Duke Raleigh Hospital

Keep Yourself Safe During Tick Season

Ahhh, the smell of fresh air, the sound of a running stream, no traffic jams, just miles of trees and trails ; there is nothing like enjoying the outdoors!

Unless of course, you end up with an unwanted souvenir.

In the United States, some ticks carry pathogens that can cause human disease, including the two most well-known – Lyme disease and Rocky Mountain Spotted Fever (RMSF).

A tick bite can be serious, but if you find a tick attached to your skin, there’s no need to panic. Fine-tipped tweezers will remove a tick quite effectively. The steps to remove a tick are simple:

• Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
• Once you’ve grasped the tick with tweezers, pull upward with steady, even pressure. Don’t twist or jerk the tick. This can cause parts of the mouth to break and remain in the skin. If this happens, remove the mouth parts with tweezers.
• If you’re unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
• After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub or soap and water.

Avoid folklore remedies such as “painting” the tick with nail polish or petroleum jelly or using heat to make the tick detach from the skin. The goal is to remove the tick as quickly as possible. Don’t wait for it to detach.

Tick bites are usually painless and, consequently, most people will be unaware they’ve been bitten. In some individuals, a reaction to the bite will aid in its detection, but most people will be unaware a tick is attached and feeding. Ticks often crawl to warm, moist places on the body like the neck, behind the ears, under the arms and the groin. They then attach themselves to the body to feed. That’s when they can spread disease.

Many tick bites are benign if removed promptly. It typically takes six to 12 hours for a tick to transmit an infectious bacterium to the host. The longer the tick is attached, the greater the likelihood of disease transmission.

Protect Yourself

While it is a good idea to take preventive measures against ticks year-round, be extra vigilant in warmer months (April through September) when ticks are most active. Avoid wooded and bushy areas with high grass and leaf litter. While hiking, always walk in the middle of the trail. You may also keep ticks at bay with repellants that contain 20% or more DEET. When applying, avoid hands, mouth and eye exposure. You may also consider using a product called Permethrin on clothing.  Treat clothing and gear, such as boots, pants, socks and tents. It will remain effective through several washings.

Consider bathing or showering as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks. Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body. Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist and especially in their hair. Examine your gear and pets. Ticks can hitchhike into your home on clothing and pets and then attach themselves to you later.

If You Find a Tick …

It is unlikely anyone will contract disease from a tick within the first few hours after it bites, so if ticks are found and removed quickly, any danger is reduced.

Save the tick in a jar or plastic bag or tape it to a card using clear tape and make a note of the day you removed it. If you develop flu-like symptoms over the next several weeks, see your doctor and let him or her know you were bitten. Tickborne diseases can result in symptoms that range from mild and treatable at home to severe infections requiring hospitalization. Although easily treated with antibiotics, these diseases can be difficult to diagnose. Early recognition and treatment of the infection decreases the risk of serious complications. So see your doctor immediately if you have been bitten by a tick and experience any of these symptoms.

• Fever/chills.

• Aches and pains. Tickborne disease symptoms include headache, fatigue and muscle aches. (With Lyme disease, you may also experience joint pain.)

• Rash. In Lyme disease, the rash may appear within three to 30 days, typically before the onset of fever. The Lyme disease rash is the first sign of infection and is usually a circular rash. This rash occurs in approximately 70 to 80 percent of infected individuals and begins at the site of a tick bite. It may be warm, but is not usually painful.

The rash of STARI, another tickborne illness, is nearly identical to that of Lyme disease, with a red, expanding “bulls’ eye” lesion that develops around the site of a tick bite. Unlike Lyme disease, STARI has not been linked to arthritic or neurologic symptoms.

The rash seen with RMSF varies from person to person. About 10 percent of people with RMSF never develop a rash. Most often, the rash begins two to five days after the onset of fever as small, flat, pink, non-itchy spots on the wrists, forearms and ankles and spreads to the trunk. It sometimes involves the palms and soles. The red to purple, spotted rash of RMSF is usually not seen until the sixth day or later after onset of symptoms.

Remember: Finding a tick is no reason to panic. Take precautions and take care after spending time in the woods. But don’t let a fear of ticks keep you from enjoying the season and the out-of-doors.