Ticks and tickborne Illness: part 2

In Part 1, we discussed the basic biology of ticks and trends in tickborne illness in the US. In Part 2, we will focus on tick bite prevention and treatment and leave you with some resources for continued learning.

Prevention Strategies
We spend significant time focusing on prevention during our classes. It’s an essential part of planning any trip to identify the risks that can be prevented, reduced, or managed. It is faulty to assume that accidents, injury,  and illness are an inevitable outcome of travel into the backcountry. This emphasis ensures a better experience, reduces strain on medical systems, and reduces serious negative outcomes that could have been avoided. 

Preventing tick bites is the best way to reduce the chances of acquiring a tickborne illness. Together, four actions work to reduce the risk.

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Avoid Tick Habitat: Ticks wait on grasses and plants to crawl onto humans. Avoid traveling through areas with tall grasses and dense or bushy vegetation, if possible. 

Use Physical Barriers: Wear long pants and tuck in your socks and shirt. This ensures that a tick will have a much longer journey before it can reach your skin. Wearing lighter colored clothing will help you spot ticks, but remember that some are very small and may go unnoticed. If possible, use a camp chair, groundsheet, or blanket instead of sitting directly on the ground. 

Use Repellents: Repellents are an effective option, especially when combined with clothing-barriers. Always apply as directed on the product packaging. 

    DEET:  30% or higher. Higher concentrations provide longer-lasting    
    protection.

    Permethrin: is a treatment applied to clothing, shoes, and outdoor
    gear. It is a long-lasting repellent and also kills ticks and biting insects.
    It is not intended for use directly on the skin. 

    Other Effective Repellants: should include EPA-registered active
    ingredient such as picaridin, IR3535, Oil of Lemon Eucalyptus, para-  
    menthane-diol (PMD), or 2-undecanone.

Check Your Body for Ticks:  At least twice a day (every 12 hours), carefully look for ticks everywhere on your body. A mirror may be useful. Easy to miss areas include: hairline, waist and bra line, behind knees, back, belly button, and between the legs. If a shower is available, it may aid in discovering and rinsing off ticks. 

* Also, don’t forget about your pets. They are also susceptible to tickborne illnesses and can bring ticks into your home on their fur. Check your pets regularly for ticks and talk to your vet about effective preventative treatments.

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Removing an Embedded Tick 
If you do find a tick attached to your body, don’t panic. Not every tick will be carrying disease (this varies regionally). It takes at least six hours (Rocky Mountain spotted fever), but generally 24-48 hours (other diseases) of attached time for disease transmission. The sooner you find a tick and remove it, the better. 

To remove, use tweezers or a tick removal tool to grasp the tick as close to your skin as possible. Pull away from the skin surface with steady pressure until the tick comes out. If any mouth-parts remain in the skin, you can go after them with the tweezers.  
It is not necessary to save the tick for ‘testing’, but consider trying to identify what type it was. Dispose of the tick and wash your hands and tweezers with soapy water. 

Caring for a Tick Bite
Gently wash the area with soapy water. You can apply antibiotic ointment to a bandage and cover the wound. As with any skin injury, it is important to change bandaging regularly and monitor for signs of infection. Be alert for any signs of tickborne illness. These may present up to several weeks after the bite. 

When to Seek Medical Care
Tickborne illnesses typically present with one or more of the following symptoms within several weeks:

• Fever or chills
• Body aches, headache, or joint pain
• Rash at the bite or elsewhere on the body or poor wound healing
• Neurological symptoms: facial paralysis, altered mental status, or other nerve problems (less common) 

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If you experience any of these symptoms after a tick bite (or suspect you could have been bitten), seek out medical care. It is important to explain to the provider that you suspect a tick bite. Tickborne illnesses are treatable, but early diagnosis and care lead to better outcomes. 

Where to Find More Information:

• Centers for Disease Control Tick Information Page
• Access your State Health Department for local information regarding Tickborne Illnesses 
• For a more in-depth synopsis of tickborne illnesses: Tick-Borne Zoonoses in the United States: Persistent and Emerging Threats to Human Health    

Justin Brewster

When not working, Justin enjoys mountain biking, skiing, paddling whitewater, and chasing big waves on Lake Superior. Having begun his next adventure - Physician Assistant school - he's looking forward to continuing practicing medicine in remote environments, whether that's serving rural communities or on an expedition. ​