Tick season is here. It's always here. Whether you're taking a nice walk in a park or hiking with the grandkids through the woods, it's better to be aware and take precautions. Well, here they are -

TICK FACTS

Ticks are bloodsucking external parasites that feed on humans, wild and domestic mammals, birds, reptiles and others. They are totally dependent on the blood/tissue fluids of the host.

Ticks are second only to mosquitoes as transmitters of infectious agents to humans. The longer an infective tick feeds, the greater the chance of infection.

Ticks are not insects. Insects have 6 legs as an adult and three body segments, whereas, ticks have 8 legs as an adult and two body segments. Ticks are arachnids, as are chiggers, spiders, and mites.

A hard tick seeks a blood meal at ground level by climbing onto vegetation and using their forelegs to feel/grab for a host. Ticks are usually found from ground level to 3 feet above the ground. A tick uses carbon dioxide, scent, body heat, and other stimuli to find a host.

When ticks feed they cut the skin with their mouthparts, insert their mouthparts into the wound, use their "teeth" to cut blood vessels under the skin (causing blood to pool), inject anti-clogging agents into the host, and suck the victims blood.

Ticks have four life stages: egg, larva, nymph, and adult. The larva, nymph, and adult are called ''active" stages. The egg hatches into a larva. A larva (''seed'' tick) has 6 legs. It feeds and molts (shedding its cuticle) into a nymph. The nymph has 8 legs and no sex differentiation. It feeds and molts into an adult. The adult is differentiated into male or female. The female requires a blood meal in order to lay eggs.

Many tick life cycles are completed within one to two years. However, depending on the ease or difficulty of finding a blood meal, ticks may require only a few months or as long as three years to pass through all stages.

PROPERTY MANAGEMENT

Taking the following actions will reduce ticks on property.

Ticks are susceptible to dehydration. You can reduce humidity in property by: pruning trees, clearing brush, removing litter, mowing grass, and letting grass dry thoroughly between waterings. Also, move the shrubby overgrowth between the lawn and woods father away from areas frequented by people and pets.

Modify your property so that it is unattractive to animals that are hosts to ticks by: eliminating birdfeeders, birdbaths and salt-licks; erecting fencing around the property; clearing away wood, garbage, and leaf piles; and removing stonewalls.

Directly kill ticks that live on the property by applying acaricides (tick-killing chemicals). Acaricides include: cyfluthrin, chlorpyrifos, and carbaryl. Granular and liquid sprays are available.

Modify outdoor areas: widen trails, stay in the center of paths, and move playscapes to safe areas.

PERSONAL PROTECTION

Avoid tick infested areas, whenever possible.

Wear light-colored clothing. This allows you to more easily see ticks on your clothing.

Wear a long-sleeved shirt and long pants. This reduces the skin area exposed to ticks.

Tuck your shirt into your pants and pants into your socks. This keeps ticks on the outside of clothing as they crawl upwards.

Use EPA-approved tick repellents. Wash off repellents when you return inside.

Conduct frequent tick-checks. This includes a visual inspection of the clothing and exposed skin, followed by a naked, full-body examination in a private location.

Avoid sitting on the ground.

Also check your pets, especially around the ears or eyes.

Vaccine trials to prevent LD are currently underway.

TICK REMOVAL

Tick's mouthparts have harpoon-like barbs that are designed to penetrate and maintain attachment to the skin. Ticks secrete a cement-like substance that helps them adhere to the skin. For these reasons ticks often are firmly attached to humans and animals.

1. Using a fine-point-tweezer, grasp the tick's mouthparts (place of attachment) as close to the skin as possible.

2. Gently pull the tick straight out with steady pressure.

3. Place the tick in a small vial, label with the date & your name/address; send for testing, if available.

4.Wash your hands. Disinfect the tweezers and the bite site.

5. Contact your doctor.

Cautions!

Children should be told to seek adult help for tick removal.

It is better to wait and correctly remove the tick with a fine-point-tweezer than to pull the tick off with your fingers.

If you must remove the tick with your fingers, use a tissue or leaf to avoid contact with potentially infected tick fluids.

