Watch Out For Ticks

As we get closer to summer and outdoor activities, kids will be more likely to experience a tick bite. We talked to Dr. Sandy Arnold, infectious disease specialist at Le Bonheur Children's Hospital, about what parents need to know. Here's what she had to say - parents note, this one is definitely worth the read!

What are ticks?
Ticks are arachnids that live in wooded areas and fields. You can be exposed to ticks by spending time in these areas but ticks can also be found around your home. Tick bites are most common in the summer months but in warm climates it is possible to be bitten year round.

How can I be harmed by a tick?
Different kinds of ticks transmit different diseases. Ticks acquire and transmit these infections by eating blood from animals and the diseases ticks carry depends on the part of the country in which you live.

What should I do if I am bitten by a tick?
It is very important not to use any home remedies to remove a tick. Things like nail polish, petroleum jelly, heat or flames are not effective.

Use tweezers to grasp the part of the tick that is closest to the skin. Apply steady upward pressure to pull the tick's mouthparts from your skin. If you pull too hard, the mouth parts may break off. If this happens, you need to use the tweezers to pull out the remaining parts of the tick if possible.

Once the tick is removed, clean your hands and the area well with soap and water or rubbing alcohol. The saliva from the tick can be irritating and cause some redness and discomfort at the site. However, this does not necessarily mean the site is infected. Some diseases transmitted by ticks will result in a lesion or rash at the site of the tick bite but some do not. If you develop an abnormality of your skin in the area from which you removed the tick, consult your child's pediatrician.

What illnesses can I get from a tick in this region?
There are several important tick borne illnesses that are relatively common in the Mid-South.

Of note, Lyme disease is not transmitted in this region. The tick that could carry the disease, (Black Legged tick) is found in this region, but its feeding habits make it unlikely to transmit Lyme disease. The "bull's-eye" rash at the site of the tick bite that occurs with Southern Tick Associated Rash Illness (STARI) is very similar to that seen with Lyme disease - these can be easily confused. This rash may be accompanied by fatigue, headache, fever and muscle pains. The cause of STARI is unknown. As it appears very similar to Lyme Disease, most physicians will treat this infection with antibiotics.

Ehrlichiosis is transmitted by the Lone Star tick in this region. The symptoms of Ehrlichiosis usually develop within 1-2 weeks after being bitten by an infected tick. There are many symptoms associated with Ehrlichiosis. These are similar to symptoms of Rocky Mountain Spotted Fever. Patients with Ehrlichiosis have fever, chills, headache, malaise, muscle pain, nausea, vomiting, diarrhea, red eyes, confusion and rash (not at the site of the tick bite).

Rocky Mountain Spotted Fever (RMSF), caused by Rickettsia rickettsii, is an infection transmitted by the dog tick. Symptoms can begin 2 to 14 days after a tick bite and include fever, rash (which appears 2-5 days after onset of illness), headache, nausea, vomiting, abdominal pain, muscle pain, red eyes, confusion and neck pain.

These diseases can be difficult for physicians to diagnose because the symptoms overlap with many common, self-resolving, viral illnesses. It is important to note that not all patients have all symptoms and some people have very mild or no symptoms. Unfortunately, there is no test that your doctor can do to easily diagnose these infections so treatment must be started based on suspicion. The infection may be confirmed by doing a blood test 10-14 days after the diagnosis but this will not influence the decision to treat.

Treatment should never be withheld pending the results of a blood test. Severe Ehrlichiosis or RMSF infection can be fatal if not treated appropriately. Prompt treatment is associated with rapid resolution of symptoms. The appropriate treatment for Ehrlichiosis and RMSF is doxycycline for children of all ages. This is the drug recommended by both the Centers for Disease Control and the American Academy of Pediatrics. No other drug should be used to treat these infections.

Tularemia is a disease that can be transmitted by both the Lone Star tick and the Dog Tick. This disease is much less common than the others. While tick borne Tularemia can present in many ways, it may be associated with an ulcerated lesion at the site of the tick bite with or without a swollen lymph node nearby. If this occurs, you should see your child's doctor.

How can I prevent myself from being exposed to these illnesses?
The best prevention for tick infections is the prevention of tick bites. To keep ticks out of your yard, you should remove leaves, tall grasses, brush and trash from the yard.

You can keep ticks off yourself and your family by avoiding wooded areas with tall grasses and staying on trails when hiking. Use insect repellents with DEET (20% or more) on exposed skin and Permethrin on clothing and gear. Wear long sleeve shirts and long pants tucked into socks to avoid contact of skin with ticks.

You should also do regular tick checks after coming in from outdoors. Particular areas to check include:

• under the arms
• in and around the ears
• inside the belly button
• behind the knees
• between the legs
• around the waist
• and in the hair.

Also check your gear and pets because ticks can come into the home then attach to you later.

Please consult the CDC website for more information.
http://www.cdc.gov/ticks/index.html