Health

Be TICK Smart

By April 10, 2020 No Comments

About the time you will be reading this will be the one-year anniversary of me performing life saving emergency surgery on myself. Perhaps it wasn’t as much of an emergency as I originally thought, but it did upset my wife that I used a pocketknife and didn’t just drive ten minutes to the doctor. No, I didn’t take out my own appendix, cut off a mole, or lance a boil. But in a bit of a grossed-out panic, I did incise a deeply buried tick from a spot just above my twelve-pack abs. And, here’s the point. It was February. And it wasn’t there the last time I had admired myself in front of the mirror after a shower (no more than a week, no jokes please). Sometime, three hours to three days before, I had been walking my dog in the ten-acre woodlot behind the house and had presumably enticed a tick to hitch a ride and enjoy a meal. On me!

Besides leaving a really cool scar, which I sometimes threaten to show people, I mangled the subject of my disdain pretty badly. But, I placed the cadaver in a plastic baggie and took it to a colleague that had previously worked for the insect-borne disease team at the Ohio Department of Health. (And yes, he and I know that ticks are actually arachnids with two body segments, hydrostatic skeletons, booklung breathing, and eight horrible legs, and not winged, three segmented, six legged, antennae bearing insects).

His thoughtful, terrifyingly long study of the remains under the microscope revealed that it was a Blacklegged tick (commonly called the “deer tick”), but that its gut appeared empty implying that it had not managed to begin feeding upon (or back-washing into) my precious A-positive serum.

But THIS WAS FEBRUARY. As a kid just a few decades before, there was only species of tick that I ever routinely encountered and that was the common dog tick, normally in August, after chasing bluegills with a flyrod and a rubber spider from the high grass surrounding Tycoon Lake.

Post self-surgery, I heard a number of stories. Not too long ago (during deer bonus weekend), a hunting buddy reported being covered with ticks in a matter of minutes while sitting on the ground in Gallia County. I received a Christmas card this year from a friend in Colorado reporting that his wife nearly died from a tick-borne disease it is believed she contracted while at a family reunion in Missouri. And then there are the stories of a new tick borne disease that leaves you allergic to red meat. It was time for investigation.

So, what are we dealing with here?

According to the Ohio Division of Wildlife’s webpage, there are three species of ticks that sportsmen are likely to encounter: the American (or common) dog tick, the Blacklegged tick (aka the “deer tick”), and the Lone star tick. Generally speaking, these ticks share similar life cycles, needing a blood meal to develop from larva to nymph, nymph to adult, and to produce eggs. They can cycle through these stages, breed, lay eggs and die in as short as a few months or as long as two-three years. But, if they miss a blood meal, it’s the end of the line. It is during their meals that they can pick up or transmit infections. The host on which a tick feeds (and whether or not that host is capable of carrying an infection dangerous to humans) plays a role in a tick’s ability to pick up and transmit a disease. Hosts can include reptiles, birds, and mammals both small (like a deer mouse) and large (like a deer).

To find their next blood meal, ticks will “quest.” This entails grasping vegetation with one or two pairs of legs and waving the remaining pairs in the air waiting to sense a victim’s breath, body odor, body heat, moisture, vibrations, or even shadow to trigger their effort to climb aboard. Once onboard, some ticks will attach immediately while others may spend up to a couple hours looking for a cozy spot to dine (you’re feeling a crawling sensation right now, aren’t you?). When satisfied, the tick will make an incision in the skin, inject a mild anesthetic to prevent you from noticing, insert its straw-like mouthparts, and begin to feed. It is in this period that diseases can be picked up and transmitted. When finished, which can sometimes take several days, the tick drops off to develop into the next stage, or mate and die if you’re a male tick, or lay eggs and die if you’re a female tick. That’s it, if you’re a tick.

Simply speaking, juvenile and adult ticks can be active anytime it is warm enough (even in winter and even after the prayed-for mosquito killing hard frosts of deer season). Ticks don’t abide by a calendar anymore than the weather does these days. But, they are primarily active and questing late winter through early autumn.

But what about us? If you catch a tick before it begins to feed, you are out-of-the-woods or grassy meadows, so to speak. If it latches on and gets a meal started, then it depends upon the species of tick, where its from geographically (which plays a role in which ticks and diseases are present), and how long it has fed. That combination of factors can give you a zero to fifty percent chance of contracting a disease. So, knowing what ticks and diseases have been found in the areas you frequent is important to how you need react to a tick bite.

To remove a tick, the universally prescribed method is to use tweezers, grasp the tick’s body as close to the skin as possible and with a little force as necessary but as much as is needed, pull the tick away as smoothly as possible without twisting. Sometimes, easier said than done. Mine was buried so deep I couldn’t effectively grasp it with tweezers. It had penetrated my wintertime physique much too easily. While there are some tweezers marketed for tick removal with a notch to make it easier to gain leverage without as much squeezing, any available tweezers can suffice with if its what you have available. What you don’t ever want to do is use petroleum jelly, or kerosene, or gasoline, or cigarettes or matches or anything besides tweezers and gentle pulling. Anything else and you risk the tick regurgitating its meal back into you and increasing the risk of infection (and setting yourself on fire if some of the treatments above are combined). After removal, it is advised that you wash the area with soap and water. And, the advice in print is that if the head remains in the skin after your attempts at removal, rather than dig away with a pen knife like I did, its better to leave it alone for your body to deal with like a splinter you can’t get out and monitor for infection. If possible, follow-up with an alcohol wipe and/or antiseptic to help prevent topical infection of the wound.

