Outdoor Safety in the Summer: Avoid Tickborne Diseases

It’s that time of year when the weather starts to warm up and we start to have outdoor activities.  As we go outside to enjoy the sun so do other living things.  We may not realize the prevalence. According to the Smithsonian Institute “insect /arachnids species have been found to be quite numerous, with calculations of from 3 to 23 million per acre” (1). That’s incredible!

Ticks are not insects. They are, in fact, arachnids with eight legs and are related to mites and spiders. Do you know what types are most common in Pennsylvania? It is estimated that the most common types of tick are the black legged (deer tick), American dog ticks, lone star ticks, and groundhog ticks (2).

“Blacklegged ticks can transmit pathogens that cause Lyme disease, anaplasmosis, babesiosis, and bartonella. American dog ticks can carry the pathogens that cause Rocky Mountain spotted fever and tularemia. Pathogens that cause ehrlichiosis, tularemia, tick-associated meat allergy, and southern-tick-associated rash illness can be transmitted by lone star ticks. Blacklegged ticks and American dog ticks can transmit Powassan virus.

The pathogens that cause Lyme disease and other tickborne diseases are zoonotic, meaning they naturally infect animals and can be transmitted to people. However, tickborne pathogens are only transmitted by the bite of an infected tick.”

Erika Machtinger (2)

Caution

Remember that we are not alone outside. We need to take caution to avoid these diseases and other conditions that could be transmitted by ticks. The most prevalent tickborne disease in Western PA is Lyme Disease. 

The agent or pathogen is the microorganism that causes infection. The agent for Lyme Disease is Borrelia burdorferi. Pathogens are carried inside the tick.  The pathogen transfers when the tick attaches itself to a human and bores a hole in the skin to begin “feeding”. 

Understand that not all tick bites will lead to Lyme disease or other tickborne diseases.  However, it is important to know the risks and steps to attempt to avoid contact with ticks. Once a tick is attached to a person the illness can manifest signs and symptoms as soon as 3-30 days. This is the incubation period.  If the disease goes undetected, complications can occur months after the bite. 

Signs and Symptoms

Since detecting is so important, consider what signs and symptoms you should be on the alert about.

Early Localized (3 to 30 days after a tick bite):

• Erythema migrans (EM): Red annular or homogeneous rash at the site of tick bite. It expands gradually over several days to more than 5 cm in diameter. Central clearing may develop as the rash expands, resulting in a “target” or “bull’s-eye” appearance. It may feel warm to the touch but rarely itchy or painful. EM occurs in 70%-80% of infected persons. The classic rash is not present in all cases.
• Fever, chills, malaise, fatigue, headache, myalgia, arthralgia
• Lymphadenopathy

Disseminated (days to months after a tick bite):

Untreated or unnoticed early Lyme disease can progress to disseminated disease. This happens for about 60% of patients, all with diverse clinical manifestations. Most manifestations appear in the first few weeks to months of infection. Rheumatologic manifestations may be particularly delayed. Consider the different possible manifestations listed below.

Dermatologic manifestations – Skin Changes and/or Rash

• Multiple EM (erythema migranes) rashes are characteristic rashes. The rashes can be distant from site of tick bite.

Neurologic manifestations

• Cranial neuritis (inflammation of cranial nerves), most commonly Bell’s palsy (facial paralysis, can be bilateral)
• Lymphocytic meningitis (inflammation of meninges that surround the spinal cord)
• Painful radiculoneuritis (inflammation of one or more spinal nerve roots) which causes numbness and/or tingling, as well as increased sensitivity to any painful stimuli
• Painful peripheral motor and sensory neuropathy or pain in the extremities and joints
• Intracranial hypertension (rare) is pressure on the brain

Cardiac manifestations

• Lyme carditis is inflammation of cardiac or the heart muscle, which is rare but can be fatal.

Rheumatologic manifestations

• Oligoarticular arthritis is a type of arthritis that comes and goes. It can be migratory meaning arthritis that can affect any joint at any time. It can also cause effusion or fluid in one or multiple joints, often large joints.

(2)

Play it safe and protect yourself!

Ticks and Tickborne Disease (psu.edu)

Be aware when you are in a tick habitat. Take preventive measures. Stay close to the center of trails. Avoid areas with dense vegetation. Be especially cautious from May through July when nymphs are seeking hosts.

Blacklegged ticks do not jump or fly. Instead, they crawl onto people and animals from the ground or low vegetation. Tuck your pants into your socks. This makes ticks crawl over the pants rather than under them. These small details in preparation increase the chances you will see the ticks before they bite. Permethrin treated clothing can provide a repellent barrier between you and ticks. Apply products containing DEET, picaridin, or IR3535 on skin as recommended by the Centers for Disease Control and Prevention.

Conduct frequent tick checks while in the field. Complete a full-body tick check after you come indoors. While ticks can attach anywhere, they often prefer tight areas, such as around the waistband, behind the knee, and under the armpit. All clothing should be laundered in hot water and dried on a hot cycle to kill any ticks.

Removal

If you find an embedded tick, remove it with fine tweezers by grasping the head as close to the skin as possible and pulling with steady, firm pressure. Do not grab the tick in the middle of its body. Pressure can force gut contents into the skin, increasing the likelihood of infection. The use of matches, chemicals, petroleum jelly, and essential oils is not recommended. These methods will irritate the tick and may cause it to regurgitate its stomach contents, thereby increasing the possibility of infection.

Be active this summer but take care to outsmart the ticks too. Awareness of the risks is the first step. Now, apply practical tips to keep you and others tick free. Help share the education to others so that this summer is safe and not soured by Lyme Disease.

References

1. Prepared by the Department of Systematic Biology, Entomology Section, National Museum of Natural History, in cooperation with Public Inquiry Services, Smithsonian Institution “Numbers of Insects (Species and Individuals).” Information Sheet Number 18, 1996, https://www.si.edu/spotlight/buginfo/bugnos
2. Erika Machtinger, assistant professor of entomology. “Ticks and Tickborne Disease.” Penn State Extension, 11 Oct. 2018, extension.psu.edu/ticks-and-tickborne-disease.