A new-to-us tick-borne disease in Northern Michigan

By Aubrey Ann Parker
Current Editor

“I’ve had Lyme disease before,” says Gerard Grabowski (64) of Bear Lake. “This was different.”

Back in June 2022, Grabowski was having night sweats, and they were getting progressively worse.

“He was sick for almost three weeks before we realized what was going on,” says his wife, Jan Shireman (64). “During the day, he’d feel okay again.”

Grabowski interjects:

“With Lyme, I felt bad all the time.”

A tall and lanky man, Grabowski is fit—he spends his winters cross-country skiing and his summers working outside.

Already considered thin, when he lost 30 pounds in less than a month, his wife recalls telling him:
“Gerard, I’m terrified. I think you might have cancer. You are losing weight rapidly.”

That is when he went to seek treatment.

It was Maryann Smith, a physician assistant at the Crystal Lake Clinic in Manistee, who diagnosed Grabowski with anaplasmosis, a tick-borne disease that is actually carried by the same black-legged tick (Ixodes scapularis)—known commonly as a “deer tick”—as carries Lyme disease. Grabowski says he was prescribed doxycycline, an oral antibiotic, twice daily.

“It reminds us that we are not at the top of the food chain,” Grabowski says. “We never found a tick on me. We are people of the soil, so we have to be outside where the mice and the deer and everything live, too, so we are pretty vigilant about checking.”

Grabowski says that the disease created “such a debilitating brain and body connection,” so that he “couldn’t think straight.”

“That was the first year it had even been in Manistee County,” Grabowski says. There were 13 confirmed and suspected cases that year, according to local health district records. “And then Bernie was a few months after me.”

Grabowski is talking about Bernie Ware (75), a farmer who lives just down the road who was hospitalized for five days with anaplasmosis.

“He lost an incredible amount of weight, too. And he’s 12 years older than us,” Grabowski says, “It almost took him out. He was skinny.”

Bernie Ware’s wife, Sandee Ware (70), explains:

“He started to seem off. He was still in a collar, because he had broken his neck earlier in the year. This was near the time he was getting the collar off. It was October, and he was leaving for a men’s weekend. I remember thinking he seemed confused, like he couldn’t figure out how to turn the oven off and on, and that was odd. That was on a Thursday, and he left on Friday. He came back on Sunday, and he’d been miserable all weekend with a fever and chills. So I took him to the [emergency room] on Monday.”
She says that she dropped her husband at the door of Munson in Traverse City, and she went to park the car.

“They asked him why he was there, and he was confused and just said a fever. So they tested him, and it
was only 99. It had been going way high and way low, so at that point, it was within the normal range,” Sandee Ware says. “He immediately went downhill, and he was out of his head and his body. It was really scary.”

By Wednesday, now two and a half days into his hospital stay, Sandee Ware asked the physicians if they thought it maybe had to do with a tick bite from six weeks prior to his initial symptoms.

“That’s when they got the specialist, the infectious disease doctor,” says Sandee Ware, who keeps every single tick that the couple pulls off of each other, taping them to a piece of paper and writing down the date and other information, just in case it was ever needed for a moment just like this.

At this point, Bernie Ware was prescribed doxycycline on Wednesday, and he was discharged from the hospital on Friday.

“I could tell within an hour it was working,” Sandee Ware says. But it was still a long road to recovery. “He couldn’t walk or do anything. He came home with a walker.”

A blood test was sent to Mayo Clinic in Minnesota on that same Wednesday that he began the new antibiotic, and the results came back the next week as positive for anaplasmosis.

Now more than two years later, the Wares continue to work outside and practice active measures to keep ticks at bay.

“Still, I had a bite every month from February to November last year,” Sandee Ware says.

It Hits Home
Grabowski and Ware are not alone; The Betsie Current spoke with several others in Northern Michigan who were diagnosed with anaplasmosis themselves, or their pets were. We also spoke to doctors, veterinarians, and the local health departments, as well as combing reports on the subject.
All of this research started because we had quite a scare ourselves last fall when we got back from a Halloween party.

Around 6 p.m., we had left our 2.5-year-old dog, Indie, in the back-of-the-house upstairs bedroom, so as to minimize her disturbance by trick-or-treaters coming and going on the street while we were gone.
When we got back around midnight, six hours later, she was acting odd—she was shaking, and she just seemed a little goofy.

We wrote it off as anxious nerves from the hundreds of people who had descended upon the streets of Frankfort earlier in the evening—she probably had felt the need to “stand guard” and defend the house.
The next morning, she was still not right, though—she was still shaking, plus now we could tell that she was lethargic, barely getting out of bed. Typically, we are greeted with a wagging tail and a happy girl, who is ready to meet the day.

