In situations where people find themselves spending a lot of time outdoors, they’ll be exposed to all sorts of creatures that want to make a meal of them. I’m not talking about packs of wolves or grizzly bears: In this case, I’m talking about ticks. As many tick-borne illnesses are treatable in the early stages, the family medic must know how to quickly identify and treat these conditions.
Ticks are well-known carriers (also known as “vectors”) of disease-causing organisms that affect humans, pets, and wildlife. As a matter of fact, they’re responsible for the vast majority of vector-borne diseases in the U.S. They’re not just a problem in the States: Ticks exist worldwide, with about 25 of the almost 900 known species being of medical importance. In extreme cases, they can be a severe threat to long-term health.
You might think of ticks as insects, but they are actually eight- legged arachnids related to scorpions and spiders. The range and “season” for ticks seems to be increasing, with the National Institute of Health blaming higher temperatures in recent years as the reason. For example, the blacklegged or deer tick now ranges all the way from the East coast to the South to the Upper Midwest. The Western blacklegged tick covers the entire Pacific coast. Others are more regional, such as the Lone Star Tick, mostly found in (you guessed it) Texas.
Ticks survive by biting the skin of a host and extracting a meal of blood. Unfortunately, they also transmit various disease-causing microbes to humans and animals through their infected saliva. The CDC recognizes more than fifteen, including:
- Lyme disease
- Anaplasmosis
- Tularemia
- Babesiosis
- Rocky Mountain Spotted Fever
- Ehrlichiosis
- Relapsing Fever
LIFE CYCLE
Ticks have a life cycle that can last two to three years and includes egg, larva, juvenile (also called “nymph”), and adult stages. As an adult, some tick species, like the blacklegged tick, are only as big as a sesame seed. Others, like the American dog tick, are larger.
For a larva to develop into a nymph or for a nymph to develop into an adult, a blood meal in needed. It appears that the nymphs cause the most cases of Lyme Disease. The CDC estimates that about 30 percent of all ticks in the Northeast and Upper Midwest carry the organism, Borrelia, that causes the disease.
Ticks don’t jump like fleas do; they don’t fly like, well, flies. Usually, ticks hang on grasses and bushes, holding on with their back pairs of legs and latching onto passersby with their front pair(s). The larvae like to live in leaf litter. In inhabited areas, they can be found in shaded woodpiles, leaf piles, or tall grass. To pass along a disease to animals or humans, ticks must first find their hosts by detecting smells, sensing body heat, or feeling vibrations from movement. When the tick latches onto its victim, its mouth parts pierce the skin and start extracting blood.
Without finding an actual tick attached and feeding, it’s hard to tell one insect bite from any other. While there may be a small, red bump after the tick detaches, some experience a more expanded area of irritation and itching. The appearance of acute Lyme disease is a little different and will be discussed in my next article.
Given the risk for disease, a thorough examination of the entire body for ticks is warranted within two hours of returning from a day outdoors. This is most easily accomplished during a shower. Look behind the knees, in armpits, around the ears, hair, groin and even the belly button (navel). Be especially certain to examine dogs and children as well when they return from a day outdoors. Inspect clothing and backpacks for ticks as well.
TICK REMOVAL
Once found, it’s important to remove the tick as soon as possible. It may be possible to just brush or wash it off if it hasn’t bitten you yet. If that doesn’t work, the simplest method is to use fine-tipped tweezers to grasp the bug as close to the skin’s surface as possible and pull straight up in an even manner. Twisting as you pull or pulling at an angle may cause the mouth parts to remain in the skin.
After removal, thoroughly clean the wound area with soap and water or isopropyl (rubbing) alcohol and apply antibiotic ointment. Wash your hands afterwards. As an added precaution, launder clothing in hot water and dry in high heat. If all this is done soon after the bite occurs, infection is highly unlikely.
There are other methods of tick removal, such as using specially-designed instruments, smothering it with petroleum jelly, even lighting it on fire. No method, however, is more effective that simply pulling it straight out.
PREVENTION OF TICK BITES
An ounce of prevention is, they say, worth a pound of cure, and this old saying is particularly relevant when it comes to infections caused by tick bites. For prevention, consider:
- Long pants and sleeves while on the trail.
- Thick socks and high-top boots (tuck your pants into them).
- Walking in the center of trails to avoid brushing up against vegetation.
- Using insect repellants like DEET (20% or greater) on skin (oil of citronella or lemon eucalyptus are natural alternatives).
- Applying Permethrin 0.5% insecticide to clothing, hats, shoes, and camping gear 24-48 hours before using (proper application will even withstand laundering). It is not useful for application to skin, however.
- Thorough exams after a day outdoors, again, paying special attention to children and dogs.
Although not technically associated with poor hygiene, ticks are often first detected while bathing. This means that failure to bathe may allow them to remain on the body and increase the chance of disease transmission. Be sure to enforce good hygiene in your group members. If you do, you’ll be better able to keep it together, even if everything else falls apart. The next article below covers Lyme Disease
Joe Alton MD
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