Newtown resident Chuck Stevens is a strapping six-foot, 200-plus-pound contractor who hasn't allowed several bouts with Lyme disease get him down. But it only took one of those poppy-seed-sized insects to - diplomatically speaking - knock him on his backside thanks to a recently discovered coinfection.

"I'm a big guy, and some days I can't even move," Mr Stevens told The Newtown Bee recently. "I can't imagine how this must affect little kids."

After discovering he was bitten by a tick on a job site last fall, Mr Stevens said he watched and waited for some of the typical signs of Lyme disease to hit, but felt okay after several weeks. Around the same time, however, he began experiencing escalating severe ankle and knee pain, so he consulted his physician.

While a negative test for Lyme was delivered, the pain continued to get worse, and on occasion Mr Stevens found himself so weak and fatigued that he spent days just trying to muster the energy to get out of bed. Then came the results of additional blood tests, which revealed he had babesiosis.

"Babesia is just one of a number of coinfections you can get from a tick bite," he said. "It's treated like malaria with specific medications and antibiotics, but I'm told it's never cured once you get it. The best I can hope for is it goes into remission."

Mr Stevens said he decided to reach out to The Bee, because he is afraid his Newtown neighbors may be so tuned into the threat of Lyme, that they may be ignoring symptoms of something much more invasive, and dangerous.

Coinfections Detailed

Kirby C. Stafford III, PhD, chief entomologist, state entomologist at the Connecticut Agricultural Experiment Station in New Haven, has identified a host of coinfections that can be transmitted by tick bites. They include: Anaplasmosis, babesios, spotted fever Colorado tick fever, ehrlichiosis, Ehrlichia muris-like agent, Heartland virus disease, Lyme disease, Stari (Southern tick-associated rash illness), Powassan encephalitis, Rocky Mountain spotted fever, relapsing fever, and tularemia.

According to a 2014 report by Dr Stafford, babesiosis is a malaria-like illness caused mainly by Babesiamicroti, a protozoan parasite of red blood cells. The protozoan is spread principally by the bite of the blacklegged tick, Ixodes scapularis. Signs and symptoms include fever, fatigue, chills, sweats, headache, and muscle pain, beginning usually one to six weeks after the tick bite.

From 1991 through 2013, he writes that 2,155 confirmed or probable cases of babesiosis have been reported to the Connecticut Department of Public Health, with almost 20 percent of those cases in Fairfield County. Babesiosis can be severe or fatal in the elderly, immunocompromised individuals, and people without spleens. Death has been reported in about five percent of cases. The greatest incidence of severe babesiosis occurs in those older than 50.

Anaplasmosis and ehrlichiosis are diseases of both animals and humans are caused by several bacteria in the genus Anaplasma and Ehrlichia.

Human monocytotropic ehrlichiosis (HME) was first described in the mid-1980s, and is typically transmitted by the lone star tick. White-tailed deer, a major host for all motile stages of the lone star tick, are a reservoir host. The lone star tick is uncommon in most of Connecticut, Dr Stafford reports, but residents living mainly in coastal communities in Fairfield and New Haven Counties occasionally being bitten.

Nonspecific signs and symptoms for both diseases include fever, headache, muscle pain, nausea, vomiting, and malaise. Most patients show a decrease in their white blood cell and blood platelet counts. Illness may be mild, moderate, or severe and is generally self-limited, resolving in a few weeks. However, fatalities do occur and treatment should be started promptly.

As far back as 2010, Connecticut, New York, New Jersey, Rhode Island, Wisconsin, and Minnesota produced 90 percent of the cases of human anaplasmosis and ehrlichiosis.

Rocky Mountain spotted fever (RMSF), caused by Rickettsia rickettsii, is rare in Connecticut and New England; however, cases have occurred in New York City. In the Eastern United States, the American dog tick is the insect responsible for carrying this disease. Scientists at the Connecticut Agricultural Experiment Station found that less than one percent of 3,000 American dog ticks examined in Connecticut contained spotted fever-group organisms.

Dr Stafford says symptoms usually appear within two to nine days after a tick bite. Symptoms include sudden fever (90 percent of 1989 cases), headache (89 percent of cases), muscle pain (83 percent of cases), and rash (78 percent of cases). The rash is noticed two to four days after illness begins and may include the palms (50 percent of cases) and soles of the feet.

The report indicates that most other tickborne diseases on Dr Stafford's list either do not occur yet in Connecticut, or had only occurred in a tiny fractional number of Connecticut residents as of the publication of his report.

Time To BLAST Ticks

Locally, Donna Culbert, director of heath at the Newtown Health District, knows that tick season has begun. So she said the Health District, along with its community partners, will be doing their best to get the word out about the risk of tick bites, tickborne disease, and how to protect themselves.

"We are in tick country," she said. "If you haven't seen one yet, you are among the few - and it won't be long."

Ms Culbert shares Mr Stevens' concern that these other tickborne diseases, in addition to Lyme, that have become more prevalent in recent years, but are not necessarily well known to the public unless they or a loved one has been affected.

Lyme disease is caused by the bacterium Borrelia burgdorferi and is transmitted through the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. It is known that many patients do not develop the rash or do not detect it. If left untreated, infection can spread to joints, the heart, and the nervous system.

The health director said it is important to remember that one tick can transmit more than one disease, or coinfection.

"All the more reason to take precautions to prevent tick bites," Ms Culbert said. "Tickborne disease isn't just Lyme disease and ticks and tickborne disease aren't going away, so it's up to you to take action. With no available effective vaccine and no consistently efficient and comprehensive method to reduce ticks, understanding the risks and avoiding tick bites are key steps to preventing tickborne disease."

The Health District encourages residents to learn more about ticks and tick bite prevention and to remember its BLAST message. BLAST stands for five important things

you and your family can do to stay safe from tick-borne diseases:

BE AWARE of the risks of tickborne disease:

B also stands for Bathing soon after spending time outdoors.

L reminds everyone to Look their bodies over for ticks daily and for expanding rashes.

A encourages you to Avoid ticks when possible and, when you cannot, apply repellent

S stands for Safeguarding your yard to reduce your possible tick exposure;

T reminds everyone about Treatment. Receiving early medical treatment is the key to preventing long-term health effects. It is also important to treat your pets.

Helpful, detailed information about the BLAST message can be found on the Newtown Health District's web page at newtown-ct.gov/health-district.