Forum for Nordic Dermato-Venereology Nr 3, 2018 | Page 18

Paul-Erik Uggeldahl – Ticks and humans
distribution of Ixodes ricinus in Finland mainly during the
summer period in 1958, which was published 1961 (10). Since
that date, no other extensive field study has been carried out
in this country. In her paper the author mentions the huge
number of people (400,000) and cattle evacuated, mostly
from Karelia, southeastern Finland, before the end of the
USSR–Finnish war (1941–44). Many ticks were introduced with
these mammals. Humans and animals certainly also displayed
symptoms, especially of borreliosis.
At this time, Finland lost nearly 10% of its territory to the
Soviet Union. This national and human tragedy was beneficial
for mosquitos, horseflies and ticks. The population of Ixodes
ricinus increased, perhaps permanently, in our country. The
population of Finland also diminished, because approximately
100,000 Finnish soldiers died in the two wars, 1939–40 (the
Winter War) and 1941–44. In addition, there were lots of more
or less seriously wounded soldiers.
Case reports
Patient cases are often the most interesting in articles, so here
are 3 of them – from the smallest tick to the largest (larva,
nymph, adult female):
First case: It happened in July 2008, when our granddaugh-
ter was 1½ year old. One evening we noticed what seemed
to be a “dot of a typewriter” in her left axilla. The only
larva I have seen. After much struggling of the patient, I
succeeded to remove it with a forceps. Evidently unneces-
sary. I refer to my text about larvae.
Second case: To my practice came a young mother with her
son, exactly one year old. On one of the boy’s buttocks
was a typical homogenous erythema migrans. More than
5 cm in diameter. No sign of tick-bite could be seen. And
the mother had not seen the tick, which sucks blood at
least 24 hours! I assume that it was a nymph, because an
adult tick is so much bigger. Astonishing anyhow. Looking
at a tick but not seeing (observing) it! And she was taking
good care of her son.
Third case: One August morning 2010 after waking up I saw
in the mirror on my chest an adult bloodsucking female tick
surrounded by a red area 2–3 cm in diameter – bite reaction,
not infection. With the usual method, my own fingers, I
took it away. It seemed to be bloodless, having recently
started its bloodsucking. So, what was the explanation?
All these 3 cases are from Joensuu.
80
R eview
Conclusion
Ticks are not harmless, although they are far from as dangerous
as the media would have us believe, at least here in Finland. If
symptoms of tick-borne disease develop one should visit a doc-
tor. It may be necessary for the clinician to contact a colleague
who is familiar with tick-borne diseases; consultation is the key.
Much work is needed to understand the life of ticks, and the
symptoms, diagnostics and treatment of tick-borne diseases.
If you have the will and endurance to seriously penetrate this
item, then begin from the beginning (2, 3)!
If the readers regard what I have written as a speech for the
defense of the ticks they are wright. Microbes have huge
importance for the evolution and probably also those that
ticks can transmit from one living organism to another. Ticks
have existed far longer (100 million years) than we humans
(depending on criteria: 100,000–200,000 years), and these
bloodsucking giant mites may still have a significant role in
the ecosystem of the world.
Having been involved in this “Tick business” for over 30 years,
a Russian proverb has become my favourite: “Paper will accept
any writing” – Even this one!
I express my gratitude to MD Eva Åsbrink for her remarks and
suggestions for the better of this article. The kindness and help
of the Managing Editor Agneta Andersson has been crucial.
References
1. Uggeldahl P-E. Malaria from ticks – Babesiosis. Forum for Nord
Derm Ven 2017; 22: 40–43.
2. Jaenson Thomas GT. [Medical entomology. About insects and
mites that cause human diseases.] Stockholm, Liber 1985, p. 1–95
(in Swedish).
3. Åsbrink E. Erythema chronicum migrans Afzelius and acroder-
matitis chronica atrophicans. Early and late manifestations of
Ixodes ricinus-borne Borrelia spirochetes. Acta Derm Venereol
1985; Suppl 118: 1–63.
4. Dumler JS, Walker DH. Tick-borne Ehrlichiosis. Lancet Infect
Dis 2001; 121: 21–28.
5. Junttila J, Peltomaa M, Soini H, Marjamäki M, Viljanen MK. Prev-
alence of Borrelia burgdorferii in Ixodes ricinus ticks in urban rec-
reational areas of Helsinki. J Clin Microbiol 1999; 37: 1361–1365.
6. Mejlon H. Host-seeking activity of Ixodes ricinus in relation to the
epidemiology of Lyme borreliosis in Sweden. Dissertation, Uppsala
University, Sweden, 2000.
7. Uggeldahl P-E, Peltomaa M. [Skin manifestations of Lyme bor-
reliosis.] Duodecim; 2010; 10: 1151-61 (in Finnish, with a short
English summary).
8. Uggeldahl P-E. [About the vector of the bacteria Borrelia burgdor-
feri.] Skinfo 2/2012; 39: 11 (in Finnish).
9. Uggeldahl P-E. Doxycycline deficiency syndrome: Ehrlichiosis.
Forum for Nord Derm Ven 2017; 22: 13–15.
10. Öhman C. The geographical and topographical distribution of
Ixodes ricinus in Finland. Acta Soc Pro Fauna et Flora Fenn 1961;
76: 1–37.
Forum for Nord Derm Ven 2018, Vol. 23, No. 3