You just got back from a week of camping or a weekend of hiking. A few days later, you get a sudden high fever, a terrible headache, and terrible muscle pain. You might want to write it off as just a summer flu, but if you've been around ticks, it could be something worse: Ehrlichiosis. This common illness that comes from ticks needs a lot of suspicion and quick treatment to stop serious problems from happening. In this case, the Direct Primary Care (DPC) model's quick access and ability to take action can be a very important health benefit.
Ehrlichiosis is a bacterial infection that people get when they are bitten by an infected tick, most often the lone star tick (Amblyomma americanum). The southeastern and south-central parts of the United States have the most of it.
What the "Summer Flu" Symptoms Are: The sickness usually starts 1–2 weeks after a tick bite with flu-like symptoms that aren't very specific and can be mistaken for other viral illnesses:
Chills and fever
Very bad headache
Fatigue and muscle pain (myalgia)
Diarrhea, vomiting, and nausea
About 30% of adults get a rash, but it's less common in kids. Not having a rash does not mean you don't have the disease.
The Risk of a Late Diagnosis: Ehrlichiosis can be serious, but most cases are not. If not treated right away with the right antibiotic, the infection can get worse and lead to serious, sometimes life-threatening problems, such as:
Acute respiratory distress syndrome (ARDS)
Failure of the kidneys
Bleeding that can't be stopped
Harm to the central nervous system
Failure of multiple organs
Older people and people with weak immune systems are much more likely to get serious diseases.
Direct Primary Care (DPC) is a membership-based system that lets patients talk to their doctor anytime they want. The DPC model is a game-changer for an illness like ehrlichiosis that comes on suddenly and needs to be treated right away. DPC is the best option for this condition because:
Quick access, early diagnosis, and quick treatment: This is the most important and life-saving thing that DPC does.
Evaluation Right Away: If you get a fever and headache after being around a tick, you can see your DPC doctor the same day or the next day.
A High Level of Suspicion: If you have time for a full history, a DPC doctor will ask about your recent outdoor activities and exposures. This will make them think about tick-borne illnesses as one of the most likely causes.
Your DPC doctor will start you on the antibiotic doxycycline right away based on your symptoms and how long you have been exposed to it. The CDC's expert guidelines say that treatment should start based on clinical suspicion alone, without waiting for blood tests that can take days to come back. This early treatment is the most important thing to do to avoid serious problems.
Care that is right for all ages and follows the rules: Your DPC doctor can give you clear, evidence-based advice.
They know that the CDC and the American Academy of Pediatrics strongly recommend doxycycline as the first-line treatment for suspected ehrlichiosis in people of all ages, even young children.
They have the time to tell parents why this medicine's life-saving benefits are much more important than any old worries about giving it to kids.
Close follow-up and reassurance: Your DPC doctor is there to help you get better.
Continuous Monitoring: Your doctor can check in with you every day for the first few days of treatment to make sure your fever is going down and you are starting to feel better. DPC makes it easy for you to talk to your doctor by text or phone.
Peace of Mind: This close supervision is a very important safety net and source of comfort while you get better from a bad infection.
Case 1: David, 50, calls his DPC doctor on a Monday because he has had a high fever, a bad headache, and body aches for two days. He says he was clearing brush on his land in Missouri over the weekend. His DPC doctor wants him to come in right away. The doctor draws blood for testing because he thinks David has a high chance of getting a tick-borne illness. He also gives David his first dose of doxycycline in the office and a prescription to fill that day. David's fever goes down in less than 36 hours.
Case 2: The parents of 8-year-old Emily are worried because she has a fever and is very tired after a camping trip. Their DPC doctor sees her right away. The parents are unsure about her taking doxycycline. The DPC doctor calmly explains the CDC and American Academy of Pediatrics recommendations for 20 minutes, telling them that a short course is safe and that the risk of not treating ehrlichiosis is much higher. The parents agree, and Emily starts the treatment. She gets better quickly at home.
Q: I never saw a tick on me. Is it still possible that I have ehrlichiosis? A: Yes. The nymphs of the lone star tick, which are often the ones that spread the disease, can be as small as a poppy seed and don't hurt when they bite. A lot of people who have ehrlichiosis don't remember getting bitten by a tick. The most important clue is a history of living in an area where ticks are common, like woods, tall grass, or fields.
Q: Why would my doctor start treatment before the test results come back? A: Because time is very important when you have ehrlichiosis. It can take a few days for the confirmatory blood tests to come back. There is a high risk of serious, life-threatening problems if you wait to get treatment, but there is a very low risk if you take a short course of doxycycline. Because of this, expert guidelines say that treatment should start based only on clinical suspicion in the right setting.
Q: I thought doxycycline was bad for kids? A: This is an old worry based on older drugs in the same class. The CDC and the American Academy of Pediatrics both say that doxycycline is the best and safest treatment for people of all ages who have serious tick-borne diseases like Ehrlichiosis and Rocky Mountain Spotted Fever. The drug's life-saving benefits far outweigh the small, if any, risk of staining teeth that comes with a short course of treatment.
DPC has a clear advantage for this serious infection because:
Providing Life-Saving Rapid Access & Treatment: DPC's ability to see sick patients right away and start doxycycline based on suspicion is the most important thing that keeps people from getting very sick.
Encouraging care that follows the guidelines: DPC doctors have the time and the relationship to make a confident clinical diagnosis and avoid dangerous delays while waiting for test results.
Doing a great job of preventing problems through education: The DPC model gives you the time you need to get detailed advice on how to avoid getting bitten by ticks in the future.
You can't wait and see when you suddenly get a high fever after being outside in an area where ticks are common. It could be a serious illness spread by ticks, and every hour of delayed treatment counts. Direct Primary Care gives you immediate access and decisive, life-saving action so you can diagnose and treat ehrlichiosis as soon as possible, keeping you and your family safe.
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