for Lyme disease? Is it hard to diagnose?

Answer:
The name Lyme comes from a town in Connecticut. This is where the original studies originated. Lyme disease is caused by the bite of a deer tick that causes a bacterial infection. There are about 30,000-40,000 cases reported in the United States each year.

In the early stages, normally fever, muscle aches and maybe a “bull’s-eye” type rash occur a few weeks after the bite. Diagnosis is done clinically, and confirmation tests are done by blood samples. The tests look for antibodies in the blood and have now become routine. There are several other tests, but the diagnosis can be complex.

If you have symptoms as you described and definite confirmed tick bite, I would draw labs and start antibiotics. Waiting is not the way to go. Left untreated, Lyme’s can be problematic and long lasting.

Certain species cause different types of disease. Some bites never cause any problems other than a sore spot at the bite site. The following seven can be devastating: Lyme disease, Rocky Mountain spotted fever, tularemia, ehrlichiosis, relapsing fever, Colorado tick fever and babesciosis.

Question:
My co-driver and I are engaged to be married. He goes to Brazil a couple times a year to see his family. How worried should we be about the Zika virus?

Answer:
Zika virus is brought here from South America and Central America. The CDC has issued an alert for travel to areas where Zika virus is spreading, so I’m hoping your fiance knows this. Men who have the virus may or may not show symptoms, so remember that unprotected sex could put you at risk for several weeks after he returns. According to the CDC, Zika can be passed after his symptoms end and it’s not known how long Zika stays in semen.

Transmission can come from the male or female, by the way. Virus lives in body fluids such as blood; urine; penile secretions including sperm; vaginal secretions; saliva; tears; and sores. In addition, viruses can live on skin and surfaces that we touch.  The latter we know from truckers with the flu who can infect many others every day with just a cough and not washing their hands. 

CDC does not know if Zika can be passed through saliva during kissing. 

If a pregnancy is in your future, it’s wise to stay informed and careful. Because Zika can cause birth defects, the CDC and their partners are putting considerable resources into studying it.

It’s good to beware. The Olympics are coming up in Rio, summer travelers are coming in and out, and flooding plays into the picture, too. Could mosquitoes hitching a ride aboard moving ships and barges, through the Panama Canal, for example? I would say it is possible. Three words of advice:  DEET. Use it.

A Zika vaccine will start efficacy trials 2017 in the U.S. Research, and development is being done by private companies. The encouraging news is we are always busy developing antiviral medicines.  

John McElligott is an MD and Fellow of the American college of Physicians. He is a certified medical examiner with the FMCSA's NRCME. This column is the opinion of the writer and does not necessarily reflect the opinions of Land Line Magazine or its publisher. Everyone's health situation is different. If you have questions regarding medical issues, consult your personal physician.

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