According to the Ohio Department of Health’s website, they do not generally recommend testing ticks for disease. While there are some private firms that do perform testing services, ODOH states on their website that the tests take time (sometime several days), delay treatment, and can produce false results. They encourage monitoring for symptoms and contacting your physician should those symptoms appear.

And, here’s the pickle: the common symptoms for many tick-borne diseases can range from unnoticeable to severe, and include headache, fever, chills, muscle pain, joint pain, nausea, vomiting and fatigue. Sounds like the morning after a successful sportsmen’s banquet. For most of us, those are easy symptoms to overlook or write-off as something else. Of the better-known ailments, Lyme disease generates a distinctive “bulls-eye” rash in about 70% of patients. But those same symptoms, minus the rash, could just as easily be early signs of Rocky Mountain Spotted Fever or one of the lesser known infections to your or my untrained eye. So you have to be cautious and take precautions.

Being cautious includes knowing what ticks and illnesses are found in the areas you frequent. You can learn more through the Centers for Disease Control website and most state’s Health Departments and DNRs. Ours include graphs and data for you to consider. In Ohio, there were 1700 reported cases of Lyme disease (carried by the Blacklegged tick) from across the state, but primarily in the eastern and southeastern counties, from 2009-2018. Its on the increase in Ohio with 460 cases reported in 2019 alone (and note, this is where the cases are reported, not necessarily contracted). Symptoms typically appear in 3-30 days. If you come down with these symptoms in August, or even during flu season when you haven’t been exposed to the “flu” then you might want to consider having yourself tested by your doctor.

Rocky Mountain Spotted Fever (carried by the dog tick) was only reported 48 times in Ohio 2019, but that is up steadily and dramatically over the single-digit reports from just five years ago.

And, part of being cautious is considering your own health. While these diseases are reported from across all age groups, you are at increased risk if you have a compromised immune system, liver or kidney disease, if you’ve had an organ transplant, are under going chemotherapy, or are just plain older than dirt,

All told, identification of all tick-borne diseases is up to more than a dozen types and more are being described in the US and globally as we speak. And, under the worst of circumstances, if they go untreated they can result in permanent disability or death.

Prevention includes wearing long pants and long sleeves, tucking pant legs into socks, using “insect” repellants, and getting someone to look at you naked after you’ve spent time outdoors. Be creative here. If you must fly solo, use a mirror and your own hands to search from scalp to toes and everywhere in between.

Speaking of repellants, there are many (mostly anecdotal) claims regarding everything from peppermint to lemongrass that use natural odors offensive to ticks to keep them off. DEET works wonders on mosquitoes, and reportedly is effective against ticks, but I’ve experienced it eating through graphite flyrods and other synthetic materials and question its impact on my skin. Permethrin is a common repellant that is synthesized similar to compounds found naturally in Chrysanthemums. It’s odorless (to humans at least) and may be less toxic to humans in the commonly used repellants than others. There are a number of clothing companies that make clothing infused with Permethrin that will last through numerous washings (some claiming up to seventy washings), other companies will treat the clothing you send them, and yet others sell home treatment products you can wash-in yourself. So, wash, wear and forget options to deter ticks in the first place are available. I have personally used Permethrin-based products and was satisfied. Still, you are introducing something to your clothes, your skin, and your immune system; you have to weigh the risks accordingly. And, remember your pets. In most cases, tick-borne diseases can not be spread directly from your pet to you (or vice verse), but ticks can travel on pets and climb off of them and on to you. If you’ve owned an outside dog that lives in the house, you’ve found ticks crawling off of them an onto your furniture not doubt…

Finally, while reports of tick-borne diseases are on the increase everywhere nationwide, mortality rates are trending down because of better information, education, prevention and treatments available. If you spend time outside running your trap line this winter, scouting next year’s deer stands, or fishing for steelhead on a warm winter day, enjoy yourself, but be mindful of the risks associated with ticks.

I’m happy to answer questions and dig a little deeper on anything you might like to know. To investigate further yourself, start here:

Ohio Division of Wildlife: Ticks in Ohio

http://wildlife.ohiodnr.gov/species-and-habitats/ticks-in-ohio

Ohio Department of Health: Tickborne Diseases in Ohio

https://odh.ohio.gov/wps/portal/gov/odh/know-our-programs/zoonotic-disease-program/resources/tickborne-diseases

Centers for Disease Control and Prevention: Tickborne Diseases of the United States

https://www.cdc.gov/ticks/diseases/

A couple last notes: the red meat allergy is a real thing. Alpha-gal syndrome is linked to the transmission of the Alpha-gal sugar molecule via Lone star tick bites that trigger an immune response resulting in mild to severe reaction to red meat. Symptoms appear 3-6 hrs after eating red meat – hives, itching, swelling, difficulty breathing, wheezing, abdominal pain, diarrhea, headaches (can be confused with watching the Cleveland Browns) and anaphylaxis which is the severest form of respiratory distress and can lead to death.

The CDC reports that although 30,000 cases of Lyme disease are reported annually, there are some estimates that ten times that number may go unreported or undiagnosed each year. A vaccine for Lyme disease was briefly available in the 1990’s, but low sales numbers, liability issues, and suggestion that it may have caused arthritis in some patients resulted in its demise. A couple pharmaceutical companies are exploring new vaccines now, but availability is still three to five years away at best.

Impress your grandchildren. Apparently, Justin Bieber (he’s a teen-idol musical artist, so I’m told) announced that his disheveled appearance is not due to illegal drug use, but rather he is afflicted with Lyme disease. Don’t be like Justin Bieber.

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