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      Dealing with Ticks

      Dr. Justin Puckett from Complete Family Medicine in Kirksville is answering your medical questions. Monday's question comes from Stewart Donald of Southern Iowa. He asked about tick bites.

      Are diseases from tick bites very common?

      • In the US, ticks are responsible for more human disease than any other insect
      • Tick bite diseases are one of many zoonotic diseases that can be transmitted from animal to human
      • Ticks are effective because they will take blood from about anything that bleeds
      • Ticks must ingest blood before they can molt and move on to the next stage in their life cycle
      • Two major ticks cause disease in Missouri, the Lone Star Tick and the American Dog Tick

      Is Lyme disease the only disease they carry?

      At least six different human tick-borne diseases have been reported in Missouri: Rocky Mountain spotted fever, ehrlichiosis, tularemia, Lyme or a Lyme-like disease, Heartland virus and the southern tick-associated rash illness (STARI).

      • Most of these diseases have been identified in the last 30 years
      • There were 270 cases in MO of RMSF in 2011, the last year the data has been examined.
      • We talk a lot about Lyme disease, but of all the cases of Lyme like disease in Missouri, they do not isolate the same infectious agent (Borrelia burgdorferi)

      So what can we do to avoid getting a tick bite?

      First, prevent getting a tick on you!

      • Understanding a little about tick behavior can give some clues on how to avoid being bitten.
      • For example, one tried-and-true prevention measure is to walk in the center of trails to avoid overhanging brush and tall grass. This is effective because of the way some ticks seek a host, which is called "questing." A questing tick will perch itself, front legs extended, on the stems of grass, low brush or on the edges of leaves on the ground. Using this ambush strategy, the tick waits until a suitable host brushes against the vegetation. Ticks do not jump, fall or fly and are generally found within three feet of the ground.
      • Ticks are smart! Carbon dioxide, which is exhaled while breathing, as well as heat and movement serve as stimuli for tick questing behavior.
      • Using an insect repellent that contains DEET on your skin protects you because it interferes with ticks' ability to locate you. Another repellant called permethrin, which is used on clothing, actually kills ticks (as well as mosquitoes and chiggers). Permethrin products are designed to bind with fabric and persist through launderings when used according to label directions.
      • Light-colored clothing helps you spot ticks more easily and tucking or even taping your pant legs into your socks helps slow them down in their quest for your skin. Prompt, careful inspection and removal of ticks is an important method of preventing disease.

      What about kids, can they use bug sprays?

      • Yes, the American Academy of Pediatrics recommends using DEET in all children above 2 months of age who might be exposes (30 percent or less)

      So Stewart specifically asked about what he should do after getting bite by a tick?

      • First, if you find an attached tick, it should be removed promptly. The longer it is attached the greater the risk of infection. There are many "old wives tales" about how to remove a tick. However, to reduce the chance of disease transmission correctly using tweezers or commercial tick removal tools is preferred. The key to using tweezers correctly is to position the tips of tweezers around the area where the tick's mouthparts enter the skin. Then use a slow, steady motion when pulling the tick a way from the skin. After removing the tick, disinfect the skin with soap and water, or other available disinfectants.
      • The signs and symptoms of tick-borne disease vary among individuals and differ according to the infecting agent. In general, a person should consider consulting a health care provider whenever he or she experiences a sudden high fever, severe headache, muscle or joint aches, nausea, vomiting or diarrhea. If these symptoms occur following a tick bite, or even after exposure to a tick habitat, the health care provider should be informed of this fact. Another possible sign of tick-borne disease is a rash or pus-filled wound that appears at the site of a tick bite, or a spreading rash that follows a tick bite or exposure to tick habitat.
      • An area of redness around the tick bite is a hypersensitivity reaction (allergic reaction or chemical irritation) if it occurs within 3 days of the tick first biting. If the redness gets larger than 5 cm (2 inches) and occurs 3-30 days after the bite, it could be erythema migrans, a rash with a central clearing that is associated with Lyme and Lyme like disease.
      • When you seek medical care, we do have tests to look for your bodies immune response to the ticks, but they are expense and take some time to result. We often treat suspicious cases with antibiotics. Doxycycline is the drug of choice.

      Dr. Justin Puckett, D.O.

      Complete Family Medicine

      1611 S. Baltimore

      Kirksville, MO. 63501

      660-665-7575