Confirming Long-held Fears, State Health Department Says Arkansas Ticks Transmit Lyme

Mar 5, 2017

Mom, Alarie Bowerman, with daughters, Emory, Anais and Elise. Emory and Anais are the first two documented cases of Arkansas Lyme disease contracted in-state.
Credit J. Froelich / Arkansas Public Media

Last May, sisters Anais, Elise and Emory Bowerman spent the night at a Girl Scout slumber camp in Lowell. The girls came home the next day covered with ticks. 

“One second my life was going great," says Anais, 11. "Then a tick bites me and it’s all ruined.”

Anais, a budding artist, says her hands started to shake. Her sisters Elise, 10, and Emory, 7, also started to feel ill.

“I threw up twice," Emory says. "I felt sluggish and my head was kind of dizzy.” 

Their mom, Alarie Bowerman, had sprayed the girls with tick repellant before dropping them off at the sleepover. Still, she and her husband Josh removed 27 ticks from the girls' bodies.  By Sunday, Emory and Alise complained of headaches and fatigue. Mom took the girls to a walk-in clinic where they received oral antibiotic treatment. Afterward, Emory, who her mom says had stopped speaking, developed a strange mark between her toes.

“It looked like a bruise," Alarie says. "It was purple around the bite.”

Emory had a bulls-eye rash, characteristic of Lyme disease. When Lyme-infected ticks bite a human, they inject Borrelia burgdorferi spirochetes, corkscrew bacteria, which churn outward in a circular pattern just under the skin, creating a bruised halo. Left untreated Lyme bacteria can invade the heart and nervous system.

Arkansas authorities have long insisted that Lyme disease-carrying ticks are extremely rare in Arkansas. Bowerman says she had to convince her pediatrician to test the girls’ blood for Lyme. She then followed up with an out-of-state Lyme disease specialist — none practice in Arkansas. That physician, she says, later conferred with Arkansas Department of Health officials to confirm the girls were indeed Lyme positive.

This past February, Arkansas Department of Health tick disease specialists contacted the Bowermans. They were told because Emory and Anias met the U.S. Centers for Disease Control surveillance definition for Lyme disease. They were the first cases in 10 years to have contracted Lyme, and the first since state record keeping to have been infected in Arkansas. 

“The tick that transmits Lyme disease is the blacklegged tick, Ixodes scapularis," says Dr. Dirk Hazlow, state epidemiologist with the Arkansas Department of Health.

They're also called deer ticks.

Experts who study them say Southern ticks acquire Lyme bacteria from feeding on the blood of infected birds, lizards and mice. Given ticks seek only two blood meals in their life cycle, tick-to-human transmission rates are rare to impossible, they say.

Social network groups like Arkansas Bytes Back and the Arkansas Lyme Foundation--inhabited by Arkansans claiming to have contracted the tick-borne illness in Arkansas, insist getting Lyme disease in Arkansas is very possible.

The CDC has estimated for several years now  that more than 300,000 Americans a year are infected with Lyme Disease, primarily in Pennsylvania, New York and the upper Midwest. The International Lyme and Associated Diseases Society says five subspecies of borrelia burgdoerferi along with one hundred strains are now present in the U.S., strains which society experts believe may evade antibiotic therapy, leading to chronic infection.

To determine the presence of tick-borne illness the Arkansas Department of Health is collaborating with insect scientists at the flagship campus in Fayetteville who are sampling certain environments for ticks to identify tick-borne disease organisms. A University of Arkansas for Medical Sciences team is also investigating Borrelia species that may be present in the state.

Last year, the Arkansas Department of Health received 2,000 tick illness case reports. Half of those met the case definition for tick-borne illness. In Arkansas the most common ticks are the American dog tick, which spreads Rocky Mountain Spotted Fever and tularemia, and the Lone Star tick, a vector for ehrlichia, tularemia, and Southern Tick Associated Rash, or STARI — a disease which can mimic Lyme disease, says Dr. Dirk Haselow.

“People have a fever and develop a rash," he says. "But thankfully STARI is self-limiting.”

Left untreated, Lyme disease can affect the nervous system, cognition and immunity, but proving a person has it, especially chronic Lyme illness, is difficult, says Dr. Dirk Haselow.

Black-legged tick
Credit Arkansas Department of Health

“Testing for Lyme is complicated, so we recommend it be done in two stages," he says. "The first is a Lyme screening, a blood test that looks for antibodies, and the second phase, if positive, is the Western blot."

Haselow says the Western Blot has two components which test for various immunoglobulin measures or antibodies in the blood, proteins made by the immune system to fight antigens, such as bacteria, viruses, and toxins. To be positive, you must have a certain number of antibodies. The process is not exact, depending on the amount of antibiotics consumed at symptom onset and testing time frames, all of which can yield both false negatives and false positives. The CDC, Haselow says, is currently looking for simpler algorithms to test for Lyme.

The Infectious Disease Society of America suggests a course of doxycyline to treat acute Lyme cases. Chronic Lyme, what the CDC refers to as "Post-Treatment Lyme Disease Syndrome" which can result in residual damage to tissues and the immune system, may require a different course of treatment, an issue which is currently under intense debate. 

Given Lyme disease has officially been detected in Arkansas ticks, the state health department, with a recently awarded $15,000 grant, plans to further educate the public.

As for the Bowerman girls? 

Emory, her mother Alarie says, has recently starting to talk again. Anais still copes with hand tremors. And sister Elise who hopes to be a geologist when she grows up, has been afraid to go outside.  

But this summer the girls have decided, along with their three brothers, to attend War Eagle Camp, located deep in the Ozark forest.

This story is produced by Arkansas Public Media. What's that? We're a nonprofit journalism project for all of Arkansas and a collaboration among public media in the state. We're funded in part through a grant from the Corporation for Public Broadcasting, with the support of partner stations KUAR, KUAF, KASU and KTXK. And, we hope, from you! You can learn more and support Arkansas Public Media’s reporting at arkansaspublicmedia.org. Arkansas Public Media is Natural State news with context.