Tick Safety

 

TICK SAFETY

Did you know that we’re in a geographical zone at risk for tick bites? And mid-summer is the prime time for tick exposure? Wisconsin is one of 10 states in the U.S. where 90% cases of Lyme disease, one of the most common and potentially devastating diseases, occur.

That makes searching for your golf ball in the tall grass, hiking in the woods, and camping just a little, well, creepy. Ticks are one of those creatures that make you wonder how they made it into the food chain. They can contract various diseases through feeding off other infected animals and pass them on to humans (um, gross).

Since we live in a beautiful state and since we’re not going to stay inside all summer, it’s good to be armed with a little knowledge about how to prevent tick bites—and if one occurs, what to do about it. In my clinic work as a nurse practitioner, I’ve observed the effects of Lyme disease in patients who did not receive early treatment, so I’m well aware of the dangers ticks can pose. I’ve also recently noticed multiple questions about ticks on parent buy and sell sites and people weighing in with anecdotal advice. Since the waters can get muddy, I spent some time researching the questions I hear most from patients and parents.

1. How do I prevent tick bites?

  • Walk in the center of trails to avoid long grass and leafy piles.
  • Wear boots, socks, and pants when hiking.
  • Wear clothing treated with permethrin.
  • Use insect repellent with DEET (20-30%).
  • Wear a hat or bandana on your head.
  • Look for ticks crawling on skin, clothing, gear, and pets after spending time in the outdoors. Ticks like to migrate to warm areas of the body: carefully inspect the back of ears, underwear line, between the legs, underarms, heads, back of knees, and the belly button, both you own and your children’s.
  • Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors.

Up to Date, a website that summarizes current research states, “An individual who is bitten by a tick has a very low risk (about 1 in 100 chance) of acquiring Lyme disease if the tick is removed before it is engorged (filled with blood). Thus, a careful search for ticks after spending time outdoors is useful in avoiding a tick bite; a tick that has not bitten cannot cause Lyme disease.”

2. What do ticks look like?

In the photo below, the deer tick (the kind that transmits Lyme disease) is shown on the top row and from left to right you see a nymph, adult male, adult female, and an engorged female that has been feeding and is full of blood. Deer ticks are about the size of a pencil tip or poppyseed.

Dog ticks, shown on the bottom row, do not transmit Lyme and have white markings on their backs. They are larger than deer ticks, about the size of a pencil eraser. 

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3. If I find a tick stuck to me or a family member, should I remove it?

Yes, see below. Make note of its appearance in case it gets crushed in the removal process.

4. How do I remove a tick?

  1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
  2. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
  3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.
  4. Dispose of a live tick by submersing it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers.

(Centers for Disease Control (CDC), 2016)

5. Do I need to keep it and show it to my doctor?

If you have questions about whether or not you’ll need treatment, keeping the tick can help a healthcare provider identify the type. Taking a picture is another good alternative.

 6. What are the symptoms of a tick-borne illness? 

  • Fever/chills
  • Aches and pains: headache, fatigue, muscle/joint pain
  • Rash: Per the CDC website, “In Lyme disease, the rash may appear within 3-30 days, typically before the onset of fever. The Lyme disease rash is the first sign of infection and is usually a circular rash called erythema migrans or EM. This rash occurs in approximately 70-80% of infected persons and begins at the site of a tick bite. It may be warm, but is not usually painful. Some patients develop additional EM lesions in other areas of the body several days later.” (CDC, 2016)

Early recognition and treatment is key! See a healthcare provider immediately if you have been bitten by a tick and experience any of the above symptoms.

7. I found a tick feeding on my child, do I need to take him/her to the doctor?

If a person is bitten by a deer tick, there are two options a provider will take.
 
1) The wait and see approach.  Does a rash develop? Does a patient develop other symptoms of tick-borne illnesses within a few days or weeks after a tick bite? They may need follow up treatment if this turns out to be the case. If my children are bitten by a tick, I plan to write all the information on a calendar in case I need it for the future.
 
2) Administer antibiotics “just in case.” There is a list of criteria an individual must meet to get an antibiotic without a confirmed case of Lyme. For the most part, children under age 8 will not be given prophylactic (“just in case”) antibiotics.
 
According to Up to Date, “Ticks take up to 24 hours from the time of first contact with the skin before they actually start to feed on the host’s blood. The tick must remain firmly attached to the skin for 48 to 72 hours to pass the bacteria that causes Lyme disease to humans [1]. Thus, there is a long period of time between the tick’s first contact with its host and the transmission of infection.”
 
Additionally, “There is no benefit of blood testing for Lyme disease at the time of the tick bite; even people who become infected will not have a positive blood test until approximately two to six weeks after the infection develops (post-tick bite). The history of the tick bite will largely determine which of these options is chosen. Before seeking medical attention, the affected person or household member should carefully remove the tick and make note of its appearance.” 
 
If you do not know how long a tick has been feeding, or think it has been longer than 24-36 hours, there is a higher risk of contracting a disease from an infected tick.
 
Keep in mind, if the tick is flat, it is more likely that it attached recently. If it’s engorged (fat, full of blood), it means it’s been feeding for longer.
 
Bottom line, do what makes you feel comfortable; but bites by deer ticks that fed for an unknown amount of time, especially accompanied by a rash within days, post the highest risk.

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