LINCOLN, Neb. (WOWT) – As the weather gets warmer and more Nebraskans are again enjoying the outdoors, the state health department is again warning about tickborne diseases.
While Lyme Disease is always top-of-mind when talking about ticks, there are other sorts of diseases and syndromes that tick bites can bring about.
One of these is Rocky Mountain Spotted Fever, which the Nebraska Department of Health and Human Services says is often overlooked or misdiagnosed, which can lead to serious outcomes.
While there have been only an average of 6.6 cases reported in the last five years, “Nebraska has experienced fatal cases of RMSF,” Monday’s release from DHHS states, noting that immediate treatment can and should be administered, even while awaiting test results.
Symptoms can include fever and headaches and sometimes a rash.
“The skin rash is not always present when the patient first presents to a physician,” the DHHS release states.
Tularemia and Ehrlichiosis are two other tick-borne illnesses present in the state; respectively, Nebraska has reported an average of 11.2 in 2019-2023 and 13 cases in the last five years. DHHS said Nebraska has had “outbreaks” of Tularemia in 2015 and 2024; Ehrlichiosis was the most reported tickborne disease in the state in 2022 and 2023.
Tularemia can be caused by tick bites or deer fly bites, or any skin contact with infected animals — even cats — but mostly rabbits, muskrats, prairie dogs, and other rodents. It’s also possible to contract it from drinking contaminated water or inhaling contaminated dust.
Typically treated with antibiotics, Tularemia symptoms are generally mild but can become life-threatening. Symptoms include: a fever as high as 104 degrees; eye irriation and inflammation; swollen lymph glands in front of the ear or in the neck, armpit, or groin; a skin ulcer near the entry of the bacteria; sore throat, mouth ulcers, tonsillitis; or couch, chest pain, and difficulty breathing.
Ehrlichiosis symptoms include severe malaise, fever, and headache. In rare circumstances, it can be deadly, the DHHS report states.
“With the expansion of the lone-star tick (Amblyomma americanum) in Nebraska, this disease is likely underdiagnosed,” according to the report.
Anaplasmosis has has similar symptoms: malaise, fever, and headache. Anaplasmosis can also cause difficulty breathing, hemorrhage, renal failure, or neurological deficits. If left untreated, DHHS says it can be fatal.
Established populations of ticks that transmit Anaplasmosis — the same sort of ticks that can bring on Lyme Disease — were identified in Douglas, Sarpy, and Saunders counties in 2019 and Thurston County in 2021, making it more likely to occur in eastern Nebraska.
Southern Tick-Associated Rash Illness, also referred to as STARI, is sometimes identified by “a red, expanding “bull‘s-eye” rash similar to those seen in patients with Lyme disease.” As with other tick-borne illnesses, symptoms can also include fever, malaise, and headache. Also passed on from the “lone-star tick,” STARI is generally treated with a 21-day course antibiotics.
Heartland and Bourbon viruses were first identified in Missouri in 2009 and in Kansas in 2014, respectively. While they also generally originate from a “lone-star tick” bite, no cases have yet been verified in Nebraska, the DHHS report states. Initial symptoms of Heartland virus include fever, fatigue, anorexia, nausea, and diarrhea; Bourbon virus symptoms can include these as well, in addition to vomiting and a skin rash with both flat and raised lesions.
Early symptoms of Lyme Disease occur weeks or even months after the tick bite. They can include fever, chills, severe headache, fatigue, muscle and joint pain, swollen lymph nodes, neck stiffness, facial palsy, arthritis (particularly of large joints), heart palpitations or irregular heartbeat, and inflammation of the brain and spinal cord. In most cases, there is also a rash that can look like a “bull‘s eye,” but often doesn’t. Nebraska has reported an average of 6.8 cases per yaer in the last five years.
DHHS noted in its update on Monday that established populations of the sort of ticks that can cause Lyme Disease had been identified in Douglas, Sarpy, and Saunders counties in 2019. Two years later, there was also an epidemiological investigation into a cluster of Lyme disease cases in Thurston County.
PREVENTION
The CDC advises anyone spending time in or around grassy, brushy, or wooded areas and those who spend time outside — or are around animals that do, even just in your own yard — to always check for ticks. Both the CDC and the U.S. Forest Service recommend sticking to the center of trails to avoid tick-infested areas.
Treating clothing with products containing 0.5% permethrin can also help; as can use of insect repellants containing DEET, picaridin, lemo eucalyptus oil, IR3535, para-menthane-diol.
“If you are using sunscreen, apply sunscreen first and insect repellent second,” the CDC recommends.
After coming inside, inspect clothing for ticks, and examine gear and pets for ticks as well. Showering soon after you get back indoors will also help limit the risk of tick-borne diseases.
Check your body for ticks, especially under the arms, in and around the ears, inside the belly button, on the back of the knees, around the waist, in and around hair, and between the legs.
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