My Turn: Tick-borne diseases in the time of COVID

  • Mary Carey STAFF FILE PHOTO

Published: 8/18/2021 9:38:25 AM

In early July, I was hoping my husband Brian, who was feeling uncharacteristically under the weather, would bounce back to his hardy self soon, so we could rent an AirBnB on a lake or a beach for a few days.

By the end of the month, I just wanted him to get better.

We were increasingly anxious to find out what was causing his pillow-soaking sweats, violent chills, head and neck aches and extreme fatigue as one week, then a second, and half of the third week went by. Despite two visits to an urgent care clinic, a diagnosis of cellulitis and an antibiotic, he was getting worse. An emergency room doctor at Cooley Dickinson Hospital, for whom we are deeply, deeply grateful, eventually identified the culprit. But it was a confounding journey leading up to the revelation. Living in the shadow of COVID, as we all are, didn’t help.

The idea that Brian could be one of the unlucky minority of the fully vaccinated to get a breakthrough infection was always on his mind. He had had three COVID tests which all proved negative — a relief on the one hand, he said, but a little bittersweet, because if he had COVID, at least we would know what was wrong with him.

In addition to his other symptoms, Brian had two swollen and red toes. It was another reason we thought he could have the virus, since they resembled COVID toes we’d seen in photos. He showed them to a physician’s assistant at the clinic who diagnosed them as cellulitis, a bacterial infection that can potentially lead to deadly sepsis in some people. She prescribed an antibiotic.

It seemed likely that cellulitis could be causing Brian’s other symptoms, but although his toes returned to normal after five days of antibiotics, the head and neck aches, fever, chills and fatigue got worse. The first of a series of blood tests didn’t show any abnormalities other than slightly elevated liver enzymes, so he was told to stop taking acetaminophen.

At times, after taking ibuprofen, Brian would feel OK, and I would hope that he was trending in the right direction. But then he would shiver severely and his skin would become clammy. He’d sit on the couch with his eyes closed, and his face would turn brick red, then he would sweat through all his clothes. At night, he slept in the basement, where it was cooler than our bedroom, but he also had an electric blanket, heavy sweaters and winter hats on or nearby for when the chills set in. His pillow, blankets, sheets and the mattress protector would be drenched when I checked on him in the morning.

We entered his symptoms into Google, searching for possible causes. “Check Lyme disease, meningitis and new daily persistent headache syndrome (NDPH),” I called out to Brian, who was doing his own search. I was also looking up what would cause erratic fluctuations in temperature, and finding ominous references to tumors, enlarged blood vessels in the brain and cancer. The third COVID test came back negative about this time.

Finally, on the 17th day of symptoms, we went to the emergency room, which was packed pretty much to capacity. We arrived around 2 p.m., and it was almost 6 before we saw the doctor. He had reviewed Brian’s chart and blood tests and he wasted no time, saying, “I think I know what this is.” He asked if Brian had trouble urinating or body aches and checked for tenderness in his stomach. “I think you’ve been bitten by a tick,” he said, adding that they’ve seen a lot of tick-borne diseases, not just Lyme, at the hospital this summer. These diseases are here now.

“Of course!” I said. We had considered Lyme disease, after all. But it didn’t stand out in the gallery of suspects.

The doctor ordered two kinds of antibiotic and some intravenous fluids for Brian, and by 9 p.m. we were on our way home, immensely relieved. Blood tests confirmed the next morning that he has a tick-borne illness called Babesiosis, caused by microscopic parasites that infect red blood cells. Not as well known as Lyme disease, it is one of the most common tick-borne diseases in Massachusetts, along with Lyme and Anaplasmosis, according to Mass.gov, and can range in severity from asymptomatic to life threatening.

Two days later, another emergency room doctor called to confirm that Brian also has Lyme disease and — pending confirmation, which could take two weeks — Anaplasmosis (which attacks white blood cells) too.

As it says at Mass.gov about the black-legged ticks in the state, “These ticks are capable of spreading more than one type of germ in a single bite.”

In the days after our trip to the emergency room, with Brian showing slow but seemingly steady improvement, I reflected on an anecdote one of my Facebook friends had posted early in the pandemic. “Dad,” his precocious little daughter asked him (I’m paraphrasing), as they were walking on the bike path, “Where should I walk, so I’m not near other people who could be infected with the coronavirus but not too close to the grass where the ticks hang out?”

Mary Carey is an adjunct instructor of journalism and public relations at UMass.

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