Lyme Disease: Can you get it in Missouri?


It’s officially summer folks, and with the hot weather comes lots of outdoor activities. Unfortunately with the great outdoors comes mosquitoes, sunburns and lastly TICKS.
Often, during this time of year we have patients come in and they are very concerned because they realized they have had a recent tick bite and they are frightened by the possibility of getting Lyme Disease. There is a high amount of confusion though and I hear patients ask things like “Can I get Lyme disease here?” or “I have heard that most people have Lyme disease from ticks but just don’t get diagnosed correctly.”  I am hoping that by the end of this post you will be experts on Lyme, other tick born illnesses, and how to prevent and treat tick bites. So let’s dive in!

As of 2015 there were 2 confirmed cases of Lyme in all of Missouri.You read that right. TWO confirmed cases.(You can see this data here.) In my opinion, this shows that we have a high fear of Lyme disease when it might not be the disease we should focus our attention on. There are plenty of tick-born illnesses out there and all have similar symptoms. The CDC, therefore, requires very specific testing to confirm that a person has Lyme disease. So often there are patients who report Lyme like rashes but then when tested for the illness it is not confirmed. You can read more about Lyme in our state on the Department of Health and Human Services of Missouri website here.

Just because it is rare to have active cases of Lyme disease from ticks in Missouri does not mean that our ticks are safe. Currently we do have ticks carrying Rocky Mountain Spotted Fever, Ehrlichiosis, and Tularemia. We also have reports of Lyme Like syndrome and a syndrome called STARI(Southern Tick-Associated Rash Illness) that are known illnesses described by medical providers after a person has had a known tick bite but their vector is still not known.

So how do you know if you should worry about your tick bite? Great question. Here are some worrisome signs/symptoms after having a known tick bite that you should contact your health care provider about:

  1. Fever/Chills
  2. Aches/pains: headache, fatigue, muscle aches, nausea or diarrhea.
  3. Rash. Here are some examples:

Erythema Migrans-Like Rash of STARI:

Circular erythema migrans-like lesion with central clearing on the lower leg of a patient with STARI. The central papule was the site of a recent tick bite.
STARI: Southern tick-associated rash illness.
Courtesy of Edwin Masters, MD.
Graphic 60256 Version 4.0
Rocky Mountain spotted fever rash:
Child with Rocky Mountain spotted fever has the rash that is characteristic but typically does not appear until several days after fever onset.
From: Fatal Cases of Rocky Mountain Spotted Fever in Family Clusters — Three States, 2003. MMWR Morb Mortal Wkly Rep 2004; 53(19):407.
Graphic 58061 Version 5.0
Tularemia eschar:
Courtesy of Todd M Pollack, MD.
Graphic 51005 Version 2.0
Erythema migrans:
Erythema migrans with central clearing and a necrotic center.
Courtesy of Dori F Zaleznik, MD.
Graphic 81270 Version 1.0
Another great question is how do you prevent tick born illnesses? Here are some helpful tips:
1. Prevent the bite in the first place.
-Use Deet/bug spray when outdoors.
-Tuck pants into shoes and wear long sleeves
-When hiking walk in the center of the trail avoiding brushy areas and high grass.
2. Shower off within two hours of being outside to try to rinse them off before a bite occurs.
3. Do full body tick checks daily after being outdoors. (I’m pretty sure Brad Paisley wrote about this…)
For more tips read more here.
Finally, I often tell my patients “Peace of Mind is Priceless,” meaning if you have gotten bit and have a concern contact your health care provider. He or she can help you determine if you need testing and what type of testing needs to occur. And as always, we at Tri-Lakes Family Care would be glad to help you if you are in need. Remember, we even offer Video Chat Visits if that would be more convenient for you and your family to discuss your medical questions.
As always, I hope you stay happy and healthy.
Carolyn Clark, NP-C