It was during the dog days of summer, 1963 in the Cariboo region of British Columbia that I saw my first case of tick paralysis. The second case was seen a few weeks later.
The emergency room of the dilapidated rural hospital in Williams Lake was abuzz after the Williams Lake Stampede, an annual July 1st event. Things were slowly settling down after a week of drinking, steer decorating, saddle bronc busting, calf roping and quarter horse races and accidents. The dust was slowly settling as the First Nations people loaded their kids and summer supplies in their Cayuse pulled covered wagons and with their quarter horses trailing, they headed home across the Fraser River for the Chilcotin.
My first patient July 3rd was Judy, a blond, blue eyed six year old girl. Her folks ran a neat and tidy motel in the town but also had a small hobby ranch just west of town on the Dog Creek road. The two kids had spent the previous five days at their ranch playing with the dogs and riding their ponies. Her mother explained, “Judy, my daughter had wanted to come into town early in the morning. She had not been feeling well and had fallen down a few times. Joey, her younger brother was still at the ranch with Dad, riding their pony Daisy.”
Usually, Judy was an alert, strong happy young girl on the go. This pretty blond little girl had golden thick braids. When I first saw her she seemed unsteady on her feet and held onto Mom for support and complained of a funny feeling in her legs and a headache. Mother assured me that she had been given her Salk vaccine, an inoculation to prevent polio, at the beginning of grade one, ten months ago and no one was sick at home. I had to find another cause of weakness of Judy’s legs now that polio had been ruled out.
My examination revealed marked weakness of her lower extremities and absent knee and ankle reflexes but little else. Her Complete blood count and her spinal fluid revealed no abnormalities. Then, on a hunch, I asked the mother to undo Judy’s braids and re-examined Judy.
Under the knot in her upper braid I found a large engorged female tick, a Rocky Mountain Wood Tick called Dermacentor andersoni. Her mother was flabbergasted that her daughter should have an engorged tick on the back of her neck but relieved when I explained that once I removed the tick Judy would make a full recovery from tick paralysis.
We decided to keep Judy in the hospital overnight and in the morning this sweet little girl was back to her normal self. The next morning she said, “She wanted to see her kitty, Tigger and ride their pony, Daisy.”
Tick paralysis is not due to an infective agent but is due to the secretions of a neurotoxin by the blood feeding, egg filled, mother wood tick. In the Cariboo, there are few human cases but many cattle and sheep die of tick paralysis. The disease is well known to veterinarians
The second case of tick paralysis was a First Nation 12 year old boy from the Chilcotin region. He was brought to the hospital by Nursing Sister Roberte of the Alexis Creek Catholic Mission, from the Redstone reserve. This little guy had paralysis of his lower legs and had difficulty breathing. Sister Roberte didn’t think he’d had any of his immunization but according to his grandmother said, “Joey had been sick for over a week.” The parents had been away salmon fishing at Farwell Canyon on the Chilcotin River since the Williams Lake Stampede, July 1st.
This skinny little guy, Joey, had complete paralysis of his legs and had difficulty breathing. I located an engorged tick in his ear. The tick had completely filled his ear canal and I had to remove the tick in small pieces. I then intubated Joey, placed an endotracheal tube in his trachea and started resuscitation with an Ambu inflatable bag. With my partner, Hugh Atwood, we bagged him for 18 hours. The Cariboo War Memorial Hospital did not have a mechanical ventilator at this time.
The tick neurotoxin, secreted by the female tick salivary glands, was now in complete control of Joey and slowly he became unresponsive. Joey died the next morning. This was a sad rare human death from tick paralysis.
By: Sterling Haynes