2017’s growing tick problem: How to protect yourself

We’re reminded every spring and summer to beware the return of the tick. These tiny, bloodsucking parasites carry a wide range of infections they can pass on to the humans they bite.

But ticks have cropped up more in the news in spring and summer 2017 than in years past. This is thanks to a couple milder-than-normal winters leading to a rise in the tick population and increased awareness of a tick bite-induced meat allergy.

I’ve yet to see a patient who has developed an allergy to red meat after a bite by the lone star tick, but we do treat plenty of patients every year for Lyme disease – the most common tick-borne illness. In 2015, the most recent year for which we have stats, 2,429 cases of Lyme disease were reported in the District of Columbia, Maryland and Virginia. In fact, 95 percent of Lyme disease cases are reported in 14 states, including Maryland and Virginia.

Even if you live in the city, you are not safe from ticks. While they are more common in rural areas, they can still be found in city parks and your yard. Ticks also can hitch a ride into your home on the backs of pets. Let’s look at the infections that ticks in our area can spread, how to remove ticks correctly and how to prevent getting bitten in the first place.

Tick-borne infections in our area

Three main types of ticks found in our area are deer ticks (also known as black-legged ticks), lone star ticks and brown dog ticks. Each type of tick can spread various diseases.

Lyme disease

This illness is transmitted by deer ticks. The first sign often is a rash at the site of the bite. This angular or oval rash can expand to the size of your hand and take on a “bullseye” appearance. You’ll also likely experience flu-like symptoms such as fever, chills, headache, and muscle and joint aches.

Close up view of a tick

Lyme disease bullseye rash

Rocky Mountain spotted fever

The first symptoms of Rocky Mountain spotted fever, spread by the brown dog tick, appear a couple days after the bite and include fever, headache, vomiting and muscle pain. A rash also may develop later in the disease. It will look like small pink spots on the arms and legs.

Ehrlichiosis

Ehrlichiosis, transmitted by the lone star tick, is a name for several less-common bacterial diseases and can cause fever, headache, fatigue and muscle aches. While a rash may develop, it’s not common.

Babesiosis

Some people with this rare deer tick-borne disease don’t experience any symptoms. Others may develop fever, headache, nausea, vomiting and loss of appetite. Babesiosis also can cause a type of anemia that leads to your skin turning yellow (known as jaundice) and dark urine.

Powassan

This virus spread by the deer tick is rare but very serious, as it can cause inflammation of the brain. About 10 percent of people who develop it will die, and half of survivors will have permanent neurological symptoms, such as frequent headaches or memory problems. Early symptoms include fever, headache, weakness and vomiting. Later symptoms can include confusion, loss of coordination or speech difficulties and seizures. There are no medications to treat Powassan directly, and patients may need respiratory support or treatment to reduce swelling in the brain.  

While most tick-borne diseases are easily treated with oral antibiotics if caught early, you can become very ill if treatment is delayed. Let your doctor know you’ve spent time outdoors even if you don’t remember being bitten.

You likely won’t feel a tick bite, and the tick may fall off before you spot it, so it’s important to know the symptoms of these illnesses and seek treatment as soon as possible.

How to remove ticks from your skin

If you find a tick on yourself or on your child, don’t panic. There’s likely no need to race to the emergency room. A tick needs to be attached to the body at least 24 hours to transmit most diseases. So if you remove it the same day, you’ll likely be fine.  

The best way to remove a tick is to use tweezers to grab it as close to the skin as possible and pull straight out. Don’t twist as you pull, because it can cause the tick’s mouth parts to break off and remain in the skin. Then clean the area with rubbing alcohol or soap and water.  

There are a few methods you shouldn’t use:

  • Don’t use your fingers: If you crush the tick, you run the risk of the juices spreading on your hands.
  • Don’t burn it off: I’ve seen people try to use cigarettes to kill the tick, but they usually just end up with a burn and a tick bite.
  • Don’t use Vaseline to smother it: This is a myth. It doesn’t work.  

How to prevent tick bites

The best way to prevent illnesses such as Lyme disease is to avoid exposure to ticks. If possible, stay out of wooded or brushy areas. If this isn’t possible, here are some tips to protect yourself and your loved ones.

Tips to repel ticks: 

  • Use repellent that contains 20 percent or more DEET or picaridin on any exposed skin. The Environmental Protection Agency has a tool to help you find the best repellent for you and your family.
  • Treat clothes with products that contain permethrin, an insecticide.
  • Wear long sleeves and pants.
  • Tuck your pants legs into your socks.
  • Treat your pets with flea and tick collars, sprays or topical treatments to avoid them bringing ticks home with them.  

Tips to find ticks on your body and clothing:

  • Check every inch of your body after spending time outdoors. Don’t forget around your ears, the backs of knees and elbows, armpits and hairlines. Do the same for your pets.
  • Take a shower within a couple hours of spending time outside. Ticks tend to wander around a bit before attaching, and you may be able to wash them off before they attach. This is also a good time to do a tick check.
  • Don’t forget about your clothes. Throw them in the dryer on high heat for 10 minutes to kill any hiding ticks. 

Ticks will return every year. And we must remain vigilant to prevent tick bites and notice the symptoms of tick-borne diseases as soon as they appear.

 

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Glenn Wortmann

Glenn W. Wortmann, MD, is section director of infectious diseases at MedStar Washington Hospital Center and program director of the Infectious Diseases Fellowship Program. 

Dr. Wortmann was drawn to the field of infectious diseases because he wants to care for people, and he enjoys the combination of science and patient care. He finds his work extremely rewarding and has a high positive impact on his patients’ health, as most diseases he treats are reversible or controllable. Dr. Wortmann says that the biggest challenges to treating patients are barriers to care caused by poverty and the complications faced by patients with multiple medical problems.

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