Friday, March 18, 2022

Tick bites 2022

 

Tick Bites 2022

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."

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.

There are 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 identified as the ixodes pacificus.

Although only a small percentage of tick bites are harmful, Tick Borne diseases can have a major health impact, so we need to pay attention. There are multiple types of bacteria responsible for tick borne illnesses. Ticks here in California are known to transmit several different diseases, including Lyme. The rates for tick borne diseases are higher in California than previously thought. A study from 2021 found that about 4% of the ticks tested positive for Lyme. Interestingly that also found that there were plenty of ticks close to the beach!

The key is prevention.

If you are going to be playing or hiking outdoors near woods or grass, 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.

If you are looking for more natural remedies, here is a list of essential oils that are associated with insect control:

Lavender - This smells sweet to us but bugs tend to hate it. It can repel mosquitoes, flies and other insects.

Lemongrass - this essential oil comes from tropical lemongrass. It has a nice citrusy scent. It is a natural flea and tick repellent that can be sprayed directly on the skin.

Eucalyptus - use this alone or along with citronella oil to keep bugs away. According to the Journal of Medical Entomology, eucalyptus extract can reduce tick bites.

Lemon - Some lemon essential oil can work against fleas and other bugs. Dilute it and spray it on your clothing and and skin.

PennyRoyal - this is a member of the mint family. It is toxic to insects. Be wary of this one.Pregnant women should avoid handling this essential oil because it has been linked to miscarriage.

Sorry to say, as much as I love the natural remedies, none of the above are going to work as well as the DEET.

If you are going to be walking or hiking try to stay in the middle of the path. Avoid wood piles and logs. Light colored long sleeves and long pants are recommended. 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, or a romp in the grass!

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 between the fingers, toes and behind the ears. Check armpits and belly buttons as well. You 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. Doing a daily body check is a good habit in general. If there are any new rashes, bites or bruises, you will have a timeframe for when they showed up.

If you are returning to your home after a hike, use a lint roller to do a quick pass over your clothes. You may be shocked at what you collect from that. Then take off all clothing and put everything in a hot dryer for 60 minutes to kill any wandering ticks.  

Don’t forget to check the car seat!

it is very important to remove any ticks as quickly as possible. For Lyme disease, the tick generally needs to be on you for more than 24 hours to be a concern. The bacteria that causes Lyme migrates from the tick's gut to its salivary glands before the pathogen can be transmitted. One infectious disease expect at UCSF says that might be 36 hours!

If you do find a tick, please stay calm. I have vivid memories from my time at NVP of a mom carrying her toddler into the office. She was screaming (the mom, not the kid) "HELP ME GET THIS THING OUT OF MY BABY!" There was a large tick attached behind her little one's ear. It looked like a Star Trek alien. It was indeed freaky, but put on a brave face for your child.

Arachnophobia is appropriate in this case. Ticks are indeed arachnids (the spider family). For the record, the big ones are usually wood ticks and those are not the ones that carry Lyme.

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. This is not the time to try any of the folk remedies such as Vaseline or a burning match.

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 from any sporting good or pet store. Amazon has a ton of different brands.

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 the tick, but now what???

I am going to have you keep your antenna up for at least 30 days. If there is any odd rash, flu like illness, aches, or fever it is important to notify your doctor. They will want to know the date of the bite, and if possible the region where the tick came from. Any recent travels could provide important data.

Unfortunately the blood tests for tick borne diseases such as Lyme are not all that helpful. Frequent false positive and false negative results minimize their usefulness.

The tests become more accurate several weeks after the bite, Decisions about when to treat are best made earlier.

Testing the tick might make more sense than testing the patient. Keep a little baggy in your backpack or diaper bag.
This way you have a place to stick any ticks that you remove. 

The Sonoma County Health Department will identify the tick for free. This tells you if it is the type you need to worry about. They can also take it a step further and test it for Lyme disease. The fee for testing is $36 (such a deal.) They don't test the ticks for other illnesses. They do the testing every Thursday and they will have the results by Friday. They say that about 1-3% of the ticks test positive.


707-565-4711

In Marin they will also test the ticks:


Read the instructions on their website for how to send the tick.

Ah, but there are other experts who don't agree that testing the tick is worth the effort. A tick testing positive doesn't mean it was on long enough to transmit a disease.

A tick testing negative for LYME might be infected with an illness that we can't test for yet

It is possible that there was another tick on the body that you didn't find.

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. A bulls-eye rash around the tick bite site and/or any type of flu symptoms would be a concern. Some of the less frequent tick borne illnesses might have a more diffuse rash. Not everyone gets all symptoms.

If there are any suspicious symptoms speak to your doctor. They may opt to do a course of antibiotics.

There are new guidelines that emerged in August 2019.
In the areas where Lyme is endemic, they may now give a single prophylactic dose of doxycycline. Doxycycline can be associated with tooth discoloration, so it isn't used unless suspicion for Lyme exposure is high.

Prophylaxis can be started within 72 hours of tick removal. They don't wait for symptoms to show up.

We don't want to treat every tick bite with antibiotics for obvious reasons. 

It is a 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. Carefully brush out your pets as well!

No comments:

Post a Comment