But there was no tail-wagging.

I immediately called Betsie River Veterinary Clinic in Benzonia, and Dr. Susan Daly was able to get her in right away. Indie was running a fever—107 degrees Fahrenheit, when a dog is typically between 100 to 103 degrees.

Before she even ran the blood test, Dr. Daly called it: “I think this is anaplasmosis. It’s a tick-borne disease.”

We, of course, had heard of Lyme disease, and we work pretty hard to prevent it: Indie has had the Lyme vaccine that is available for dogs—though, unfortunately, not humans—and she takes oral tick medication monthly. Plus, we are very diligent in checking her for ticks when we get home after an outing in the woods. At this point in her young life, I think that we had only ever found three ticks attached to her.

One of those had been attached just four days before this had all started; it had only been attached for fewer than three hours, so it was not engorged, and we had not worried much about it, since conventional wisdom is that it typically it takes 24 to 48 hours for an attached tick to transmit Lyme disease—plus, she had been vaccinated against Lyme.

At that point, we had never even heard of anaplasmosis.

The official literature, depending on what source you are reading, says that it takes between 12 to 36 hours for a tick to convey anaplasmosis into its host, but Dr. Daly told us that her work in the field is contradicting that. Moreover, she is now seeing anaplasmosis cases rising faster than Lyme disease rates.

“The presence of anaplasmosis [in dogs] has increased every year, while Lyme has tapered off,” Daly says

“People are better at fighting [Lyme] now; better at tick control, and it takes a day to transmit from the tick once it’s attached to a host—they’re less likely to get it, as long as the tick doesn’t stay on too long.”
Obviously it helps that there is also a vaccine for Lyme—and none currently for anaplasmosis.

But Daly believes there is more to it than that, and she hopes that more studies will be done soon as an update on the transmission times for anaplasmosis, because of what she is seeing in her office.

“We see anaplasmosis frequently in dogs who are on oral tick medication,” says Daly, who explains that these oral medications claim to be killing attached ticks within a shorter time window than the 12 to 36 hours reported for anaplasmosis to enter the dog’s bloodstream.

Cornell University’s College of Veterinary Medicine’s website says:

“Oral preventatives containing isoxazoline (e.g. Nexgard, Simparica, Credelio, Bravecto) do not prevent tick attachment, but they have a relatively fast tick kill time. The tick kill time is important to note because of the diseases that can be spread if a tick remains attached and alive too long.

Meanwhile, PetMD’s website says:

“Oral tick medications typically start killing ticks within a few hours, with some beginning to work in as little as 30 minutes for some medications. For example, Credelio can begin killing ticks within four hours, while Simparica can kill ticks within eight hours. Some medications, like Bravecto, may take up to 12 hours to kill all attached ticks.”

The point is: there seems to be a disconnect between the time that official reports say it takes for anaplasmosis to be transmitted from a tick to a host and the time that the pharmaceutical industry says that the oral tick medications are killing attached ticks—and it seems like more research in this area is needed to better understand this discrepancy.

The Betsie Current reached out to a tick specialist scientist at Michigan State University for more information, but as of press time, had not heard back.

With what she knows at this point in time, Daly says it is especially important to be diligent in other, additional ways—not simply giving an oral tick medication or trying to make sure that attached ticks are removed before they become engorged. Those are great things to do, but there is more that can be done.

Additionally, Daly is encouraging dog owners to also use tick collars or potentially other topical solutions.
“When I have people come into the office who have dogs on an oral flea and tick medicine, I talk to them about repellency, too,” Daly explains. “Advantix has permethrin in it. Or Vectra, which is marketed through veterinarians. Or collars like Serestro, which last for eight months. They work pretty well for most dogs, unless they swim a lot. There are some others that have deltamethrin instead; I don’t know comparatively if they are as good. They might do the job okay, too.”

Will some of the natural repellency products work?

“I don’t know,” Daly says. “They might. I haven’t used them or put them to the test.”

Are there topical solutions like this for humans, too?

“There is permethrin-impregnated clothing,” Daly says. “You can also get a spray; take your pants out and spray them, and it will stay on for more than 20 washings. One of my clients came in who had been hunting with his dog, and the dog had 30 ticks on him; the hunter was wearing coveralls with permethrin coating, and he had no ticks on him. It is pretty effective.”

It may be anecdotal, but our household is deciding to lean in—better to be safe than sorry.

