Ware, MA – While it is a good idea to take preventive measures against ticks year-round, be extra vigilant now and through September when ticks are most active.
“Due to the extraordinarily mild winter and the early spring experts are predicting an early boom in the tick population—something we are clearly seeing right now,” said Dr. Paul Gerstein, Emergency Department staff physician at Baystate Mary Lane Hospital. “Although ticks can pose quite a problem, that shouldn't stop people from enjoying outdoor activates. But to be safe, families should simply be more vigilant and take proper precautions to avoid a tick bite.”
According to the National Centers for Disease Control and Prevention (CDC) in 2010, 94% of Lyme disease cases were reported from 12 states, Massachusetts being one of them. The Massachusetts Department of Public Health reports of Lyme disease have risen for most of the past decade across Massachusetts, most dramatically in communities west of Boston. Statewide, there were 4,116 confirmed cases in 2008 and 4,061 in 2009, and the number dropped off sharply in 2010, with 2,627 confirmed cases due to the hot and dry summer, which took a toll on the tick population.
“There is no way to ensure zero risk of Lyme disease and other tick-borne illnesses. However, exercising caution is the best way to reduce risk,” said Dr. Gerstein. “Wearing light-colored clothing will help you and others notice ticks on your clothing before they can attach themselves to your skin. Also by tucking your shirt into your pants and your pants into your socks, ticks will be less able to crawl onto exposed skin.”
Applying repellents that contain 20% or more DEET (N, N-diethyl-m-toluamide) on the exposed skin can offer protection that lasts up to several hours, notes Dr. Gerstein, who encourages families to always follow product instructions. Parents should apply this product to their children, avoiding hands, eyes, and mouth. The CDC also recommends picaridin and oil of lemon eucalyptus. These repellants offer protection similar to low concentrations of DEET, when used in similar concentrations. Spraying pant legs and socks with permethrin (lice spray) will also repel ticks.
“Once indoors, you should scan your body for what appears to be a small black dot that feels like a scab (if attached),” said Dr. Gerstein. “While checking for ticks, pay special attention to the areas that they prefer to hide, like the back of the neck, the hair line, the armpits, the upper back, behind the ears and behind the knees. Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine them.”
“If you do find a tick, don’t panic,” notes Dr. Gerstein. “By removing a tick in the first 24 hours after attachment, you reduce your risk of infection to almost zero. Using tweezers, grasp the tick as close to the skin surface as possible, and pull it directly straight out.
Avoid using petroleum jelly and hot matches, which are not effective or can cause injury. These methods may make matters worse by triggering the tick to release more of its bodily fluids, and that could cause further infection.”
Once the tick is removed, you should dispose of it and wash the area of the bite and your hands with warm soapy water. Don’t worry about mouth parts remaining embedded. These will not cause harm and cannot transmit disease. The body will expel these parts in a few days. Digging to remove them can cause more injury.
“In the case of a tick bite, watch for early symptoms of tick-borne disease,” said Dr. Gerstein. “These include headaches, lethargy, fever, chills, muscle and joint aches, a stiff neck, and most importantly an expanding, circular or oval area of redness at least 1-2 inches in diameter. Small areas of redness around a tick bite are common and not an indication of Lyme disease if they do not expand.” In Lyme disease, the rash may appear within 3-30 days, typically before the onset of fever. This rash appears in approximately 70-80% of infected persons and begins at the site of a tick bite. The area may be warm but is not usually painful. If you know you’ve been bitten by a deer tick, watch the area of the bite carefully. But, half of all deer tick bite go unnoticed, so do not ignore any symptoms suggestive of tick-borne illness, especially, an expanding rash and/or flu-like illness.
According to Dr. Gerstein, Lyme disease in its early phases is easily treated and completely cured by a two week oral antibiotic treatment. Single dose antibiotic preventative treatment (prophylaxis) is available for older children and adults immediately after tick bite with greater than 24 hours skin attachment—but before any signs of Lyme disease. A trip to the doctor’s office or local emergency department is warranted for prolonged deer tick attachment or any signs of illness to enable prompt treatment. It’s important to note that testing for Lyme disease in its acute phase (under 4-6 weeks from the bite) is almost never indicated, is inaccurate and unhelpful.
For more information about ticks visit the Centers for Disease Control and Prevention (CDC) at www.cdc.gov/Features/StopTicks/ .
Dr. Paul Gerstein is one of the board certified Emergency Physicians who proudly provides expert care in the Baystate Mary Lane Hospital Emergency Department. The Emergency Department is open 24 hours per day 7 days a week, providing urgent and emergent care for all medical, surgical and pediatric problems. For more information about Baystate Mary Lane Hospital visit www.baystatehealth.org/bmlh.