Thursday, July 22, 2004
Be aware of dangers of ticks
Hikers, hunters, gardeners and others who spend time in grassy and wooded areas can be bitten by ticks that spread disease. Tick-borne diseases such as Lyme disease, tularemia, Rocky Mountain spotted fever and ehrlichiosis share symptoms with more common illnesses, but may have serious effects. Prevention, proper removal and prompt recognition of symptoms are important steps in protecting one’s health against these diseases. Ticks thrive in vegetation that provides darkness, warmth and moisture. These pests transmit disease by attaching to humans and animals by their mouths. It takes 24-36 hours of attachment before a disease is transmitted from tick to person. During this time, bacteria in the tick’s saliva enter the victim’s blood through the bite.

Take the following steps to prevent tick bites:
  • Wear long sleeves and long pants in light colors that make ticks visible. Tuck your pant legs into your socks.
  • Spraying boots and clothing with repellents containing permethrin provides protection for days. Repellents containing DEET can be applied to the skin but last only a few hours before reapplication is necessary. Wear insect repellent containing less than 50 percent DEET for adults, less than 30 percent DEET for children. Do not overuse; application of large amounts of DEET on children has been associated with adverse reactions.
  • Search your body for ticks when returning from potentially tick-infested areas. Check children for ticks, especially in the hair.
  • Be alert to ticks carried into the household on blankets, lawn chairs, clothing and pets.
  • Mow grass to below six inches in height to allow the penetration of sunlight and soil ventilation.
Removing ticks promptly reduces the risk of disease:
  • Use fine-tipped tweezers or shield your fingers with a tissue, paper towel or rubber gloves. Avoid removing ticks with bare hands whenever possible.
  • Grasp the tick close to the skin surface and pull upward with steady, even pressure.
  • Do not squeeze, crush, or puncture the body of the tick, since this may force infected fluids (saliva, body fluids, gut contents) into the wound.
  • After removing the tick, cleanse the site with an antiseptic or soap and water, and wash your hands.
  Delaware’s Division of Public Health does not recommend the use of home remedies such as petroleum jelly or hot matches for tick removal. These methods are not effective. Once bitten by a tick, recognizing the following symptoms and receiving prompt treatment can limit the severity of disease. Individuals infected with tick-borne diseases may be treated with antibiotics. More than 23,000 cases of Lyme disease occurred in the United States in 2002, with 212 in Delaware in 2003.

Symptoms include a characteristic bull’s-eye rash, fever, fatigue, headache, muscle aches and joint aches. Occasionally, chronic joint, heart and neurological problems may occur. Lyme disease is rarely fatal. Tularemia is carried by rabbits and rodents. Humans are infected by tick bites, by handling infected animal carcasses, and by eating or drinking contaminated food or water. Two confirmed cases and one probable case of tularemia were reported in Delaware in 2003. Symptoms include sudden fever, chills, headache, muscle aches, joint pain, dry cough, weakness and pneumonia. Other symptoms depend on how a person was exposed and can include skin ulcers, swollen lymph glands and sore throat. If untreated, up to 40 percent of those with advanced tularemia may die.

Nationwide, 250-1,200 cases of Rocky Mountain spotted fever (RMSF) are reported each year, with over half of RMSF infections occurring in the South Atlantic region. There have been no confirmed cases in Delaware in the last three years, however 55 cases were reported from 1995-1999. Symptoms include fever, nausea, vomiting, severe headache, muscle pains and appetite loss, followed by rash, abdominal pain, joint pain and diarrhea. Many patients require hospitalization, and approximately 3-5 percent of cases are fatal. Nearly half of all ehrlichiosis patients require hospitalization. Symptoms include fever, headache, malaise, muscle aches, nausea, vomiting, diarrhea, cough, joint pains, confusion and occasionally rash. Ten confirmed cases of ehrlichiosis were reported in Delaware in 2003. An estimated 2-3 percent of patients may die from the infection. For additional information contact Delaware Division of Public Health, Bureau of Epidemiology at: 1-888-295-5156. vv