The birthday gift I didn’t know I got

I wrote my last blog entry, about the loss of a half a thyroid along with its cancer, the morning after the surgery. That was during a calm moment similar to right now.  I had no idea how short that moment was going to be.  An hour later I was chilled, and soon I was in bed with all the blankets on me that I could get my hands on. By seven PM I was in the ER with a fever of  104 F, writhing around in an isolated “Covid suspect” room. I explained to the ER doctor about the thyroid surgery the day before, and the immunosuppression due to chemo for lymphoma and even the vaccinations I had gotten a few days earlier in preparation for moving to India. He looked at me, a middle aged lady in pajamas with a post chemo hairstyle, and said “Maybe you have a tick borne disease.” I think the nurses assumed it was Covid.

 They took blood for many tests and gave me some meds for nausea and to bring down the fever.  After a few hours the fever went down and the covid test came back negative. The doctor was still fixated on ticks, and it was clear from blood and urine tests that I had some type of infection, so he gave me antibiotics and sent me home. That was Friday. By Sunday the fever was mostly gone but I was still feeling bad.  Monday night Dr. Law, the endocrinologist, called to tell me that I had indeed tested positive for the tick borne disease Borrelia miyamotoi.  The treatment for it is the antibiotics I had started Friday night.

Borrelia miyamotoi isn’t very well known. It was first identified in Japan in 1995. It is closely related to the bacteria that cause Tickborne Relapsing Fever, which is surprisingly vectored by both lice and ticks (surprising becuase ticks and lice are about as closely related to each other as are spiders and butterflies). It is more distantly related to the bacterium that causes Lyme disease.  It is carried by deer ticks as well as some other tick species.

I thought hard about when the last time I had found a tick on me might have been, and came up with September 12th, which was a beautiful late summer day…my birthday! I was rooting around in the brush between the East Hill Recreation trail and Dilmun Hill student farm on the Cornell campus, preparing for the Ecological patterns Bingo game lab (photo, above) that I taught near there later that week for the Ecology course I am co-teaching.  On my way home I found a tick feeding on my forearm, and took it off.  It had fed for only three hours at the most.  Recently I read that unlike Lyme disease, Borrelia miyamotoi  can be transmitted quickly.

Now a week later I am feeling much better, but still beat. The ER doctor, Dr. Forest, called the other day.  I thanked him for sticking with the tick disease idea.  He said there are a lot of tick borne disease cases around these days (not Borrelia miyamotoi).  But then he also said “I send in a lot of those multi-tick disease screening panels and this is the first one that has come out positive.”

Getting a tick borne disease, even a rare one, in itself isn’t a big surprise.  I am an entomologist and I do wander around outside. I have had Lyme, twice.  It is much less of a surprise to me than having lymphoma or thyroid cancer.  However, coming down hard with a tick borne disease the day after surgery for thyroid cancer was surprising timing.