Dealing with Tick bites
Ah, the twisted thinking of an advice nurse. For most folks, spring
brings to mind warmer weather, longer days, lovely flowers etc. Me? I
think,"Here comes tick season"
Indeed the calls are already coming in and I have spoken to a half dozen patients about tick bites just this week.
It makes sense. With the nicer weather more of my patients are out
there taking walks, hiking and enjoying the beautiful area that we live
in.
Ticks can be an issue all year long, but the nymphs are born in the
spring. These tiny little ticks are the ones most likely to transmit
diseases.
Of
the many varieties of ticks out there, the ones responsible for the
majority of disease transmission are the deer ticks. If you want to
impress folks at your next cocktail party, our local deer tick is
officially identified as the ixodes pacificus
Although
only a small percentage of tick bites are harmful, the diseases can
have a major health impact, so we need to pay attention. There
are many conflicting reports, but recent studies coming out this year
suggest that the rates for tick borne diseases are a bit higher in
California than previously thought. Ticks that have been caught and
examined are testing positive for two separate bacterial illnesses. We
are most familiar with Lyme (Borrelia Burgdorferi)
but they are finding that here in the San Francisco Bay Area just as
many, if not more ticks are infected with Borrelia Miyamotoi. This
second illness is a close cousin to Lyme. It has the similar flu like
symptoms including headaches, nausea and muscle pain. It does not have
the rash that is associated with Lyme.
They are both treated with the same antibiotics.
The key is prevention.
If
you are going to be walking or hiking in densely wooded areas try to
stay in the middle of the path. Avoid wood piles and logs. Light colored
long sleeves and long pants are recommended. Spray the clothing
with the bug repellent Permethrin. This is okay for anyone over 2
months of age. Use Deet on exposed skin, avoiding hands, eyes, and
mouth.
But let's face it, on a hot day we are not going to have our bodies covered completely, so here is the deal....
Everyone
needs to get a naked head-to-toe body check after a walk in the woods.
If you are camping, do a full body check daily. Ticks can hide in out of
the way places on your body. Don't forget to check the scalp. If you
are dealing with thick darker hair, you can rub your fingertips along
the scalp and feel for any bumps. Check in between the fingers and toes,
check armpits and belly buttons.You really need to be very thorough.
Many of the ticks are very tiny and hard to see. Be familiar with little
moles and freckles so you can recognize a new spot which might be a
little tick.
If
you are returning to your home after a hike, take all clothing and put
everything in a hot dryer for 60 minutes to kill any wandering ticks.
It
is very important to remove the tick as quickly as possible. If a tick
is removed within 4 hours of the bite, the chances of any disease
transmission are SIGNIFICANTLY decreased. For Lyme disease, the tick
generally needs to be attached for more than 24 hours to be a concern.
If
you do find a tick, please stay calm. I can still remember vividly,
years ago, a mom carrying her toddler into the office screaming (the
mom, not the kid) "HELP ME GET THIS THING OUT OF MY BABY!" Hey,
Arachnophobia is appropriate in this case, because ticks are indeed
arachnids (the spider family), but put on a brave face for your child.
The
best way to remove a tick is with tweezers or a special tick removing
tool. Grasp the tick as close to the skin as you can and firmly pull up
and away. Do not twist. The Public Health department councils that you
should not try any of the folk remedies such as Vaseline, burning match
etc. If you own a dog or go hiking frequently, do yourself a favor and
get one of the tick removing tools. You can get them pretty cheaply from
any sporting good or pet store. Amazon has a ton of different brands. I
do not have a favorite.
Once
the tick is out, clean the area with an antiseptic soap, apply a dab of
Neosporin and then keep watch on the area to make sure there is no
infection.
Okay, We got a tick bite. We removed it, but now what???
*watch the site for sign of local infection
* observe for 30 days, If there is any
odd rash, flu like illness, aches, or fever it is important to notify
your doctor. We will want to know the date of the bite, and if possible
the region where the tick came from. Any recent travels are important
data.
Unfortunately
the blood tests for tick borne diseases such as Lyme are initially not
all that helpful. To start off with, you can get both false positive and
false negative results.(Making it pretty useless). It turns out that
once you have symptoms several weeks after the bite, the tests for Lyme
are apt to be more accurate, but that isn't all that helpful right after
the tick encounter when we are trying to decide whether or not to
treat. There are no current tests widely available out there yet for the
newer B.Miyamotoi
Rather
than testing the patient, I would focus on the tick. If you do a lot of
hiking, keep a little baggy in a pocket of a backpack or diaper bag so
that you have a place to stick any ticks that you remove.
The Sonoma County Health Department will identify the tick for free and test it for Lyme disease.They charge a fee of $29 (such a deal.) They don't test the ticks for other illnesses. They do the testing every Thursday and get you the report by Friday. They say that about 1-3% of the ticks test positive.
707-565-4711 Read the instructions on their website for how to send the tick
Here is the bottom line. Regardless of whether or not you get the tick tested....
Watch the person who has been bitten very carefully for the next 4-5 weeks.
If
there are any suspicious symptoms within the month following a tick
bite you absolutely want to speak to your doctor about doing a course of
antibiotics.
Reactions that are a cause for concern would be a bull's eye rash
around the tick bite site and/or any type of flu symptoms. Not everyone
gets all symptoms.
We
don't want to treat every tick bit with antibiotics for obvious
reasons. As with everything, we need to strive for balance. We can't
keep our kids in a box. Go out there and enjoy the hike, but then do
that thorough body check and you should be fine.
If you are a pet owner and you treat your pet with one of the flea and tick treatments, keep in mind that those ticks may leave the pet and go find someplace else to hang out.
This post is an updated version of one that was run last year.