Tick-Borne Diseases In North America

Special thanks to Tom Bush of GoodGear

Simple precautions can minimize risk of exposure while living or traveling in regions with endemic disease. Light colored clothing can help make ticks more noticeable before they attach. Long-sleeved shirts and long pants tucked into socks can also prevent attachment. Insect repellents containing N,N-diethyl-m-toluamide (DEET) are effective deterrents. Repellents containing more than 33% DEET have not shown to be significantly more effective than lower concentrations. It is important to remember that DEET is a neurotoxin and can be dangerous in the very young and very old. Seizures have been reported in children using high concentrations of DEET. Permethrin is an insecticide that kills ticks on contact and is approved only for application on clothing.

Check for ticks daily on all family members. Twice daily is recommended in highly infested areas. This is the single most effective strategy for prevention of disease. Minimizing the length of attachment reduces the likelihood of disease transmission. Remove the tick with tweezers by grasping it as close to the skin as possible and pulling at 90 degrees with a slow steady motion. Try to gently encourage the tick to let go rather than pulling its body off and leaving its head embedded. Use just enough force to make the skin stand up. Do not attempt to heat the tick or apply chemicals in an effort to make the tick detach. Stressing the tick may make regurgitation of stomach contents, and transmission of disease, more likely. If tweezers are unavailable, wrap tissue around your fingers and pull the tick out. Don't squeeze the body of the tick. Check your dog or cat daily as well. Remove ticks with tweezers designated for that purpose only. Flush them down the toilet. Vaccines are available to prevent tick-borne disease in dogs.

Keep your property clean. Leaf litter and debris block sunlight and provide ideal tick habitat. Pruning low branches will also improve sun penetration. Find out what plantings will not attract deer in your area. Woodpiles should be off the ground and in the sun or under cover where they will remain dry. This will make them less desirable to rodents and small mammals that carry ticks. Stone walls also attract small mammals. Shaded lawns may harbor large tick populations in endemic areas. Mow lawns regularly to keep them short.

Bird feeders attract birds and mice that may also carry ticks. Keep birdfeeders away from the house and the ground beneath them bare. Consider suspending bird-feeding activity in late spring and summer when infected ticks are most active. A hawk or owl box on your property may attract predators of mice.

Insecticides can also be used to control ticks. One or two applications a year will significantly reduce tick populations on your property. Hiring a professional is highly recommended to avoid injury to children, pets and the environment.

Have you been exposed?

An active lifestyle that involves outdoor recreation increases your odds of exposure to ticks and tick-borne disease. A flu like illness with intermittent or worsening symptoms and a history of potential tick exposure is cause for concern. High fever and/or severe headache are hallmarks of many tick-borne illnesses. Ticks may transmit many diseases simultaneously making identification of the tick less valuable than was once thought. A thorough history and physical exam from a health care provider knowledgeable of tick-borne disease will help determine the need for treatment. Considering the difficulty diagnosing a potentially fatal disease in its early stages it is reasonable to have a low threshold for antibiotic therapy. Although there is potential risk there is no need for paranoia. Transmission of disease is likely only if an infected tick goes unnoticed for several days. A preventative strategy that includes frequent inspection is clearly better than curative treatment. Be happy, be active and beware, ticks suck.

Tom Bush MSN, FNP
Family Nurse Practitioner
Department of Family Medicine
The School of Medicine
University of North Carolina at Chapel Hill
explore@med.unc.edu

Links To Tick Related Sites
University of Rhode Island tick research laboratory
http://www.uri.edu/artsci/zool/ticklab/

Integrated control of ticks and tick-borne disease in developing countries
© Article copyright Tom Bush and Goodgear. All rights reserved.