After our big scare with Indie last fall, we have decided that she will be wearing a tick collar when she is out, at least in the spring and fall, and maybe in the height of summer, depending on how many ticks we are pulling off her at that point. (We find that the number tends to go down in summer heat.)

We do not want any repeats with anaplasmosis, if we can help it.

When Indie was sick last fall, Dr. Daly prescribed 10 days of doxycycline, given twice a day. For the first dose, she had us give Indie two pills, to try to knock down the fever.

It worked.

Within just a couple of hours, Indie was not shaking anymore—that had been the fever—and she was actually wagging her tail a bit, and she was slightly less lethargic. It took two to three days before she was back to normal, running and playing.

But fast-forward to less than a month later, at Thanksgiving dinner, we were told that my partner Jordan’s uncle, Tim Burke (72), was in the emergency room at Munson in Traverse City, potentially for a heart attack or maybe a stroke.

A few days later, however, we were told that, in fact, Uncle Tim had been diagnosed with anaplasmosis: the same disease that had made Indie so sick at Halloween!

At that point, we started to hear of more and more of our human and dog friends in Benzie and Manistee counties who had had run-ins with this new-to-us tick-borne disease—Gerard Grabowski, Bernie Ware, both men in their 60s and 70s, like Uncle Tim. But we also heard of a mid-40s woman in Frankfort, and a couple of friends’ dogs, including one that had died.

I began to dig around and research a bit, and to my surprise, I could not find any media outlets really reporting on what seemed to be a striking increase in cases locally; all I could find were general press releases from various health offices.

Thus I set out to tell what is sure to become an ongoing story for our area.

Cases Increase
A study was published in November 2024 by the Bureau of Infectious Disease Prevention’s Emerging & Zoonotic Infectious Disease Section (EZID) within the Michigan Department of Health & Human Services that chronicled five years from 2019 to 2023.

Caused by viruses, bacteria, parasites, and fungi, zoonotic diseases can be transmitted between animals and humans directly or via a vector, like mosquitoes or ticks.

In addition to things that you have likely heard of—such as anthrax, dengue fever, head lice, malaria, West Nile, rabies, and harmful algal blooms—the EZID report also featured things you may have never heard of, such as various fungal diseases, spotted fever, and invasive aedes mosquitoes.

There was also a whole section on tick-borne diseases, such as Lyme disease—something that, unfortunately, we are quite familiar with now in Northern Michigan.

“From anaplasmosis to Zika virus…” says the first page of the report.

That first disease is now on the rise here, too.

Confirmed human cases of anaplasmosis in Michigan have increased more than 10-fold over the past decade: four cases in 2014, seven in 2016, 14 in 2017, 14 in 2018, 13 in 2019, 18 in 2020, 58 in 2021, 54 in 2022, and 67 in 2023. (A footnote says that all data for 2023 are “provisional,” pending final review, and that, if we include both the “confirmed” and “probable” cases, the number rises to 115 from 67.)

Anaplasmosis is now the second-most common tick-borne disease in Michigan, following Lyme disease, which has confirmed cases most intense along the western coastline of Michigan, especially in southwestern Michigan, and also in the western portion of the Upper Peninsula.

Generally, anaplasmosis follows this same pattern. Currently, Michigan counties with the highest incidence of anaplasmosis border Wisconsin, though cases are creeping up along the western edge of the Lower Peninsula, as well; 35 counties had 115 confirmed and probable cases of anaplasmosis in 2023. Eight of those counties had their first cases in 2023.

This follows the trend of other tick-borne diseases over the period from 2019 to 2023: Babesiosis (also from the black-legged tick) increased from one to 10 cases; Ehrlichia (from the lone star tick) increased from two to six cases; and Lyme disease increased from 424 to 1,146 cases. (There are two other Ehrlichiosis types that had zero cases across the board, and Rickettsial disease, also known as Rocky Mountain Spotted Fever, caused by the American dog tick, actually decreased from 10 to three cases. However, the report notes that, in most cases, Ehrlichia and Spotted Fever were acquired while traveling out of state.)

Benzie and Beyond
“There was only one confirmed case of anaplasmosis in Benzie and Leelanau counties in 2023,” says Dr. Josh Meyerson, medical director for three local health departments: Benzie-Leelanau District Health Department, District Health Department 4, and Northwest Michigan Health Department. “But in 2024, there were four confirmed cases in Benzie and six in Leelanau. So we are seeing a definite increase.”
Notable: A confirmed case of anaplasmosis means that a blood sample has been taken and shipped to a clinical laboratory—such as Mayo Clinic in Minnesota, like in the case of Bernie Ware—for testing and has come back positive.

