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Tick talk

What you need to know about ticks

With summer nearly here, people are spending more time outside enjoying nature, but experts caution that when you are out hiking, camping or playing, you need to protect yourself against ticks.

Many people are unaware of the risk associated with ticks but tick-borne diseases are on the rise, according to the Centers for Disease Control and Prevention (CDC). During the spring, summer and fall, more people and their pets are susceptible to tick bites which expose them to a number of illnesses including Lyme disease, Rocky Mountain spotted fever, Powassan virus and several other diseases.

Dr. Sloan Manning, medical director of Novant Health Urgent Care & Occupational Medicine, said that in North Carolina tick season never really ends because the weather is so temperate.

The CDC estimates that each year, more than 30,000 cases of Lyme disease are reported nationwide, but studies suggest that the number of people who contract the disease annually is more likely 300,000

Lyme disease is carried by ticks that are predominantly found in the northern United States, but there is increasing evidence that the ticks which carry this disease are becoming more common in the South. Between 2010 and 2015, there were more than 1,600 confirmed cases of Lyme disease in North Carolina.

The predominant tick-borne illness in North Carolina is Rocky Mountain spotted fever (RMSF). Manning noted that he sees more cases of RMSF than Lyme disease associated with tick bites at his practice. “North Carolina has the highest incidence of Rocky Mountain spotted fever than any other state in the country,” he added.

Between 2008 and 2012, more than 2,000 cases of RMSF were reported in the Tar Heel state. The disease is caused by a bacteria carried most often in the southern and eastern U.S. by the American dog tick. Despite its name, the tick is indiscriminate and will feed on people as well as dogs.

People who acquire RMSF will show flu-like symptoms, Manning said. “They’ll complain of fever, chills, headache, nausea, vomiting, and often, abdominal pain,” he said. “We’ll conduct an evaluation of the patient keeping in mind the possibility of a tick bite and ask whether they have been in wooded environments or places with high grass.”

“Patients will have a sudden onset of fever and develop a rash within about three to four days of the onset of fever,” Manning said. “It takes two to 14 days to develop symptoms after being bitten by an infected tick. About one in 10 persons will not develop the rash. We’ll examine the forearms and wrists to look for a rash of red to purplish little dots, which is an inflammatory reaction in the blood vessels to the bacteria passed on by the tick.”

The doctor said patients will be treated on suspicion of having RMSF pending blood work for antibody levels as confirmation.

The antibiotic doxycycline is the first line of treatment for RMSF and the Centers for Disease Control and Prevention recommend a patient start a course of treatment immediately.

Manning cautioned that people get bitten by ticks all the time, but in most cases they will not develop Lyme disease or Rocky Mountain spotted fever. “Most ticks do not carry these illnesses,” he said. “In most cases, removing the tick using tweezers with firm pressure will do, but if you need reassurance contact your provider to discuss any symptoms you might have. Under certain conditions, a single dose of doxycycline can be used to prevent Lyme disease, but it is important to check with a health care provider to be certain you meet those conditions.”

He also advised taking these simple precautions to avoid tick bites:

  • Apply insect repellent containing DEET on exposed skin.
  • Wear clothing and gear, such as boots, long pants, long sleeve shirts and socks, treated with 0.5 percent permethrin.
  • Avoid wooded, grassy or damp areas or places where you might encounter deer or other animals.
  • Bathe or shower as soon as possible after coming indoors to wash off and more easily find ticks.
  • Conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body, including under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist and especially in the hair.
  • Make sure your pets are treated monthly with flea and tick protection.

“It takes several hours for a tick to transmit bacteria into the skin,” he added “If you think it has been attached for more than 24 hours or if you’ve developed a fever, rash or other typical symptoms, you should seek medical attention.”

Manning urged people who are active in the outdoors to visit the CDC’s website on tick-borne diseases in order to better inform themselves about the prevention and symptoms associated with tick illness.

Published: 6/7/2017