Frank Lee

Doxycycline went on the federal government's national drug shortage list in January because of manufacturing delays and rising demand.

SARTELL, Minn. -- Jakin and Nicole Koll would have never guessed something so small could cause such a big problem.

The Sartell couple believes deer tick bites are responsible for their Lyme disease, which has cost them almost $100,000 for treatments.

"There's more than just the initial infection; there can be co-infections with it," said Nicole Koll, an administrative assistant at St. Cloud Technical & Community College.

As tick season has arrived, an antibiotic commonly used to treat Lyme disease is in short supply, and some politicians are calling on the federal government to do something about it.

Almost 30,000 cases of Lyme disease were reported nationwide in 2011, which makes it the sixth most commonly reported infectious disease in the United States, according to federal officials.

"I have taken that antibiotic but did not react well, so I was taken off of it," said Koll, a 31-year-old mother of two. "But that is the one that my husband primarily depends on for his treatment."

Doxycycline shortage

Sen. Amy Klobuchar, D-Minn., recently called on the Food and Drug Administration to take action to reduce the shortage of doxycycline, an antibiotic that is a common first-line treatment for Lyme disease, which is most commonly contracted in May and June, during peak tick season.

"As summer approaches, hospitals and doctors need to be ready to treat the rise in Lyme disease cases," Klobuchar said in a statement. "The FDA needs to do everything in their power to make sure patients and doctors have access to the medication they need."

Doxycycline went on the federal government's national drug shortage list in January because of manufacturing delays and rising demand, which has driven up the cost to obtain it in some cases.

"The St. Cloud Hospital Inpatient Pharmacy has been able to obtain supply when needed, although it has been more challenging to obtain," said Jeanine Nistler, communications director for CentraCare Health.

According to the Minnesota Department of Health, almost 15,000 cases of tick-borne diseases were reported in Minnesota from 1986-2010, of which the majority were Lyme disease.

"The CentraCare retail pharmacies have also been able to get adequate product. However, because the price of doxycycline hyclate has gone up tremendously, we have changed to doxycycline monohydrate," Nistler said.

"There is no difference in the effectiveness of the products, but the pharmacy is required to get approval for the change from the prescriber, which takes time and can dissatisfy patients."

Tick season

Exposure to deer ticks (also known as blacklegged ticks) and Lyme disease in Minnesota occurs primarily from May to July, and again in the autumn, when people are outdoors and ticks are actively feeding.

The majority of cases occur in June, July and August, peaking just after the mid-May to mid-July period when the nymphal deer tick is feeding; the lag is due to the three- to 30-day period between an infected tick bite and the start of signs and symptoms, according to the Minnesota Department of Health.

"The ticks were not killed by the winter weather. In fact, all that snow that we had kind of insulated the ticks and kept them warm enough to survive on the forest floor where they lived until the snow could melt," said Dave Neitzel, an epidemiologist at the Department of Health.

Besides Lyme disease, deer ticks can sometimes also transmit babesiosis and anaplasmosis. Lyme disease and anaplasmosis are treated with the same antibiotics, according to the Centers for Disease Control and Prevention, but babesiosis is a parasitic disease that is treated with different medications.


In addition, wood ticks (also called American dog ticks) can carry Rocky Mountain spotted fever, among others.

The best way to prevent tick bites is to avoid tick habitat during warm weather months: wooded or brushy areas for the deer tick, and grassy or wooded areas for the wood tick.

Use repellent to reduce the risk of Lyme disease: DEET-based repellents (up to 30 percent DEET), which can be applied to clothing or skin for temporary protection, or permethrin-based repellents, which are used to pre-treat fabric.