In Manistee County, 2022 was the beginning of anaplasmosis being documented, and there were 13 “confirmed and suspected” cases—including both Gerard Grabowski and Bernie Ware. Then there were eight cases in 2023, seven in 2024, and there have been two so far in 2025, according to Claire Janson, communicable disease coordinator for District Health Department 10, which is the largest geographic health department in Michigan, serving 10 counties including Crawford, Kalkaska, Lake, Manistee, Mason, Mecosta, Missaukee, Newaygo, Oceana, and Wexford.

“The counties with the largest increases [over the past two years] were in the Western [Upper Peninsula] and Benzie and Manistee counties. Benzie is considered a relative hotspot. Why? I don’t exactly know,” Myerson says.

He admits it could be that area physicians are more well-versed in this relatively new disease than other areas, so they know to look for it. Additionally, it could be that there is a greater number of black-legged ticks here that are infected and carrying the bacteria that causes the illness.

Likely, it is a combination of both these factors.

“I think most people know all about Lyme and have not heard about anaplasmosis,” Meyerson says. “We have tried to do a little bit of awareness for the general public and have provided information to the area doctors, so they are knowledgeable. What we do know is that more cases are being reported to us from that area.”

When asked what his office was doing to help get the word out, Meyerson responded:

“In 2023, the state put out information about anaplasmosis, the second most common tick-borne disease after Lyme disease, and I sent a notice to all of the area healthcare providers highlighting the rise in cases here.”

Meyerson explains that there is always the possibility that a tick infected with Lyme disease could also be co-infected with anaplasmosis, and vice versa; they are not exclusive. He notes that the symptoms show up slightly different, but that both are treated with the same antibiotic: doxycycline.

Not everyone who is diagnosed with Lyme or with anaplasmosis gets a formal test done, however; sometimes, healthcare providers might give a clinical diagnosis that is based on symptoms alone, like in the case of Gerard Grabowski. In these instances, these cases are counted as “suspected” and not “confirmed.”

“Some people may be getting treated for Lyme disease, but they actually have anaplasmosis. Since they’re both treated with the same antibiotic, unless there is a test, it might get counted as one instead of the other,” Meyerson says. “To confirm it, you have to test specifically for it.”

Regardless of whether a case is diagnosed with a test or with symptoms, both Lyme and anaplasmosis are considered “mandatory reporting,” meaning that healthcare practitioners must alert the local health department.

“We get reports one of two ways,” Myserson says. “If they order labs and they are positive, it is more automatic that it gets sent to us. Nobody has to remember to call the health department. Sometimes, the diagnosis is clinical, so we count on the doctors to report to us by calling or faxing. If you are a citizen and you’re worried about it, you can ask your doctor if they reported it. But from a personal health perspective, it won’t make a difference.”

Could numbers be higher than those reported? Of course.

“We know that we don’t have all of the cases,” Meyerson says.” If we had four [confirmed] cases reported [last year in Benzie County], we know that there are more cases out there—but we can look at the trends. We know it’s increasing.”

Prevention for both Lyme and anaplasmosis is the same, though, Meyerson notes.

“Avoiding tick-infested areas, staying on the trail. There are ways to protect your pets and yourself using insect repellent and protective clothing and doing tick checks frequently, and removing them promptly if you find them on you or attached,” he says.

If someone wonders whether the tick that bit them has the potential to be infected with anaplasmosis, their local health department can help to identify the tick, or people can submit a picture online via the Michigan Department of Health and Human Services (MDHHS) website.

“A lot of times, someone shares a tick that they found over the weekend that they’re concerned about,” Meyerson says. “And it was a big dog tick. You can’t get Lyme disease or anaplasmosis from it, so you don’t have to worry.”

He adds:

“We generally don’t test the tick for the bacteria. That’s not something that is routinely done. For a while, the state was doing that, as they were learning about the epidemiology. That takes pretty special testing and can’t be done in a normal human microbiology lab.”

He says that the Benzie-Leelanau District Health Department does have an environmental health sanitarian who is doing some surveillance for ticks in the area

Local Practitioners
“We are seeing a slight increase [in anaplasmosis cases], but we started at a low spot,” says Dr. Brian McComb (55), chief medical officer for Munson Healthcare’s south region. “It’s not a huge number of patients. It’s not something that I was seeing every summer, but I haven’t practiced in an office for the last 2.5 years. It is slowly on the rise, though.”

When asked about the rise in cases specifically in some regions like Benzie and Manistee counties, McComb responds:

“It is not uncommon to see some clusters here and there. A group of ticks hanging out together, sharing that bacteria. It tends to grow once it gets established.”