Do not prick, crush or burn the tick, as it may cause the release of infected tick fluids.

Do not try to smother the tick (e.g. petroleum jelly, nail polish) as the tick has enough oxygen to complete feeding.

TICK TRANSMITTED DISORDERS

BABESIOSIS
This is a malaria-like infection caused by protozoa, Babesia spp., that parasitize red blood cells. There are several species in the East and a newly described species from the western U.S. The first U.S. case report of babesiosis in a human was from Nantucket Island, MA in 1969. Immunosuppressive may occur during this disease.

Symptoms: fever, chills, fatigue, headache, muscle pain, and a breakdown of red blood cells (hemolytic anemia). Laboratory confirmation is based on identifying the parasite within red blood cells or on a positive antibody titer. Subclinical chronic infection does occur and a negative blood smear does not exclude infection. This disease is more severe (sometimes fatal) in elderly people and those who have had their spleens removed. Treatment is with clindamycin with oral quinine. Extremely ill patients may benefit from a blood transfusion.

Transmission: The black-legged & western-legged ticks.

COLORADO TICK FEVER
This is a viral disease of short duration and low mortality that occurs in the western U.S. Between 200-300 cases are voluntarily reportedeach year.

Symptoms: sudden onset of fever, chills, severe headache, muscle aches, and occasionally, a faint rash, which lasts about a week. After a 2-3 day remission, symptoms, accompanied by a drop in white blood cells, may recur. Complications include encephalitis and severe bleeding. Diagnosis is assisted by serologic testing. Treatment is with analgesics and supportive therapy.

Transmission: Rocky Mountain wood tick.

EHRLICHIOSIS (HME & HGF)
The various forms of human and animal ehrlichiosis are caused by rickettsiae (intracellular parasites). The first case of ehrlichiosis was described in dogs in Africa in 1935. In 1986 the first U.S. acquired human disease was described. This human infection was named human monotypic ehdichiosis (HME) and is caused by Ehdichia chaffeensis. Most cases are reported from the South Central and Southeastern U.S. A rash occurs in a small percentage of people. A related variation, called human granulocytic ehrlichiosis (HGE), was described in 1994. HE is the human disease caused by E. equi, the cause of ehrlichiosis in horses. It has been found in AK, CA (serology), CT, FL, GA, MA. MD, MN, NY, PA, RI, TN, and WI. Separate tests are required for each disease, Coinfection with LD varies, but 9% to 21% is the average. Persisting infection can occur.

Symptoms: fever malaise headache chills, severe muscle aches & pain, vomiting, anemia, lung infection
abnormal decrease in white & red blood cells, decrease in platelets, or elevated liver enzymes. Sometimes
symptoms are nonspecific. Laboratory diagnosis is made by testing acute and convalescent serum. Delayed treatment can result in death. Treatment is with tetracycline/doxycycline.

Transmission:
HME - probably the lone star tick.
HGE - probably the black-legged tick.
Worldwide there are over 850 tick species, about 100 of which are capable of carrying diseases. In the U.S. four genera, Amblyomma, Dermacentor, Ixodes and Ornithodoros transmit to humans the vast majority of diseases caused by bacteria, viruses, protozoa, and toxins.

LYME DISEASE (LD)
LD is caused by the bacterium Borrelia burgdorferi. The disease was first described in European literature over 100 years ago. The causative agent was discovered in 1981 byWilly Burgdorfer, Ph.D., M.D.(Hon). New Borreliastrains causing Lyme-like symptoms have recently been discovered in various parts of the world. There are over 300 strains of this bacterium in the U.S. alone. Coinfections can make LD worse.

Symptoms: initially are flu-like (fever, headaches muscle aches and pain), with or without a centrifugally expanding rah that has lighter and darker rings of discoloration called erythema migrant (EM). Later symptoms include multiple rashes, joint swelling, joint pain, lossof reflexes, cranial nerve palsies (e.g. facial or oculomotor paralysis, loss of smell or taste, swallowing problems visual disturbances), cognitive or behavioral changes, disorder of the peripheral nerves, head conduction defects, stroke and inflammation of various parts of the eye. Serologic tests cannot be relied upon for diagnosis. Treatment is with various antibiotics. It is recommended treatment on tick-bites under certain conditions. Some people have ongoing symptoms, which may be due 10 persisting infection or the triggering of an autoimmune reaction.

