Plan & Prepare

Tick Bites

Almost all human diseases carried by insects in the United States can be attributed to ticks, and the number of tick-borne illnesses has doubled over the past two decades. Tick bites are most likely to happen in warm weather (late spring to early fall) in the Northeast, South, and Midwest United States.

A tick bite itself is rarely dangerous; however, the longer a tick is attached the more likely it is to transmit disease. Rapid removal is important but can be challenging.

Infection with tick-borne illnesses can be debilitating, require prolonged hospitalization, or even be fatal. Knowledge of high-risk areas, prevention of ticks, and prompt recognition of concerning rashes can guide you to safer travel and peace of mind.

Symptoms and Description

There are different species of ticks that carry diseases. The exact type of tick is not as important as the size. Smaller ticks represent an earlier stage in their life cycle that is more likely to transmit disease. These ticks are very small — about the size of the period at the end of this sentence. (image.ticksizes.jpg)

Most tick bites are painless. Sometimes swelling and redness will appear around the tick or at the tick bite site after removal. This is the body’s normal local reaction. If the redness is spreading, it may represent a bacterial infection of the skin that requires antibiotics and medical care.

Some illnesses actually come from infectious organisms transmitted during a tick bite, these systemic illnesses usually manifest days to weeks later (anywhere from three days to a month).

Early symptoms of tick-borne diseases can include headaches, fevers, muscle aches, red eyes, vomiting, diarrhea, and a rash. More severe manifestations of disease may cause severe headaches, joint swelling, chest pain, or even numbness or nerve paralysis.

The most common tick-borne disease is Lyme disease, which causes a “bull’s eye” rash of a large red-rimmed circle with a central clearing. This rash appears in the majority of cases; however, there may be no rashes with Lyme disease or other tick-related illnesses, so it is important to be aware of any flu-like symptoms or new rashes after returning from outdoor trips.

Symptoms

Small tick embedded in the skin.
Headaches, muscle aches and pains, fevers, nausea, and vomiting.
Red circular rash with central clearing.
Spreading redness at the site of a tick bite.

Guidelines for Safe Travel

Awareness of high-risk geographic regions is the first step to preventing tick-borne disease. (image.lymemap.jpg)

You can help prevent tick bites by using insect repellants, protective clothing, and good preventive strategies like regular tick checks on animal fur and clothing. Removing an embedded tick within 36 hours will reduce the risk of catching Lyme disease.

Preventive Clothing

Wear long-sleeved clothing to limit the tick’s ability to latch onto the skin.
Consider light-colored clothing to improve the visibility of any ticks.
Consider long pants and tucking pants into socks to minimize exposed skin.

Repellant

DEET is an effective tick repellant but may be corrosive to synthetic clothing and have side effects.
DEET with a 30% concentration will be protective for about six hours, and 5% for two hours.
DEET with 10% or less concentration should be used in those under 12 and should not be used for infants.
Picardin is another effective repellant that is non-toxic and safe to use on clothing.
Picardin with a 20% concentration offers ten hours of protection.
Permethrin is a repellant and insecticide that is used to treat clothing and reduces rates of tick attachment and bites.

Tick Checks

Remove clothing for all-over visual inspection.
Pay special attention to warm places where ticks like to burrow (armpits, knees, underwear, around hairline).
If a tick is found, use pointed tweezers to grasp it at the head (as near to the skin surface as possible). Pull up perpendicular to the skin. (image.tickremoval.jpg) Do not twist or jerk the tweezers, which can cause mouthparts to break off.
If pieces of the tick cannot easily be removed, leave it alone and allow the skin to heal.
Wash the area well with soap and water.
Watch for spreading redness and swelling at the site of the bite. This may indicate a bacterial infection of the skin.
If the tick has been attached for more than 36 hours, a single dose of a prescription antibiotic has been shown to decrease the risk of Lyme disease if given within 72 hours of exposure.

Emergency Red Flags

It is rare for a tick bite to necessitate evacuation. However, it may be necessary to seek medical care for preventive antibiotics if you are in a high-risk area for Lyme disease and are unable to remove an embedded tick within 36 hours.

Concerning rashes or symptoms of tick-borne illnesses should be evaluated by a doctor, including:

A bull’s eye rash or spreading rash all over the body.
Development of symptoms like fever, headache, and muscle aches and pains.
Embedded tick for more than 36 hours, in a high Lyme disease area that cannot access antibiotics for more than 72 hours from exposure.