I share the severity of the cases that I have heard about: Gerard Grabowski, Bernie Ware, Uncle Tim Burke, even our dog.

“The vast majority of people will kick it,” McComb says. “It’s a very low percentage of people who struggle; people with pre-existing conditions, those over the age of 65, or if they have some autoimmune systemic thing going on—people with long-term symptoms from disease or medications are going to be more susceptible.”

That was definitely the case with Uncle Tim; as it turns out, he had walking pneumonia, which his physicians believe contributed to why he got so sick and why it took him so long to get better—he spent two and a half weeks at Munson in Traverse City and then two additional weeks in the rehab facility at Paul Oliver in Frankfort. He lost 40 pounds in those first 14 days, and he had all kinds of other complications like needing dialysis.

But it had all started with just feeling kind of crummy: like in Grabowski’s and Ware’s cases, Burke would have symptoms that were fleeting—they would sometimes disappear altogether.

“Anaplasmosis is usually very similar to flu-like symptoms: fevers, chills, muscle aches, nausea, vomiting,” McComb explains. “Fatigue is a prevalent symptom, but it’s hard to quantify. Diagnosis is usually clinical, meaning that they are showing symptoms and have access or exposure to ticks, or they’ve had recent bites. Then the suspicion goes up. Testing that can be done. There are tests available that can be done—polymerase chain reaction [PCR] tests, but those are tricky to get through insurance, most of the time.”

And they have to be sent out to a lab, as Myerson had told me.

When it comes to the numbers being reported, McComb says:

“People get treated, but it doesn’t always get reported, so those numbers could be off. It’s hard to know for sure.”

As for prevention, McComb recommends removing leaf clutter from your yard and getting rid of habitats where ticks like to hang out; wearing clothes with tighter collars and sleeves, to keep them from getting a foothold on your skin.

“If you’re out and there are likely ticks, check periodically, even before you get back to your vehicle, don’t wait,” McComb says. “Just do a quick check. Any time that you’ve been in the woods. Check in the shower when you get back. The key is to get the tick off as quickly as you can. Sometimes, they are on there for several days before people notice them.”

Meanwhile, Dr. Jake Flynn of Crystal Lake Clinic’s Interlochen office had this to say:

“Five years ago, we were seeing relatively low rates of tick-borne diseases, but we’ve seen a huge spike. There are so many reasons that we’ve seen an increase; honestly, the [COVID-19] pandemic got a lot of people outside more. Which is great, generally. Spending time outside is great. But you can look at maps from five years ago, and these diseases that were mostly on the East Coast have migrated to the Midwest, and it’s a real concern.”

He advises that if people are feeling poorly this summer, they should go see their primary healthcare provider.

“Yes, the fatality is less than 1 percent, but it’s not zero,” he says. “And it can be prevented if we see you early, if you get labs done early. Then the fatality can be zero, if you just go see your doctor if you think you’ve been exposed to a tick. And even if you don’t find a tick on you, if you’re feeling malaise, fatigue, fever, muscle aches. Don’t delay. Go be seen. Let’s find out what you’re dealing with.”

He agrees with others interviewed in this article that many people are aware of Lyme disease and the recognizable red bulls-eye symptom, but he finds that fewer people are aware of the newer diseases to this region, such as anaplasmosis.

“It’s so easy to think that you just have the ‘crud,’or a summer cold. But if you live in the woods or you play in the woods or you’re just outside a lot, we’re going to look into that, to make sure that it’s not something that could be disastrous. We might prescribe some preliminary, routine labs to start,” he says. “What you’re going to see is a decrease in white blood cell count and in platelet count and an increase in liver enzymes. So, if we put the whole story together: you’ve had a tick on you, you’ve had these symptoms of malaise and fever, etc. and now there are these labs coming back, we try to do a PCR lab to find out if it’s Lyme, anaplasmosis, or another tick-borne disease.”

He adds:

“The great thing is that it’s the same treatment for all three: doxycycline. Detection and treatment early is key. It’s critical. It could take five minutes for us to see you, order labs, or not, or just treat you. It doesn’t take long, and it doesn’t take a lot of effort with our expertise to give you a prompt diagnosis and treatment plan. We can get you in the same day for something like this, if you suspect it.”

In closing: if you are someone who is outside a lot, and you are feeling sick, do not hesitate to advocate for yourself and head into your primary care practitioner’s office asking about anaplasmosis.

Featured Photo Caption: Sick as a dog. Photo by Aubrey Ann Parker.