Transmission: Transmitted primarily by the black-legged tick in the eastern and mid-U.S. and by the western black-legged tick in the far-western U.S.

ROCKY MOUNTAIN SPOTTED FEVER (RMSFI)
RMSF, also called tick-borne typhus, is caused by Rickettsia rickettsii and was first identified in 1873. The disease is reported from all over Noah America but is most prevalent in the eastern U.S.

Symptoms: sudden onset of flu-like aches and pain headache, chills, confusion, light sensitivity and high fever. A reddish-to-black rash (resembling measles) stabs on the extremities (e.g., wrists and ankles) and may spread to the entire body. Death can occur. Serologic tests will not be positive until 10-14 days after onset. Therefore, doctors must make a clinical diagnosis and treat early, as the main cause of death is delayed treatment or improper use of antibiotics. The treatment is either tetracycline/doxycycllne or chloramphenicol.

Transmission: American dog tick, Rocky Mountain wood tick, and Pacific Coast tick. All stages of ticks can transmit the pathogen. Transmission can occur within a few hours of feeding.

TICK TRANSMITTED DISORDERS

TICK-BORNE RELAPSING FEVER
This is a multisystem disease caused by the spirochetes Borrelia (B.)hermsi, B. turicata, and B. parked. In North America the disease occurs primarily in the western U.S.

Symptoms: repeating bouts of fever lasting 2-9 days alternating with afebrile periods. Additional symptoms include sudden onset of fever, chills, headache, muscle and joint pain. Laboratory diagnosis is most often made by detecting spirochetes in peripheral blood smear taken during febrile episodes. Laboratory tests are available. Treatment is with penicillin or tetracycline/doxycycline.

Transmission: The pathogen is transmitted by soft ticks Ornithodoros hermsi, 0. turicata and rarely 0. parked, and can be transmitted transovarially from the female to her eggs. 0. hermsi, O. turicata tick feed mainly at night and can transmit the spirochete within minutes.

TICK PARALYSIS
This is a potentially fatal reaction to a paralyzing toxin secreted in thesaliva of feeding tick. Tick paralysis occurs in Europe, Asia, Africa, Australia, and North America This :condition causes injury or death to thousands of animals each year. The condition was first recognized in Australia in 1824 The first North American case was in British Columbia in 1912.

Symptoms: headache, vomiting, general malaise loss of motor function and reflexes, followed by paralysis that starts in the lower body (especially the legs) and spreads to the rest of the body. This can cause respiratory failure and Oath. Death in young children can occur in one or two clays. Temperature and blood chemistry are usually normal. Treatment is to remove the tick.

Transmission: A wide variety of ticks can cause the condition Important vectors In North America include: the American dog tick and the Rocky Mountain wood tick. The black-legged tick can also pause this condition. While feeding larva and nymphs can cause paralysis in laboratory tests, the majority of naturally occurring cases involve feeding female ticks. Male ticks appear not to cause the condition.

TULAREMIA (rabbit fever)
The bacterium Francisella tularensis causes tularemia. This disease was identified in 1911 and in North America is found primarily in the south central U.S. However, cases are reported from almost every state.

Symptoms: repeated spikes of severe fever local skin ulcers enlarged lymph nodes, conjunctivitis and/or pneumonia. Laboratory diagnosis is often based on antibody test. The disease is treated with streptomycin.

Transmission: Lone star tick, Rocky Mountain tick, Pacific Coast tick, American dog tick, black-legged tick, horseflies, deerflies, and contact with infected animals or infected water. Most cases in the south central U.S. are caused by tick-bites. Most cases in the rest of the country are primarily due to contact with infected rabbits.

Reviewed By:
Jodee Meddy,
Dr. Pourrat Monahemi