Sleuthing Mysterious Tick-Borne Disease A Chilling Endeavor, Montana State Department of Public Health and Human Services
Damrow is the Montana state epidemiologist, and--along with his colleagues at the Montana Department of Public Health and Human Services, the U.S. Centers for Disease Control and Prevention, and the NIH, Rocky Mountain Laboratories--he has spent the past few years investigating reports of a tickborne rash similar to that found in Lyme disease.
Damrow first thought something strange was going on a few years ago, when he began getting reports from patients and physicians of what appeared to be Lyme disease. The patients complained of fever and severe fatigue, as well as odd circular rashes at the site of a previous tick bite. The symptoms were similar to those of Lyme disease....
Then one spring, a public health worker mailed Damrow a photo of the distinctive rash. It was unlike anything he had seen before, and it prompted him to launch a more formal investigation. He knew the Centers for Disease Control and Prevention (CDC) were looking into Lyme-like symptoms caused by unidentified infectious agents in Lone Star ticks in Texas and dog ticks in Missouri. Could the same thing be happening with wood ticks in Montana?
The only way to solve the mystery was to collect the offending ticks, extract DNA from their salivary glands, and study it with molecular probes to find out whether some new bacterium or other pathogen had infected the ticks.
“So last spring we launched a ‘save the tick’ campaign,” Damrow said.
Through news releases and public service announcements on radio and TV, the state Department of Public Health and Human Services (DPHHS) asked Montanans who found ticks embedded in their skin to carefully remove the tick, drop it alive into a plastic bag, and take it immediately to their county health department.
DPHHS staff also notified physicians and county health workers about the study, and they became integral partners in the research effort. They collected the ticks, documented patients’ symptoms, and mailed the ticks to DPHHS.
Damrow was hoping to collect around 100 tick samples.
“We thought it would be pretty hard to get people to hang onto ticks after removing them,” he said. “Usually you just want to throw the nasty little buggers in the trash.”
But the public information campaign was more effective than he had dared to hope. He soon had a collection of about 350 ticks, “and that was after excluding the ones that didn’t actually bite someone.”
His colleague, CDC epidemiologist Kammy Johnson, plans to start tracking bite victims to find out whether the mysterious disease has any late-developing or long-term effects.
DPHHS enlisted researchers at the NIH, Rocky Mountain Laboratories in Hamilton to search for antibodies in the blood of bite victims that might help to identify the pathogen and confirm its role in the disease. The partnership with the labs seemed especially appropriate, Damrow noted, since they were the first to identify Rocky Mountain spotted fever almost a century ago. And in 1982, a scientist at the lab identified the causative agent in Lyme disease.
For the second year in a row, the Montana Dept. of Public Health and Human Services is asking Montanans to help with researching a potentially new disease transmitted by ticks.
Anyone who finds a tick embedded in his or her skin is asked to remove it carefully, drop it alive into a plastic bag, and promptly take it to the county health department. County health workers will collect information about the geographic location where the tick was picked up, the location of the tick bite, and the date the tick was removed.
If an individual develops a rash at the site of a tick bite within 7 to 21 days after removing the tick, he or she is encouraged to visit a health-care provider. A doctor or nurse will collect a blood sample, which will be examined for signs of a germ that may have caused the rash. The identities of those who participate in this study will be kept confidential as required by law.
For more information, call your county health department.
