Tick Off: How to Stop the Spread of Bug-Borne Diseases

In the summer of 2005, researchers warned of a rise in Rocky Mountain spotted fever. Rocky Mountain spotted fever is a rare but potentially fatal disease caused by tick bites. Although mostly isolated to North Carolina and other Southeastern states, 11 cases of this tick-borne disease were confirmed in Arizona, according to a study led by the Centers for Disease Control and published in the New England Journal of Medicine.

"This study shows that Rocky Mountain spotted fever can show up in unexpected places, and should put physicians on alert for the signs and symptoms of the disease," stated Dr. Stephen Dumler of the Johns Hopkins School of Medicine in a statement.

In fact, experts say, the same holds true for the full variety of tick-borne infections. More diseases are transmitted to humans by ticks than by any other bug. And although certain areas in the United States have higher rates of tick-borne diseases than others—the Northeast with Lyme disease and Colorado with tick fever—virtually every state has reported illnesses from tick bites.

Many tick-borne diseases turn out to be harmless if diagnosed early and treated with antibiotics. Still, an infection from a tick can turn out to be serious, even fatal. With a vaccine for Lyme disease no longer available and few replacements on the horizon, it's up to you to protect yourself from tick bites.

The Enemy Ticks are pin-point-sized parasites that resemble a cross between a spider and a very small turtle. There are some 80 different species of ticks in the United States, but only 12 or so that are able to spread disease to humans. They are mainly found in grassy and wooded areas, where they cling to brush, high grass or whatever they can find before making their way to a host. The manicured suburbs, while safer, are not immune. "The worst golfers are more likely to get a tick bite as they are in the rough more often," says Dr. Gary Wormser, director of the Division of Infectious Diseases at New York Medical College, only half jokingly.

What Ticks Spread Ticks pick up infections by feeding on the blood of deer, dogs and other animals. Because they penetrate the skin when they bite into humans, ticks make for potent disease spreaders. The most common infections include:

  • Lyme disease—Endemic to Connecticut and much of the Northeast, Lyme disease is the most prevalent tick-borne disease, with more than 20,000 cases diagnosed each year. Although largely a problem in the northeastern part of the country, the Centers for Disease Control (CDC) warns that states such as Wisconsin, Minnesota and parts of California are also at high risk.
  • Rocky Mountain spotted fever—Spread by the American dog tick, Rocky Mountain fever was discovered in the United States in the 19th century and is now the second-most common tick-related illness. Despite the name, the disease is mostly reported along the Southeast coast and in the Midwest.
  • Southern Tick-Associated Illness (STARI)—This is rare disease, found mainly in the South; it is believed to be spread by the lone star tick. STARI is associated with a rash that makes it hard to distinguish from Lyme disease.
  • Colorado tick fever—Mostly concentrated in the West, Colorado tick fever is spread by the Rocky Mountain wood tick.
  • Ehrlichiosis—There are two distinct strains of ehrlichiosis, including human monocitic ehrlichiosis (HME) and human granulocytic ehrlichiosis (HGE). The disease occurs worldwide, but the majority cases are in the United States, in just about every region except the West coast.
  • Babesiosis—Spread by the same tick that carries Lyme disease, about 20 percent of people who develop babesiosis also show evidence of Lyme disease.
  • Tularemia—Only 150 to 300 cases of tularemia are reported each year, with majority of them occurring in Arkansas, Oklahoma and Missouri.

How To Avoid Ticks
The rise in Lyme disease and ehrlichiosis has prompted renewed concerns about tick bites. Avoidance is your best bet. Wormser recommends staying out of tick-infested areas, when possible (A city or state health agency can tell you what areas might be dangerous). If you plan to be outdoors in a rural or wooded area, try to:

  • Cover as much of your skin as possible (long sleeves, long pants) and wear light colored clothing
  • Avoid open-toed shoes and keep your pants tucked into your socks
  • Use insect repellants that contain the ingredient DEET

Once Bitten
It can take a day or two of feeding off a host before a tick spreads disease. With some diseases, such as erlichiosis, the rate of infection can be faster. Since ticks are small and their bites are painless, it may be hard to tell if you have acquired a tick. Check your clothing and body after you've been out in the woods or countryside, especially in places known to be infested with ticks. In a well lighted area, check everywhere on your body, including your scalp. Use a mirror or have someone else check your back to see if any ticks have made it there.

To remove a tick, grasp the tick as close to the skin as possible by using a thin-tipped tweezer or tick puller and pull the tick upward with a steady pressure. Most tick bites probably don't require a trip to a doctor, unless you notice a large rash or start to feel ill. However, antibiotics might help prevent Lyme disease transmitted by blacklegged, or "deer" ticks. For this kind of tick, Wormser says it is a good idea to see a knowledgeable practitioner. At the very least, save any tick that you remove from your skin for testing: You can keep it in a plastic container just in case.

Symptoms of an Infection
Every tick-borne disease has its own particular set of symptoms. But in general, you may experience a rash and flu-like symptoms about 7 to 10 days after an infection. For Lyme disease, the most common scenario is a rash at the site of the tick bite that measures more than two inches in diameter, plus aches and pains. People who have ehrlichiosis or Rocky Mountain spotted fever may suffer from fever, chills or a headache. For tulamaria, which is very rare, there are also symptoms of sore throat, diarrhea and vomiting.

The percentages of tick-bites that develop into serious illness are fortunately, very low, says Wormser. But if left untreated, ehrlichiosis can lead to respiratory failure. Late-stage Lyme disease is associated with a range of problems, including chronic arthritis, the stiffening of joints. If you feel ill or achy after a tick bite, or from being outdoors in a tick-infested area, make sure to see a doctor.

Treatment
A range of common antibiotics can be used to treat tick-borne diseases and prevent more serious complications. They are highly effective, as long as the treatment is matched to the right disease. As always, the best defense is prevention.

For more information about ticks and tick-borne diseases visit the Centers for Disease Control and Prevention http://www.cdc.gov

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