Don’t waste time — tick prevention starts now so you can avoid illness

At the first sign of blooms, many of us are itching to get outside and into nature.  

But it’s not just winter-weary humans looking to make the most of spring days; another critter is also ready to get out and get feeding: ticks.

While we in New Hampshire are blessed with an embarrassment of riches when it comes to natural beauty and resources, we also are lousy with ticks – blacklegged deer ticks to be precise, just the kind that can carry a host of diseases. In New Hampshire that includes Lyme disease, anaplasmosis, babesiosis, Borrelia miyamotoi, and Powassan virus. Ticks in surrounding New England states have also been known to carry ehrlichiosis, tularemia and Rocky Mountain Spotted Fever.

While that fact alone might be enough to scare you back into hibernation, it shouldn’t, said Abigail A. Mathewson, Surveillance Epidemiology Program Manager with the state Department of Health and Human Services.

Not every tick is infected and not every bite leads to disease, Mathewson said. In fact, a little bit of preparation and a healthy dose of vigilance, she said, can keep the whole family healthy, happy and enjoying the outdoors, even during tick season.

First, some data. In New Hampshire in 2016, there were 1,480 reported cases of Lyme disease. (Lyme disease data for 2017 was not yet available, but Mathewson said it’s expected to be similar to previous years.) According to DHHS data, incidents of other tick-borne diseases have increased over the past several years. Incidents of anaplasmosis, a bacterial disease, for example, went from 91 in 2013 to 306 in 2017. Further, incidents of babesiosis, a parasitic disease that infects cells similarly to malaria, went from 23 to 71 over that same period. (There was only one reported incident of Powassan, a viral disease, and no data was available for Borrelia miyamotoi, a bacterial disease.)

Each of the tick-borne diseases can lead to serious illness and in some cases death if left untreated. In the early stages, when there are symptoms, they are usually flu-like and include chills, fever and fatigue. In the case of Lyme, a person bitten by an infected tick may develop what is called an erythema migrans rash, more commonly known as a “bullseye” rash that expands over time.

By far, the biggest concern in New Hampshire is Lyme disease. According to DHHS data, depending on the county you’re in, anywhere from 41 percent to 85 percent of blacklegged ticks you encounter can carry Lyme disease, with the average falling somewhere around 60 percent.

What that means, Mathewson said, is “If you happen to get bitten by a tick, you should remove it properly as soon as possible. Then wash the site of the bite and surrounding area.”

How the tick gets infected

According to DHHS, blacklegged ticks have four life stages: eggs, larvae, nymphs and adults. The pathogens that cause the disease, however, use rodents, such as white-footed mice and chipmunks, as “reservoir hosts”, or hosts that are the source of the bacteria, parasite, or virus in the environment, Mathewson said. Some may use other animals as well, such as robins.

“In their immature stages,” Mathewson said, “black-legged ticks will feed upon these smaller animals and pick up pathogens while they are feeding. Black-legged ticks use the white-tailed deer as their ‘reproductive host’, or the host that they mate and feed on to ensure success of the next generation.”

People usually get bitten by blacklegged tick nymphs. They are very small, and can get overlooked. They are most active in the late spring to summer months (usually May through August), according to DHHS.

However, Mathewson cautions, “The black-legged tick will become active and quest (search) for a host when the temperatures get above 40 F. This means that you can see ticks out looking for a host during the winter months on a mild day, if they are not covered by snow.”

Prevention

A tick habitat is typically anywhere there is tall grass or brush, which means they can be found in the woods as well as in more urban and suburban areas. Clearing brush and dead leaves and keeping tall grass away from your home are good ways to prevent hosts from wanting to spend time there, Mathewson said.

As for getting ready to head out into the wild, to avoid getting bitten Mathewson recommends wearing an EPA registered repellent, such as DEET. According to the American Academy of Pediatrics, products that contain DEET can be used by and are safe for children older than two months. Parents should be careful not to get the repellent on any part the child may put in his or her mouth.

For those younger than 2 months, Mathewson recommends using a mosquito net over a carrier or stroller to keep ticks out.

Another thing Mathewson recommends is treating clothing with permethrin. She said while the DEET repels most ticks, the permethrin will actually kill any ticks that make it onto your clothing.

Furthermore, she said wearing long sleeves tucked into your pants and long pants tucked into your socks will prevent a tick from finding a place to bite before you notice it. She also recommends wearing light-colored clothing and avoiding brushy areas/tick habitat.

But even with all of that, it is still important to do a tick check daily, more often if you are out in tick habitat. Mathewson said she started teaching her kids at a young age how to check in between toes, fingers and in hair to try to spot ticks. These days, while they are still young, it’s sort of a game where the whole family takes turns checking for ticks.

Mathewson stresses that because the nymphs are so small and because they like dark, protected places, it’s important to check everywhere and often.

Treatment

Talbot said that most of the tick-borne diseases have similar signs and symptoms including fever, chills, muscle aches and then sometimes a rash.

Mathewson said that the time a tick needs to be attached to infect a person varies widely. If you find a tick and develop a bullseye rash or come down with flu-like symptoms, see a doctor right away.

Talbot said treatment for each tick-borne disease varies, but most are treated with an antibiotic or a combination of antibiotics and other drugs. Powassan does not have any known treatment, according to DHHS.

Talbot said that these treatments are very effective, but people can get re-infected via a new tick bite and a small number of patients can have lingering post-treatment symptoms, such as fatigue and just not feeling like themselves.

Talbot also said that for anyone 8 and older who has had a tick attached for at least 36 hours, a doctor can give a prophylactic dose of doxycycline within 72 hours of removing the tick.

At the end of the day, though, Talbot said the best course of action when it comes to ticks in New Hampshire is prevention.

“There’s so much that can be done to prevent tick bites,” she said. “The methods to prevent tick bites are not necessarily easy or sexy, but they are effective.”   

Melanie Plenda is a longtime contributor to PNH.

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