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Fighting tick bites

The last accumulations of winter snow continued to melt in Grand Rapids, Minn., Six years ago when Craig Engwall approached some landscaping work at his home.

Later, when he took off his watch to clean the dishes, he noticed a small black-legged tick still in its nymph state. It's not a big deal, he thought. He eliminated the error and was happy that he had not ignored it or confused it with a sin.

The first symptoms of Lyme disease hit him hard a few days later. His joints looked like glass, "as if they were going to break," he said.

Sputum's doctor prescribed doxycycline and the antibiotic quickly made him feel normal. Two weeks later, the pain returned and he feared a relapse. He was diagnosed with babesiosis, a less common tick-borne disease that is sometimes combined with Lyme. The doctors treated him with anti-malarial drugs and he recovered.

"I was lucky to have strong symptoms right away," said Engwall, a former official with the state Department of Natural Resources who heads the Minnesota Deer Hunt Association.

self-proclaimed "missionary tick" retells his story at every opportunity. He says that the joy of outdoor recreation in Minnesota is married to the obligation to protect against tick bites and to monitor the symptoms of tick-borne disease.

"I used to think it was not a big deal, I was almost indifferent about it," said Engwall, who contracted Lyme disease for the second time and once again was quick to detect it.

Meet nature mates who were slow to eliminate deer ticks or did not receive timely treatment of symptoms. As a result, some of them suffer from chronic impairments, he said.

"I will not stop being in the forest," Engwall said. "It's just being smart and doing things well."

Minnesota's peak season for tick-borne disease is June and early July. But the first cases by 2018 have already been registered with the state Department of Health and tens of thousands of turkey hunters will be put at risk as of April 18 in a spring season ending on May 31.

Mushroom seekers, birders, nature hikers and ATV cyclists are also found in forests and fields when the state's black-leg ticks are most active from mid-May to mid-July.

"All that is needed is to get out of the ATV a little," said David Neitzel, supervisor of the Vector-borne Disease Unit at the Minnesota Department of Health.

Neitzel said that turkey hunters are especially vulnerable because they often sit on the ground for long periods in wooded habitats where so-called deer ticks are abundant. Black-legged ticks want wet conditions and gather in clumps of wet leaves, he said. And as disease-carrying ticks have spread to more places like Hubbard, Becker and Clearwater counties, they have spread throughout the range of the turkey, Neitzel said.

Rick Horton, regional biologist with the National Federation of Wild Turkey, said he learned about tick prevention in 2015. He was crawling across the Kansas prairie on a turkey hunt without taking precautions. When he got home, his wife removed 10 solitary ticks from his body with tweezers.

Then he went to see a doctor and was prescribed a complete doxycycline regimen before the symptoms could appear. In Minnesota, it is a good bet that at least two out of ten black-legged ticks can infect someone with a disease. It is known that they have seven different agents of the disease. Lyme disease is by far the most prevalent, with up to 1,400 cases per year reported to the Department of Health.

Horton said his experience made him a believer in permethrin, an insecticide intended for the application of outerwear. He covers the seams of his pants especially hard and also his rubber boots. DEET is a deterrent to ticks and can be applied to your skin, but permethrin kills ticks when they come into contact with it and can last a long time on clothing. Horton said he has not had any problems since the new routine began.

Neitzel said that black-legged ticks usually adhere to people from the ankles to the knees, but turkey hunters must also apply an insecticide to their shirt or jacket if they plan to lie on the ground.

He said the Department of Health is registering more cases of human anaplasmosis, a bacterial disease first recognized in Minnesota in the early 1990s. It was transmitted by black-legged ticks to 733 people in the state in 2016, making it the second most common tick-borne disease in Minnesota, behind Lyme. Babesiosis ranked third in 2016 with 50 cases.

"Minnesota and Wisconsin are the hot spot for anaplasmosis in the United States," Neitzel said.

And where black-legged ticks need to be joined for a day or two to transmit to Lyme disease, the black-legged tick can take as little as half a day to transmit anaplasmosis.

Here are more tips from the state Department of Health on ticks. Again, early recognition and prompt medical attention are vital:

• Inspect your body for ticks and remove them. Even nymph stage ticks smaller than the tip of a pencil can transmit diseases.

• For about a month after a known tick bite, observe symptoms that include a rash, muscle aches, excess fatigue, or other changes in your health.

• Keep any ticks that have been removed in a bag marked with the date of the bite.

• Call your doctor if you are bitten several ticks in a short time.

• More than one third of adult black-legged ticks carry Lyme disease.

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