‘Tis The Season – For Ticks

By Mary Lizabeth Aquavia, Medical Director, Women’s Health Program

Warning: Often it’s the tick you don’t see that makes you sick!

It’s summer in Connecticut and many of us are spending a lot more time outdoors, enjoying activities like hiking and biking, or maybe just hanging out at home in the backyard. But it’s also the time of year when we need to be especially vigilant for ticks, which may be present in the grass, bushes, or undergrowth, waiting for a warm body to latch onto.

In Connecticut – and a large part of the country that includes most of the Eastern Seaboard up to Maine and as far west as Minnesota – tick-borne diseases such as Lyme disease, babesiosis, ehrlichiosis, and Rocky Mountain spotted fever, among others, are especially prevalent at this time of year.  The good news is that, if identified and treated promptly, these diseases are almost always curable.

Preventing tick bites

The most effective step you can take to prevent tick bites is to dress appropriately. Make sure you wear shirts with long sleeves, long pants, socks (preferably white) that you can tuck your pants into, gloves, and a hat. Avoid open-toed shoes or sandals.

For further protection, spray insect repellent containing at least 0.5% permethrin (an insecticide) on your clothes or body. You can also buy clothing that is pretreated with permethrin.

I usually recommend to my patients that they spray their socks and sleeves. Ticks typically attach themselves to your lower legs as you walk or work in areas that are overgrown and then crawl upward until they find a location to burrow into your skin. Wearing light-colored clothing, such as white socks, makes it easier to spot any ticks before they have a chance to bite you.

Shower as soon as possible after you come inside to wash off any ticks that you may not have seen. Do a thorough search of your body, focusing on areas where ticks typically like to burrow such as your underarm, hairline, ears, waist, between your legs, behind your knees, and inside your belly button. Use a mirror or have someone else check for you in areas that may be difficult for you to access. Remember: Most ticks are usually no bigger than a sesame or poppy seed, so they are easy to miss.

If you get bitten…

Use a pair of tweezers to gently grasp the tick near its head or mouth. Don’t squeeze or crush it but pull straight up, carefully and steadily. If part of the tick remains in your skin, don’t go digging for the remnants – they will eventually work their way out on their own. Once you have removed it, you can dispose of the tick by putting it in alcohol or flushing it down the toilet.

However, I recommend putting it in a sealed jar and taking it to your local Health Department. Knowing the species of tick that has bitten you is important. While only a few of the many tick species found throughout the world bite and transmit diseases to people, different species of the ticks that do bite people transmit different diseases. For example, in our area, blacklegged ticks (also known as deer ticks) carry the bacteria that cause Lyme disease and babesiosis, while ehrlichiosis is associated with the lone star tick. Tests can be done on the tick by the Health Department to determine whether it is carrying specific disease-causing bacteria.

If you have been bitten by a tick, count back to try to estimate how long it may have been attached to your body. If it has been longer than 36 hours and the tick looks engorged, you may have been exposed to harmful bacteria. If you can, call your doctor within the first 24 hours (and no later than 72 hours) of being bitten. Two doses of doxycycline within 72 hours of the tick bite will prevent you from catching Lyme disease.  Same with ehrlichiosis if it’s a lone star tick bite.

Symptoms and Treatment

Tick-borne diseases have similar symptoms but can differ in intensity. They include fever, chills, sometimes headaches or muscle aches, nausea, vomiting, diarrhea, and loss of appetite. Usually, the symptoms include a rash. Lyme disease produces a characteristic target-shaped rash called erythema chronicum migrans (or ECM), either at the site of the tick bite or elsewhere on the body.

If left untreated, Lyme disease can cause carditis, arthritis, facial palsy, joint disease, memory issues, central nervous system infection, as well as other serious conditions. Complications from untreated ehrlichiosis can include kidney failure, respiratory failure, heart failure, damage to the nervous system, seizures, coma, and secondary infections.

Treatment for both diseases is 100 milligrams of doxycycline twice a day for up to 14 days. Fortunately, recovery is usually very dramatic – patients get better within 24 to 48 hours.

So, don’t let a tick bite ruin your summer enjoyment. Stay alert when you’re outdoors and don’t forget to examine your body closely for ticks when you come inside. Don’t let the one that got away be the one that gets you sick!