Springtime in Wisconsin is finally here. This means green grass, flowers blooming, turkeys gobbling, and the emergence of the ectoparasite commonly known as the tick. Ticks are active already and are hungry. If you spend time outdoors in Wisconsin, you are likely to encounter ticks. What can you do to reduce your chance of having an unhealthy encounter with a tick?
First of all, try to avoid tick attachment. Ticks live primarily on shrubs, tree branches, and tall grasses. Staying on mowed trails can reduce encounters. While in areas likely to have ticks, wear light colored clothing and tuck your pants into your socks to make it difficult for the tick to get to the skin. You can use tick repellents on the skin and the clothing. Products containing DEET can be applied directly to the skin. The CDC recommends using products that have a concentration of 20-30% DEET. In addition to ticks, DEET also repels other biting insects. Clothing (shirts, trousers and socks) and gear (tents, backpacks) can be treated with permethrin spray. Spraying 0.5 % permethrin on clothing can be very effective at preventing tick encounters and repelling other insects. DEET and permethrin products can be purchased at department stores. Also, check yourself (or have a friend check you) for ticks after being outdoors.
Secondly, if a tick becomes attached, remove it as soon as possible. It is recommended that you firmly grasp the tick as close to the skin as possible with tweezers and gently pull it out. If you use fingers to remove the tick, it is suggested that you use paper or cloth to cover the tick and try not to squeeze the body. I have seen some ticks become partially imbedded making it difficult to remove all of it. Generally, if there are some mouth parts left after removal, the skin will be able to expel them and disease risk is low. Evidence suggests that a tick needs to be attached for at least 48 hours to transmit disease. So, prompt removal can prevent tick related disease.
Most tick exposures are just an unpleasant annoyance by a blood sucking, parasitic arachnid. However, the tick has the potential to transmit disease. Disease transmission is more likely if the tick is a deer tick, has been attached for over 36 hours, and comes from an area that has a high incidence of tick related disease. Deer ticks tend to be smaller, but other ticks in the nymph stage can also be small making tick identification a challenge. Some people bring ticks to the office or they can compare them to pictures on line. Unfortunately, Wisconsin has a high incidence of tick disease, specifically Lyme disease. Wisconsin has the third highest incidence of Lyme disease in the country.
Although, most tick bites do not need medical attention certain circumstances might require a visit to a health professional. One example would be if the tick is so imbedded that you cannot remove it. Another would be if you are sure it is a deer tick and it has been attached for over 36 hours. In that case a prophylactic antibiotic might be prescribed. Also, if a growing red rash develops at the site of the bite associated with a fever medical attention would be advised. A small red spot and scab at the site where a tick was attached is common and may take a week or more to resolve Careful washing with soap and water after removing the tick is advisable.
Enjoy the outdoors but watch out for ticks. Stay healthy my friends.
By: P. Michael Shattuck, M.D. – Community Health Network Family Physician
