Don’t let their size fool you: ticks can spell big trouble for those they bite.

In 2019, state and local health departments reported 50,865 cases of tick-borne disease to the federal Centers for Disease Control and Prevention.

“Ticks and tick-borne diseases are a popular topic this year, and we have also heard the rumors that it is forecast to be a big year,” said Elizabeth Schiffman, epidemiologist supervisor for the Minnesota Department of Health’s vector-borne diseases unit.

Blacklegged ticks, also known as deer ticks, are concerning to public health experts because their bite can cause Lyme disease, an inflammatory disease characterized initially by a skin rash, headache and fever, and later by arthritis, neurological damage and cardiac abnormalities, among a host of other tick diseases.

And after a year in decline, the number of cases involving ticks is back on the upswing.

“Our peak is typically June, July and then sometimes you see a peak again later in the fall,” said Jill Larsen, a certified physician associate at Cuyuna Regional Medical Center.

Schiffman said, “The Brainerd area has been a hotspot for years for blacklegged ticks. And while that is still certainly the case, we are now seeing that risk expand into areas where we just didn’t see it before.”

The Crosby-based health care provider saw 67 cases of tick-borne diseases in 2019 but only 37 cases last year during the coronavirus pandemic when there were stay-at-home orders, businesses were closed, and social distancing was encouraged and gatherings discouraged.

“People weren’t going out as much, but you would also think maybe they are out in nature more. Shelter-in-place in the spring, I’d guess, kept people home because that’s typically when we see those new ticks — in the spring — and when a lot of people get Lyme disease,” Larsen said.

Blacklegged or deer ticks

Dr. Nathan Laposky is an emergency medicine physician at Essentia Health-St. Joseph's Medical Center in Brainerd. He said the most common ticks in our area are deer ticks and the regular wood tick or dog tick. The deer tick is what carries the common diseases in this area — Lyme disease, anaplasmosis and Babesia, Laposky said.

Anaplasmosis is a disease caused by bacteria spread by tick bites, primarily from the blacklegged tick and the western blacklegged tick. People with anaplasmosis will often have fever, headache, chills and muscle aches, according to the CDC.

People get infected with Babesia from blacklegged ticks, which may have microscopic parasites that infect red blood cells. Some people develop flu-like symptoms, such as fever, chills, sweats, headache, body aches, loss of appetite, nausea or fatigue, according to the CDC.

“Anaplasmosis and Lyme are by far the most common diseases that we see. Babesia is not as common but we do see a few cases per year,” Laposky said.

There were almost 35,000 confirmed and probable reported cases of Lyme disease nationwide, according to the CDC, in 2019 — the last year for which figures are available. There were 14 cases seen at Cuyuna Regional Medical Center so far, according to Larsen.

“The last few years have seen reports of the disease continue to increase, and the range of ticks also seems to be slowly expanding further into the northern and western parts of the state,” Schiffman said.

Blacklegged ticks are found in wooded, brushy areas, according to the Minnesota Department of Health, and people who are in these areas, like outdoor enthusiasts or outdoor workers, are more at risk for being bitten by an infected tick.

“I don’t really hear a lot of people concerned about staying home because of ticks. But they do tend to look for symptoms and come in if they’re symptomatic,” Larsen said.

Lyme disease

According to the Minnesota Department of Health, there were 950 confirmed Lyme disease cases in 2018 that were reported in Minnesota.

“Although we weren’t able to monitor things as closely for the last year and a half, I don’t expect that those overall trends have altered. We are getting lots of disease reports that we follow up on, as well as a fair number of questions and public inquiries,” Schiffman said.

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The Minnesota Department of Health Vectorborne Diseases Unit works with residents to limit exposure to the ticks that cause the disease and monitor the spread of the disease across the state.

“I don’t hear a lot of people saying that they’re using insecticides to prevent ticks. I think they’re out doing their thing. And if they happen upon a tick, they take it off as soon as they see it,” Larsen said.

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Schiffman said, “Conditions have been good for ticks this year, so we would expect that they are out, and if people are out in wooded and brushy areas — like much of your area for sure — they are likely to come across ticks.

It is still the risk season for tick-borne diseases, Schiffman said, although things should be slowing down a bit from the late spring/early summer peak state health officials typically see.

“Risks tend to be lower for tick exposure in the latter half of the summer due to weather conditions and tick life cycles, but they will be out again in the fall just in time for hunting season, so it’s important for people to be aware and take precautions into the fall.”

The best treatment continues to be prevention — using insect repellents that contain DEET, taking clothes off and checking for ticks upon returning from the outdoors and putting worn clothes directly into the dryer for 15 minutes to kill any ticks, according to Laposky.

How to avoid tick bites

• Avoid wooded, brushy areas from mid-May through mid-July.

• Walk in the center of trails to avoid picking up ticks from grass and brush.

• Wear long, light-colored clothing to protect you from ticks and make them more visible if they are on you.

• Use a tick repellent with up to 30% DEET or permethrin-based repellents for clothing.

• Check for ticks, and remove them promptly.

Source: Minnesota Department of Health

FRANK LEE may be reached at 218-855-5863 or at frank.lee@brainerddispatch.com . Follow him on Twitter at www.twitter.com/DispatchFL .

1/5: All life stages of the blacklegged or deer tick. Dime in background for scale. Photo courtesy of the Centers for Disease Control and Prevention

2/5: Male and female adult blacklegged ticks on a sesame seed bun demonstrate the relatively small size of the arachnids. Photo courtesy of the Centers for Disease Control and Prevention

3/5: Illustration of the two-year lifecycle of blacklegged ticks or deer ticks. Illustration courtesy of the Centers for Disease Control and Prevention

4/5: A woman applies permethrin to her pants and outdoor clothing to repel ticks. Photo courtesy of the Centers for Disease Control and Prevention

5/5: A person checks the fit on a tick control dog collar. Photo courtesy of the Centers for Disease Control and Prevention