It’s a Pest-Pocalypse! What Can We Do About Ticks? Part 2 of 2

[Images combined from Mali Maeder on Pixels.com, and Erik Karits and TheUjulala on Pixabay]

Tick Prevention Is a Tough Gig

Because ticks are tiny, ticking time bombs, it’s imperative that you know what to do before you go outside where ticks might be lurking, and what to do when you get back home.

Truly unpleasant facts:

            *Some ticks can travel from your feet to head within a minute or two, which is why a full-body tick check is essential when you are outdoors and coming inside.

*Some of the infections in ticks, like the Powassan virus, can be transmitted within 15 minutes of a tick bite

*Rickettsia species can be transmitted within 10 minutes of a tick bite

 *The all-time winner is the soft bodied tick, containing relapsing fever Borrelia, which can transmit an infection in 5 minutes!

Tick-prevention is not just a good idea--it is essential, as some of these infections can be deadly. I don’t mean to scare you, but you need to know that some cases of Lyme carditis (an infection of the heart), Anaplasma and Ehrlichia infections (which have fatality rates ranging from an average of 1-3%), Babesiosis (which can be fatal in those who are very young, elderly, or immune-suppressed with chronic illness), Rocky Mountain Spotted Fever (with a mortality rate between 3–5% when treated early with antibiotics, but as high as 13–25% if left untreated) and even Powassan encephalitis (inflammation in the brain), if not fatal, can leave you incapacitated for life with severe neurological complications. Furthermore, when you consider that a recent CDC study published this past week in Emerging Infectious Diseases found that the annual number of cases of Lyme disease in the US among Medicare recipients was 7 x higher than previous surveillance reported (indicating approximately several million cases per year), it should give you pause that tick-borne infections are spreading rapidly and that you and your loved ones are at higher risk than you may have realized. 

KEEP THOSE TICKS FAR, FAR AWAY

Be vigilant and follow these recommendations to keep you and your family and friend safe!

Tick-Prevention Clothing

*Light colors are best, so you can see if any creepy crawlers are creeping.

*Don’t wear sandals or open-toed shoes. Or shorts. Or skirts or dresses. Or short sheeves. Or tank tops. Put on long socks and long pants and tuck those pants into your socks. This is necessary as ticks are usually found no more than 18-24 inches off the ground. While this isn’t exactly a fashion-forward look, it’s much better to be safe than get bitten! 

*Tie back long hair, especially if you’re going to be working in the garden or going for a picnic.

* For those who will not, or cannot, follow the above prevention advice, follow the instructions below with tick-repellant clothing and insect repellants on the skin.

Use These Tick-Repellants Faithfully

*For clothing, shoes/boots, and gear only: Use products containing 0.5% permethrin, a potent insecticide. Permethrin can be used to treat boots, clothing, and camping gear, and it remains protective through several washings. Do not ever apply permethrin directly to your skin, as it is extremely irritating, can cause side effects, and affect your liver over time. (It is also highly toxic to cats.)

*Several lines of clothing already contain 0.5% permethrin (Permanone® Products, Sawyer Clothing-Only Repellent® and Repel®). These last through 70 wash cycles.

*For your skin: the EPA has approved products containing DEET, 20% picaridin (this strength also will repel mosquitos reasonably well), IR3535 (an amino-acid-based product, safe in pregnancy), or oil of lemon eucalyptus (OLE). Follow product instructions. My preference is picaridin 20%, which is derived from the pepper plant. Apply any of these and let it dry before you leave the house.

Once You Get Home

*Check your entire body for ticks, especially in your groin, armpits, and behind your knees and ears. Have someone check your back, neck, and hair, if possible. Young ticks, (nymphs) are only about the size of a poppy seed, so they’re really easy to miss. Even harder are larvae, which are the size of a pinhead! There are reports of people walking through woods and getting hundreds of larvae on them, and in up to 1% of cases, they will transmit infections like hard-tick relapsing fever, Borrelia miyamotoi. That is why you must:

*Take a shower right away. This will wash off any ticks you might have missed that haven’t fully latched on yet.

*If you find any ticks on dry clothing, put them in the dryer on high heat for at least 10 minutes. If your clothing is damp or wet, dry them for at least 70 minutes. The heat will desiccate the ticks, dry them out for good, and kill the suckers.

*Check any pets that were outside with for you for ticks as well. Discuss tick-prevention products with your vet, as some of them can have toxic side effects. 

If You Find a Tick on Your Body

Get rid of that tick as soon as possible! But do it with care:

*There are companies that make specialized tick removal devices like the Pro-Tick Remedy, that come with a 5x magnifier. The Tick Twister is another small device that removes the tick like removing a cork from a bottle. Many hardware stores will sell different tick removal devices that you can keep on your keychain, ready for use. One that I carry with me gets underneath the tick body and allows you to lift up the tick without squeezing it. You can see the product below. Otherwise, a fine point tweezer that grabs the tick at the entry point, pulling directly upwards and cleaning the area with alcohol or soap and water after removal is advisable. See the full instructions below.

*Don’t use nail polish, Vaseline, or a hair dryer to “smother” the tick. That can cause the tick to regurgitate infections into your skin, making you sick.

These are the CDC’s instructions:

*Use clean, fine-tipped tweezers to grasp the tick as close to the skin's surface as possible.

*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 cannot remove the mouth easily with tweezers, leave it alone and let the skin heal.

*After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol or soap and water.

*Never crush a tick with your fingers.

While the CDC recommends that you dispose of a live tick by putting it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet, I advise my patients to test the tick for infections. You do this by sending it to your local health department (many do it for free); or by sending it to reliable labs, like Tom Mather’s lab at the University of Rhode Island; or by using Ticknology, a good testing company in Colorado. This is vitally important because if you get sick in the future, you’ll have a better idea which pathogen(s) were the likely culprits.

Also, write down the date you found the tick. It might take between 3-30 days to develop any symptoms. If you get a fever, headache, aches and pains that you haven’t had before, sudden onset of new neurological or psychological symptoms, or any kind of rash, see your doctor right away. Tick bites can also cause flu-like symptoms, sore throats, swollen glands, and gastrointestinal symptoms with nausea, vomiting and diarrhea, which can easily be confused with a viral infection.

Remember, Lyme is the great imitator, and causes multi-systemic symptoms, as do many of the other tick-borne diseases. If in doubt, he sure to get tested!

I’ll discuss details of tick-borne co-infections, with testing and treatment protocols in future Substacks. Stay tuned!