Introduction Tick Removal Steps Prevention Lyme Disease Web Resources Centimeter Scale

Introduction
Have you ever stepped ashore from your boat and trundled off into the bushes to answer the call of nature? Or do you hike in to your favorite fishing hole and ply the waters from the bank? Have you ever given ole Fido a big hug or had him rest next to you on the seat of your truck on the way home after a day in the woods? Then chances are that you have been exposed to ticks.

Ticks are not particularly choosy about who they attack. Any warm-blooded host will do. They climb up in brush and wait for a host to happen by. They attach themselves to the host and suck the host's blood, feeding only until they're full (6-13 days), then drop off and lay eggs. Incredibly, some ticks can survive up to two years between feedings. A female tick lays from 4,000-6,000 eggs. After the eggs hatch, the tiny larvae or seed ticks, find hosts and feed just as the adults do. The larvae of some types of ticks are almost invisible to the human eye but literally hundreds can feed on one person resulting in painful itching and in some people, an allergic reaction. In most species, the larvae feed only on small mammals and are not a problem for humans. There are over 300 species of ticks. Different species carry different diseases. Rocky Mountain Spotted Fever and Lyme Disease are two of the better known diseases spread by ticks. Some diseases, such as Lyme Disease may effect pets and livestock as well as people.

Tick Removal Steps
According to the Centers for Disease Control (CDC), embedded ticks should be removed using fine-tipped tweezers. Using fine-tipped tweezers, grasp the tick firmly and as closely to the skin as possible. With a steady motion, pull the tick's body away from the skin. Don't twist or squeeze the tick. The tick's mouthparts may remain in the skin, but do not be alarmed. The bacteria that cause Lyme disease are contained in the tick's body, not the head.

DO NOT use petroleum jelly, a hot match, nail polish, or other products. Each of those methods actually forces the bacteria, virus, protozoa, and toxins into your body.

Place the tick in a small sealable container or Ziploc bag, and label it with your name (or the name of the person on whom it was feeding), the place it was attached, the outdoor area you had been, and the date. Clean the area with an antiseptic. Clean the tweezers with an antiseptic.

The longer a tick is on you, the greater your chances for contracting a disease from it. The transmission of the bacteria that causes Lyme disease from an infected tick is unlikely to occur before 36 hours of tick attachment. For this reason, daily checks for ticks and promptly removing any attached tick that you find will help prevent infection.

Prevention
You can decrease the chances of being bitten by a tick with a few precautions:

• Avoid tick-infested areas, especially in March thru July
• Wear light-colored clothing so that you can spot ticks more easily.
• Tuck pant legs into socks or boots and shirt into pants to keep ticks on the outside of clothing.
• Tape the area where pants and socks meet so that ticks cannot crawl under clothing.
• Wear a long-sleeved shirt for added protection.
• Spray insect repellent containing a 20-30% concentration of DEET on clothes and on exposed skin other than the face, or treat clothes (especially pants, socks, and shoes) with permethrin, which kills ticks on contact. Follow the manufacturer’s instructions when applying repellents.
• Walk in the center of trails to avoid contact with overgrown grass and brush at trail edges.

Preventive Antibiotic Treatment: Giving antibiotics to prevent Lyme disease after a known tick bite is not routinely recommended. Physicians must determine whether the advantages of using antibiotics outweigh the disadvantages in any particular instance. If you have been bitten by a tick, your physician should alert you to the symptoms of early Lyme disease (and other tick-borne illnesses) and advise you to return for reevaluation if symptoms occur.

Lyme Disease
Lyme disease most often presents with a characteristic "bull's-eye" rash, accompanied by nonspecific symptoms such as fever, malaise, fatigue, headache, muscle aches, and joint aches.

The incubation period from infection to onset of the rash is typically 7 to 14 days but may be as short as 3 days and as long as 30 days. Some infected individuals have no recognized illness or manifest only non-specific symptoms such as fever, headache, fatigue, and myalgia.

The early stage of Lyme disease is usually marked by one or more of the following symptoms and signs:
• fatigue
• chills and fever
• headache
• muscle and joint pain
• swollen lymph nodes
• a characteristic skin rash, called erythema migrans, or bull’s-eye rash

Bull’s Eye Rash is a red circular patch that appears at the site of the tick bite usually within 3 days to 1 month after the bite of an infected tick. The patch then grows larger. Sometimes many patches appear, in varying in shapes and sizes. Common sites are the thighs, groin, trunk, and armpits. The center of the rash may clear as it enlarges, resulting in a “bull’s-eye” appearance. The rash may be warm, but it usually is not painful. Not all rashes that occur at the site of a tick bite are due to Lyme disease, however. An allergic reaction to tick saliva often occurs at the site of a tick bite and may be confused with the “bull’s-eye” rash of Lyme disease. Allergic reactions to tick saliva usually appear within hours to a few days after the tick bite, usually do not expand, and disappear within a few days.

Lyme disease can be treated effectively with antibiotics. Several antibiotics are effective and are usually given by mouth but may be given intravenously in more severe cases. Patients treated with antibiotics in the early stages of the infection usually recover rapidly and completely. Most patients who are treated in later stages of the disease also respond well to antibiotics. A few patients who are treated for Lyme disease may have persistent or recurrent symptoms, and may require additional antibiotic treatment. Varying degrees of permanent damage to joints or the nervous system can develop in patients with late Lyme disease. Typically these are patients in whom Lyme disease was unrecognized in the early stages, or for whom the initial treatment was unsuccessful. Lyme disease is rarely, if ever, fatal.

Web Resources
Here are two valuable links from which you can learn more about tick bites and Lyme disease:
The American Lyme Disease Foundation , www.aldf.com
The Centers for Disease Control , www.cdc.gov/ncidod/dvbid/lyme
The International Lyme and Associated Diseases Society (ILADS) provides a forum for health science professionals to share their wealth of knowledge regarding the management of Lyme and associated diseases., http://www.ilads.org/