Outdoor Safety - Ticks

By Steve Stone

In the warmer seasons, most of us spend more time outdoors and wear less.  Activities like camping, swimming, boating and hiking are normal family fun.  Simple things like picnics, long walks, and sitting outside enjoying the weather are commonplace.  Outdoors is what warm weather is for, so enjoy nature as it is meant to be, but do it carefully.  


Aside from the well advertised dangers of heatstroke and dehydration, one of the dangers outdoor lovers often face is a tick bite. In most natural areas, ticks are a major concern.  Ticks are parasitic arachnids who drop off leaves and branches, or climb from tall grasses to attach to their victims and suck out blood for nourishment.  Once a tick has gotten its fill it usually drops off its victim.


If a tick bite was a quick “Ouch!  Darn that hurts!” and then it is over, there would be no need for concern.  Unfortunately many tick bites are more than just an annoyance.  Ticks carry many diseases that transfer by their bite.  The longer they are attached to you, the more chance you have of contracting a tick-borne disease. 


The reality of life in a natural area is that some time in your life you will get a tick on you.  If it latches on; biting and digging in, you become a victim.  There are many ways to reduce the possibility of being a tick victim.  Light colored clothes reduces your attraction or visibility to the animal.  Closing off openings in your clothes also helps.  A rubber band around the bottom of your pants leg or your cuff put into you sock will help.  The idea is to make no openings for a tick to get under your clothes.


There are many “Deet” based skin-safe repellents and “Permethrin” based clothing repellants on the market.  All of them stink or are uncomfortable, but they also reduce your chances of being bitten.  A tick digging into your flesh is worse than any smelly spray.  A good soapy shower after each outdoor activity will help rid you of any unattached ticks, and remove the smell of the spray.


Checking yourself for ticks each time you return from the woods or even the wooded back yard is very important.  Ticks do not instantly bite and bury themselves, they often walk around looking for their ideal spot. Common areas for them to dig in include joints like underarms and backs of knees, soft fleshy areas and hair-covered areas, including genitals. Do not be shy in your inspections; look everywhere.  


If you find a tick, you need to remove it and seal it in a ziplock bag or a bottle or some sort.  Remove it by using tweezers or anything that can grab the small head of it; you do not want to squeeze the body, or it can release more infectious fluids through its bite.  Folk lore and old wives’ tales about using hot matches are also dangerous, as they make the tick release more saliva or infected blood back into you, increasing the chance that you will get an infection.  Once removed, the tick should be kept, without damaging it, in a clearly labeled container with date and bite location in your freezer.  If you do get ill, the undamaged tick may help your doctor diagnose your problem.  Disinfect the tick bite, and check to be sure none of the tick is still attached; if it is, see your doctor.


  The US Center for Disease Control (CDC) lists the following in their “Tick-borne Diseases (Partial List)”  

*Lyme Disease

*Stari Rash

*Tick Borne Relapsing Fever 

*Babesiosis (Babesia Infection)

*Anaplasmosis

*Erlichiosis

*Rocky Mountain Spotted Fever 


The CDC then has a general topic of “Diseases Related to Insects and Their Relatives.”  The Lyme Disease Association based in Jackson, New Jersey also notes that diseases like Lyme further weakens your system to allow tick-borne co-infections like Bartonella, Tularemia and many virus types, which assumably fall into the CDC’s related disease category.


North Carolina has put out a huge amount of information about Rocky Mountain Spotted Fever (RMSF).  We have the distinction of being one of 2 states with the highest incidence of RMSF.  Our state and Oklahoma combine to have 35% of all the incidents in the US.  Further, 2/3 of those infected are under 15 years old, most commonly 5 to 9 year olds who live near wooded areas.


Of all of these diseases, Lyme Disease is one of the most insidious.  If not diagnosed early on, Lyme Disease can stay in your body symptom-free for weeks or months, but later cause anything from simple low grade fevers to heart complications, miscarriages and premature births. Lyme Disease is found primarily by clinical tests, but these serological (blood and chemical) tests can often show false results.  Because of this difficulty in diagnosis, some doctors are very hesitant to treat an illness as a Lyme-related symptom.  Many Lyme Disease sufferers go years with varying symptoms before being diagnosed. 


In North Carolina specifically, this has been a very controversial issue. Some state officials do not recognize Lyme Disease as a reality in NC.  Because of the varying symptomology, the high percentage of false test results and the low incidence of reported cases, they say it is not actually  here.  Political lobbying on both sides of the issue argue as to whether there is Lyme Disease here or not.  Meanwhile the CDC has listed 994 confirmed cases of Lyme Disease in NC between 1995 and 2009, including the military reports of Lyme Disease in Camp Lejeune active duty personnel.  Reports vary from 16 to 157 confirmed cases each year.  North Carolina’s 15 year average is 66 cases per year. This compares to Virginia’s average reports of 302 per year, Tennessee’s average of 26 per year, and South Carolina’s average of 16 per year.


