- - Thursday, June 1, 2017

ANALYSIS/OPINION:

If you think you have everything figured out about ticks, the Centers for Disease Control and Prevention (CDC) wants you to revisit “what you know” – warning that it could be one of the worst summers on record. In fact, infections from tick-borne diseases in the United States are steadily increasing — and too, new tick-borne diseases have been discovered in recent years. Add to all of this, the geographic ranges of ticks also are expanding.

Most of us know that ticks are small insects (arachnids) that bite to fasten themselves onto the skin of an animal or human – and feed on blood. When an infected tick bites a person or an animal, the tick’s saliva transmits infectious agents — bacteria, viruses, or parasites — that can cause illness. They include: Lyme disease bacteria, Babesia protozoa, Anaplasma, Ehrlichia, and other rickettsia, even encephalitis-causing viruses, and possibly Bartonella bacteria. While “back in the day,” tick bites were more of an annoyance, today a bite is much more likely to make you sick and can even change your life!  

And it is “tick season.” The CDC reports that from May through August people get tick bites and tick-borne diseases more often than any other time of year. Let’s look at important information, measures for prevention and symptoms to watch for – for your safety.

Dr. Nina’s What You Need To Know: About Ticks

Over the past two decades, Lyme disease cases have tripled in the US as the tick that spreads the illness has expanded its territories from a few northern pockets into half of all US counties. Every year, an estimated that 300,000 Americans are infected with Lyme disease. Although a course of antibiotics can usually eradicate it, diagnosis and early treatment of this stealth disease are often delayed. However, missed (and mis-) diagnosis can cause often preventable suffering.

Humans contract Lyme disease when bitten by a tick that is infected with the difficult-to-pronounce bacteria, Borrelia burgdorferi. And because a tick’s bite is often painless — its saliva has anesthetic properties — it may go unnoticed.  

In the majority of cases, a tell-tale rash shaped like a bull’s eye will appear between 3 to 30 days after the tick bite. However, in 30% of Lyme disease cases, no rash appears. Those infected may only experience vague symptoms such as headache, fever or fatigue. In medical jargon we call these “non-specific” symptoms because we may have a headache from being dehydrated or sleep deprivation, fever from another infection, or fatigue from a plethora of causes. Because they are not “specific” to Lyme disease, this can lead to a delay in seeking medical care, diagnosis and treatment. Laboratory blood testing can be done to confirm it. However, if done in the early stages of infection, the blood test may yield a false-negative result.

Lyme disease can affect a number of organs. Some late-stage symptoms include Bell’s palsy (the loss of muscle tone on one or both sides of the face); neck pain that mimics meningitis; joint pain and swelling; shooting or pins-and-needles pain; and heart palpitations.

The majority of cases can be treated and eradicated with a few weeks of antibiotics. The antibiotic will be chosen based on your age, allergies, and stage of disease and symptoms. It is important to take the antibiotics as directed, meaning to complete the entire course even if you are feeling better. And, according to the CDC, 10 percent to 20 percent of patients who undergo the complete course of antibiotics have “Post treatment Lyme Disease Syndrome.” This manifests as lingering fatigue, pain, or joint and muscle aches.

Powassan Concerns. The CDC is also warning about a possible increase in the spread of the tick-borne illness, Powassan (POW) virus. This potentially life-threatening virus is carried and transmitted by three types of ticks, including the deer tick that transmits Lyme disease. And while POW is nowhere near as prevalent as Lyme—it is starting to show up more often.

Scientists estimate that POW is only prevalent in about 4 percent of deer ticks, way lower than the 30 percent to 40 percent prevalence of Lyme disease. But POW, goes from the tick’s body, through its saliva, and into your bloodstream within a few minutes of a bite (while Lyme takes much longer to spread from tick to human). So even though it’s not in many ticks, if the right one gets you, it’s immediate and there’s not much you can do.

Only about 75 cases were reported in the U.S. over the past decade but experts warn the disease could spread faster now that it’s transmitted by the deer tick.  

Not every tick is infected with the virus, and not everyone who is bitten will get sick.  In some people, the viral infection is mild—headache, fever, vomiting—and resolves. But others may experience more severe symptom—memory problems or confusion, trouble walking or standing, and seizures that can become permanent.

Protecting Against Ticks
    •    Avoid wooded and bushy areas with high grass and leaf litter; walk in the center of a trail; wear protective clothing; and use 20-30 percent DEET (repellant) on clothing and exposed skin. When applying repellant, pay special attention to the feet and ankles—people often forget these areas despite the fact that they are typically the most accessible to ticks.   
    •    Be vigilant. While it is wise to take preventive measures against ticks year-round, be extra vigilant in warmer months, when ticks are most active. After returning from outdoor hiking or even routine backyard excursions, conduct a full-body check. Ticks love hard-to-see places that are warm—such as our scalp, armpits, behind our ears and groin—so pay special attention to these areas. Bathing or showering as soon as possible after coming indoors (preferably within 2 hours) can make it easy to find ticks crawling or attached to us and easily wash them off.  
    •    Wash clothing that has been worm outside, especially after being in wooded or bushy areas. Program your dryer at the highest temperature because ticks are hardy and can survive washing machine cycles. And, too, this can help decrease suffering from seasonal allergies which is currently in “full bloom.”
    •    Reduce a tick’s habitat, even in our own backyards. Because ticks do not fly or jump, it requires direct contact with them to get bit and allows us an opportunity to decrease its incidence. Some helpful tips: clearing tall grass and brush; placing a 3-foot wood chip or gravel barrier between wooded and play or sitting areas; and removing trash, fallen leaves and old furniture that may be a hiding haven for ticks.
    •    Treat dogs for ticks. Our four-legged loved ones are particularly at-risk for tick bites, Lyme disease and bringing ticks into our homes or areas we visit with them. It is important to apply products that prevent tick bites to our dogs - and check them for ticks.

Found a tick?
    •    It typically takes between 36 and 48 hours for a tick to transmit the bacteria that causes Lyme disease. If you find a tick follow the next step and it is advisable to consult your physician.
    •    Use tweezers to grasp the tick as close to the skin as possible and pull directly upward. If any of the mouthparts remain in the skin, try removing them with tweezers. Use soap and water or rubbing alcohol on the bite area and place it securely in a sealed bag and then with you to consult with your doctor, or into the trash. The CDC recommends that we avoid “folklore remedies”—painting the tick with nail polish or using heat to detach it. Keep it simple.
    •    As well, see your doctor if you have any of the POW or Lyme symptoms and might have been exposed to ticks. (Call 911 or go to an emergency room for severe symptoms)

The CDC has warned that this summer looks like it might be one of the worst on record for an increase in the tick population. Though no one can say how many infections will occur this year, experts report that warmer winters have led to an increased tick population, with predictions of rising tick-borne infections of many types. Being informed is a powerful tool for our good health.


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