'Tick paralysis' strikes girl, 2
Doctors initially stumped; her recovery is fast
The tick found on Jenna Tomlins. / Courtesy photo
Jenna Tomlins, 2, of Hopewell Junction was paralyzed when she was bitten by an American dog tick this month. She has made a full recovery. / Courtesy photo
What to do if you find a tick attached to you or your child
Health professionals are
looking into a rare case of a little girl who was paralyzed after being bitten
by an American dog tick.
The 2-year-old was unable to eat or drink — immobilized by a potentially fatal illness — when she was brought to Albany Medical Center this month. Jenna Tomlins woke up May 4 feeling tired and lethargic.
“She couldn’t stand up, she couldn’t really move,” said her mother, Rachel Tomlins, 25, of Hopewell Junction. “I just thought maybe she was tired. She was up late the night before.”
Her mother recalled the girl having trouble drinking.
“That’s when I called the pediatrician,” she said.
The doctor suggested the girl, who had no rash or fever, get some fresh air. When she appeared weaker, she was brought to a local emergency care center.
“The doctor was completely baffled, so we took her to Vassar,” Tomlins said. “She had X-rays, CAT scans, urine analysis, blood tests and a spinal tap. They thought maybe she had botulism.”
But the tests came back negative. By then, the child’s tongue had swelled.
“She couldn’t even cry,” Tomlins said.
The girl was rushed to the Children’s Hospital at Albany Medical Center, where she underwent further testing and was given an intravenous therapy.
“She was very lethargic. She had difficulty opening her eyes,” said Dr. Karen Powers, assistant professor of pediatric neurology at Albany Medical Center. “She couldn’t speak. She had difficulty swallowing. She was profoundly weak. She couldn’t move her arms or legs.”
Powers recognized her symptoms as nearly identical to a case she had seen a few years ago while on a fellowship in Richmond, Va., in which a young child suffered from “tick paralysis.”
“It’s a disorder caused by a neurotoxin secreted most commonly by the American dog tick,” Powers said. “It causes an ascending paralysis. Children will present first with difficulty walking or standing as paralysis ascends. The trunk muscles become involved, and there’s difficulty sitting. Then the face muscles are affected, and they have difficulty speaking and swallowing. Eventually, the respiratory muscles become involved, and that can lead to an inability to breathe. Cases can be fatal.”
The doctor looked through the toddler’s hair and scalp, where she found an attached dog tick.The 2-year-old was unable to eat or drink — immobilized by a potentially fatal illness — when she was brought to Albany Medical Center this month. Jenna Tomlins woke up May 4 feeling tired and lethargic.
“She couldn’t stand up, she couldn’t really move,” said her mother, Rachel Tomlins, 25, of Hopewell Junction. “I just thought maybe she was tired. She was up late the night before.”
Her mother recalled the girl having trouble drinking.
“That’s when I called the pediatrician,” she said.
The doctor suggested the girl, who had no rash or fever, get some fresh air. When she appeared weaker, she was brought to a local emergency care center.
“The doctor was completely baffled, so we took her to Vassar,” Tomlins said. “She had X-rays, CAT scans, urine analysis, blood tests and a spinal tap. They thought maybe she had botulism.”
But the tests came back negative. By then, the child’s tongue had swelled.
“She couldn’t even cry,” Tomlins said.
The girl was rushed to the Children’s Hospital at Albany Medical Center, where she underwent further testing and was given an intravenous therapy.
“She was very lethargic. She had difficulty opening her eyes,” said Dr. Karen Powers, assistant professor of pediatric neurology at Albany Medical Center. “She couldn’t speak. She had difficulty swallowing. She was profoundly weak. She couldn’t move her arms or legs.”
Powers recognized her symptoms as nearly identical to a case she had seen a few years ago while on a fellowship in Richmond, Va., in which a young child suffered from “tick paralysis.”
“It’s a disorder caused by a neurotoxin secreted most commonly by the American dog tick,” Powers said. “It causes an ascending paralysis. Children will present first with difficulty walking or standing as paralysis ascends. The trunk muscles become involved, and there’s difficulty sitting. Then the face muscles are affected, and they have difficulty speaking and swallowing. Eventually, the respiratory muscles become involved, and that can lead to an inability to breathe. Cases can be fatal.”
“It was engorged and about the size of a pencil eraser,” Powers said.
The tick was removed with tweezers.
“Tick paralysis is very rare in this region,” Powers said. “It’s far more common in the South and Pacific Northwest areas of the country. The last case reported in New York state was in 1998.”
The American Journal of Medical Toxicology says only 50 cases of tick paralysis have been well-documented in the U.S. between 1946 and 2006. Powers said the tick-borne disease differs from Lyme disease, which is caused by a bacterium carried by deer ticks.
“With Lyme disease it’s an infection, and some of the ticks have it and some of them don’t,” Powers said. “This toxin is inherent in the tick.”
However, this does not mean all people bitten by American dog ticks will suffer from tick paralysis. “The tick needs to be female and at a certain feeding stage,” the doctor said. “She has to be attached, and the neurotoxin has to be released.”
Tick paralysis most commonly affects small children, Powers said, the thought being the toxin is less potent for adults because of their larger mass. Treatment involves the removal of the tick. “Once the tick is removed, the body clears the toxins and the patient can recover,” Powers said.
According to the state Department of Health, American dog ticks also can carry the bacterium that causes Rocky Mountain spotted fever. Dog ticks are reddish-brown and larger than deer ticks, ranging in size from a match head to a pea. The DOH says that both deer and dog ticks are most active during the spring, early summer and fall.
Little more than 24 hours after the tick was removed, the toddler had regained her speech and her ability to walk. “She was perfectly normal, as if nothing ever happened,” Tomlins said.
She said doctors needed to more aware of the dangers posed by ticks in the area.
“They need to be more educated on how serious a threat ticks can be,” Tomlins said, noting the family contacted several doctors before her daughter’s illness was identified.
The mother, whose home is in a woodsy area, said it was the first time a tick had been found on one of her children.
She advised other parents to double- and triple-check their children for ticks when they come in from playing outside.
“If it happens, don’t play doctor,” Tomlins said. “Go and get help.”