Doctors often follow the lead of state officials in their attitude.  When North Raleigh resident Fonda Notch was bitten in 2000, she was denied even simple antibiotics.  The doctor told Fonda,  “There is no such thing as Lyme Disease in North Carolina,” and he threw away the tick she saved rather than analyze it.  He then gave her anti-anxiety medicine rather than antibiotics.  For the next year Lyme Disease flared up and she paid thousands of dollars in medical tests to try to find out what was wrong.  Finally she went to another state and a simple test confirmed Lyme Disease.  


Louisburg veterinarian Dr. Beth Jordan had a similar experience.  Both women were forced to drive monthly for treatments to other states because no doctor in NC would treat them.  In early 2002 the two women created the Lyme Disease Foundation.  Their goal was to educate and help people.  “I get between 1 and 10 emails every day with someone going through the same thing,” Fonda said.  That would be between 4,000 and 40,000 people so far who have emailed her.  This is several times the number of reports sent to the CDC, which implies the people’s doctors are not reporting or confirming the reports.  More importantly, they are not testing for the disease.  Fortunately, some doctors have begun to recognize Lyme Disease in NC and will test for and treat it.


What is the Lyme Disease Foundation hoping for?  “Full acknowledgment would be the best,” Fonda said, “when overwhelming evidence, the US CDC, the military, and thousands of people say it is here, consider it real.”  But Fonda is more realistic.  She doesn’t expect people to change their minds once they have gotten it in their head they are right.  Her suggestion is simpler, “if they’re not allergic to the antibiotics, is it going to hurt to let the patient take them?” she asks.  “Better safe than sorry.”  She also said that tick bite victims should “demand your doctor test you, and ask for antibiotics, even if you are symptom free.  Don’t allow yourself to be a victim.”



All ticks do carry diseases, and a tick bite should never be taken lightly.  Not all ticks carry every tick-borne disease. Of the four types of ticks only one carries Lyme, and two carry Rocky Mountain Spotted Fever. 


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The 4 major types of ticks in NC each come with their own set of diseases.  

 

[[ /\ Lone Star Tick /\ ]]

The “Lone Star Tick” Amblyomma americanum is the most common one in the piedmont area, and it is a dark brown with a single light colored dot on its back.  These ticks can be as small as the head of a pin or up to 4mm (0.2 inches).  According to the Tick-Borne Infections Council of NC, they can carry Stari, Tularemia, Tick paralysis, and Babesiosis.  

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[[/\Brown Dog Tick /\  ]]           [[/\ American Dog Tick /\ ]]

The two types of Dog Ticks we have in NC can be infected and transmit Rocky Mountain Spotted Fever, and erlichiosis. The American Dog tick also transmits tick paralysis and tularemia. The brown dog also sometimes transmits babesiosis.  

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[[ /\ Black Legged, or Deer Tick /\ ]]

The Black Legged, or Deer Tick can potentially pass on Lyme Disease, babesiosis, erlischiosis, bartonella, and two types of viral encephalitis. 

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What is the treatment for these bites?  According to the Center for Disease Control, a tetracycline antibiotic is usually the appropriate treatment if given within the first 4-5 days.  Adults dosage of 100mg twice daily of Doxycycline or 2.2 mg/kg body weight per dose for children under 100 pounds.  Oral or intravenous are both effective and should be maintained for at least 3 days after symptoms subside, for a total course of 5 to 10 days minimum. Tetracyclines are not for use during pregnancy without serious risk to both fetus and mother.  Fonda reminds us that, “These ticks have all been somewhere nasty, so whether or not they carry Lyme or whatever, or not, does it hurt just to give the meds?”



Always be aware of things around you when you go outdoors, and always make sure you check yourself for unwanted passengers when you go back inside.


Information sources for further questions:

NC Lyme Disease Foundation - www.nclyme.org

Tick-borne Infections Council of NC, Inc. - www.tic-nc.org

Lyme Disease Association - www.lymediseaseassociation.org

Carolina Lyme - http://carolinalyme.org/

US Center For Disease Control - www.cdc.gov/ticks/diseases/index.html

Lyme Disease statistics - http://www.cdc.gov/ncidod/dvbid/lyme/ld_rptdLymeCasesbyState.htm


 

Bio:  Steve Stone is a native of North Carolina. As a wildlife educator and caretaker, he runs The American WIldlife Refuge Inc.  His wildlife presentations are seen by thousands of people each year, and his rescue efforts have saved the lives of hundreds of birds including bald eagles.  Steve is the only educator within 100 miles able to bring a live eagle to his presentations. He has been working with wildlife since 1996, and received recognition from NC Wildlife Resources Commission for his work.  Steve teaches courses through NC Wildlife Resources Commission and Wake Technical Community College, which are recognized by the NC Veterinary Board, and the US Fish and Wildlife Service for their licensing.

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