Ticks are a worry as they can transmit various diseases. Read more...
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Why do we worry so much about ticks?
Ticks are a worry as they can transmit various diseases. Ticks are tiny and can be frustrating simply because the initial bite can often be missed only to be followed by a number of concerning symptoms- either immediately or delayed.
What are the most common tick-borne illnesses?
The most common tick-borne illness in the US is Lyme disease. It is endemic in various parts of the country. Ticks are the carrier for the bacteria that cause Lyme disease. They transmit it to humans through a bite and the bacteria can proceed to cause a rash and impact the heart, central nervous system, the joints, as well as leading to significant fatigue. These symptoms can occur immediately or be delayed- even by months.
The range of other tick-borne illnesses includes babesiosis, ehrlichiosis, Rocky Mountain Spotted Fever, anaplasmosis, Southern Tick-Associated Rash Illness, Tick-Borne Relapsing Fever, Tularemia, Colorado tick fever, and Q fever.
Are tick-related illnesses common?
Tick-borne illnesses are considered to be on the rise. However, in practice, I also suspect that they are increasingly recognized in recent years given the nonspecific nature of the delayed symptoms. I routinely find ticks on patients when performing annual skin cancer screenings. They do not always have evidence of rashes or symptoms however there is an ongoing source of exposure in gardeners and others that enjoy outdoor recreation.
What is the best way to protect ourselves from tick-borne illnesses?
When returning indoors, especially if you live in an area endemic to Lyme disease, it is important to perform head-to-toe tick checks. Start on the scalp and feel through the hair for any ticks. Feel with your fingers across your neck, face, back, chest, abdomen, arms, and legs. Feel through the folds of the arms and knees while paying special attention to the lower back and back of the neck. Ticks can be tiny- as small as a poppy seed. Feeling for them is better than just looking for them.
Look for unexplained rashes. They do not always have symptoms. Some people expect them to feel like a mosquito bite when in fact many have no itching associated. If you have a persistent scab or bump that doesn’t seem to heal or you keep picking at it, it may be worth a check with your dermatologist to make sure a tick isn’t stuck!
Although it is true that identifying the tick can be helpful as specific ticks are more likely to transmit specific diseases. However, we are learning more about co-infections and possible exposures to multiple ticks given outdoor activities that make this more likely. I strongly recommend focusing on the symptoms that you experience to guide treatment.
It is common to find that patients either did not have a rash or do not recall a rash. The rash is more a sign of exposure. However, the rash can disappear with or without treatment. If no treatment is undertaken, secondary and tertiary Lyme symptoms can occur where it impacts other organs in the body.
With rates on the rise, how can people protect themselves from ticks?
Pennsylvania routinely tops the list for Lyme diagnoses in the country. I routinely find ticks on patients presenting for routine annual skin cancer screenings and, at times, an incidental target-like rash from Lyme disease. These patients are often genuinely shocked to find out these ticks were feasting on them or that they had evidence of a Lyme infection.
The first line of defense against Lyme is still considered personal protective measures. These include:
Wearing long sleeves, pants, socks
Performing tick checks when returning indoors
Take a shower or bath after spending time outdoors
Placing the clothes worn outdoors in the dryer (set the temperature at high heat) to kill off any ticks still present
Use of insect repellents while outdoors
Use of clothing treated with insect repellents.
Evaluating your yard or outdoor area can also be helpful to reduce the tick populations in these regions. According to the CDC, it can be helpful to:
Keep the lawn mowed and clear the brush
Create barriers between the lawn or shrubs and outdoor recreational areas such as playgrounds. This can be achieved by the use of a 3-foot wide barrier made up of wood chips or rocks.
Clear trash or unused lawn equipment to avoid hiding areas for ticks
And, of course, check your pets for ticks as well.
I also recommend consideration to Tick Tubes. These can be made at home with toilet paper roll holders, lint from the dryer, and permethrin spray. The lint is used by rodents to make their nests with the permethrin reducing the volume of ticks in the region.
Do we need any legislation?
The main benefit legislation may serve with regard to Lyme disease would be increasing public awareness of Lyme as well as ensuring insurance coverage for diagnosis, treatment, and management of the disease.
Is it essential to identify the type of tick?
This is a great question. Although it is true that identifying the tick can be helpful as specific ticks are more likely to transmit specific diseases. However, we are learning more about co-infections and possible exposures to multiple ticks given outdoor activities that make this more likely. I strongly recommend focusing on the symptoms that you experience to guide treatment.
Is it possible to have a tick bite without a rash?
It is common to find that patients either did not have a rash or do not recall a rash. I included a photo below (I own the rights to this so if used please credit) of a classic target rash for Lyme disease I stumbled across while doing a skin cancer screening. The patient had no idea it was there. The rash is more a sign of exposure. However, the rash can disappear with or without treatment. If no treatment is undertaken, secondary and tertiary Lyme symptoms can occur where it impacts other organs in the body.