How to be Tick Smart this Labor Day

​Here are some tips to keep your family safe from
Tick-Borne Diseases this labor day holiday

Taking one last family vacation before school starts and summer comes to an end is a common American past-time; but for those of us in the northeast, don't forget that this is also a "spike" in tick feeding times. 

The largest spike in adult tick blood meals is from August through October, which is probably why there is a "burst" of new patient requests for our Integrative Tick-Borne Infection Program in November of each year. 

Be "Tick-Aware": exercise extreme precaution in damp weather and canopied areas; the black-legged tick (also called the 'deer tick') will thrive under these conditions. However it is crucial to remember that the American dog tick which is commonly found in grass despite direct sun exposure- also carries many human pathogens.

​Reduce Tick Exposure:

The first thing to remember when enjoying your holiday weekend is prevention. If you are someone who enjoys hiking, fishing, and holiday camping, reducing exposure is of the utmost importance.

Deet is a chemical spray which can be applied directly to the skin to prevent bug bites of many not shown to improve protection- and too much of this chemical may be undesirable for skin absorption. However for effectiveness, coverage matters more than percentage of Deet. Therefore if you just spray your ankles, a tick could still hike under the pant leg and feed in a clean area. We recommend using 7-30% Deet along with Aloe and vitamin E.

​Long sleeves and coverage of clothing are also recommended to reduce tick exposure. This may be helpful by limiting exposed skin, but unless you abide by tucking your pants into your socks (particularly advised if camping in the woods), then ticks are still able to access the flesh. And boy do they like to hike! It is not uncommon for a tick to climb from ankle to ear to locate a safe harbor to nestle for a long feed. We ask that you do not feel over-confident by simply wearing long pant legs. 

A better precaution is to cover clothing with Permethrin- an insect repellant safe to apply on clothing. TickEncounter Resource Center explains Permethrin benefits in the following video clip: ​

For tips on how to apply Permethrin in advance, see this video:  https://youtu.be/wkPiPU8Oawk
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For our furry friends, prevention with a tick repellant is great - but doesn't mean that ticks will die on them. Be sure to check your pets before they come back into the house, as they are commonly used as transportation for the ticks next blood meal. 

Do a "Tick Check"

Even if you are quite certain you did everything necessary during your fishing trip to reduce tick exposure, it is absolutely necessary to do a proper tick check on yourselves and your children. The plus side is most currently feeding ticks are the larger, slightly more visible adult ticks in the fall. However they can still hide in the most unsightly areas. Be sure to check in and behind the ears, in hair, and any folds of skin... including - yes - the bellybutton. Notice anything that may feel like a skin tag or scab and do not scratch it off (see below for what to do if you find an attached tick). ​

If you think it will prove impossible to check every square inch of your or your child's body to check for ticks, you're probably right. That's why tick checks are best done preventatively in the shower. Leave no stone unturned- a vigorous shampoo and coating of the body in soap is also a way to force ticks to detach while checking even the nether regions! (You don't want us to tell you all​ the places we have removed ticks in the practice!) While this may not be 100.00% effective, it is as close as we can come.  

"I did everything right- Why did I find an attached tick?!"

​Preventative methods can substantially reduce the likelihood of contracting a tick-borne infection- but don't be entirely surprised if you find an attachment. Ticks are evolved to bypass our immune response to permit a prolonged feeding period by injecting a local anesthetic when they embed- so most people do not feel a thing (unless they have had many tick bites and have learned to mount an immune response). Your first benefit is finding the tick- many people never see the offending tick - so good job with your checking! More importantly, you can now take important steps to prevent disease.

Now that you have found it, do not scratch, burn, or tug it off. Tick removal is best done by applying pressure with fine-tip tweezers as close to the head as possible. With a small amount of patience, the tick will begin to loosen grip. This method also closes the channel of the tick's gut (where bacteria like Lyme Disease reside) and your body. Slowly pull the body out and have the site inspected by your primary care or an urgent care to determine if the tick was fully removed. Remember: squeezing the body could end up injecting pathogens faster. 
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      Left:  CORRECT tick removal method                            Right:  WRONG removal method

​To know what you may have been exposed to,  have the tick tested. Save the tick in a plastic bag or tightly sealed container with a moist a toilette sothe tick may be tested for bacterial or parasitic DNA (a dead tick cannot be tested). Ticks may be sent to your municipal health departments. In the state of Connecticut, free testing is offered at the Agricultural Experimentation Center in New Haven - however note that only black-legged (Ixodes scapularis) ticks are tested, so an Dermacentor variabilis ("dog tick") bite will not be assessed by the state.  However these ticks still carry several important human pathogens which are difficult to assess by blood work, such as tularemia, ehrlicia, and the incredibly prevalent babesia species. 

There are also several groups which offer private testing. If selecting a group, use your diligence and inspect customer reviews. Remember that DNA testing (called "PCR") is best, and note that longer turn-around times could impact a timely treatment. Our group can provide one such test (available to patients in the online store, but members of the public may call to have one mailed). 
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When to see your provider

Keep a well-documented understanding of your timeline of exposure and any changes to your health. Having a tick attachment does not necessarily mean you have contracted an illness, however prophylaxis may be preferred for some individuals (a 'better safe than sorry' attitude, which may depend on your individual practitioner). Watch for signs of rashes -particularly a spreading ring around the site of the bite. This is known as Erythema Migrans or a "bulls-eye" rash which is diagnostic of Lyme Disease - a condition caused by the bacteria genus borrelia. It may arise days or weeks following a bite. Symptoms such as new onset headache, stiff neck, migrating joint pain, night sweats, new onset fatigue, fever or a flu-like syndrome should also be reported to your doctor and may indicate other types of tick-borne infections. If you do develop symptoms that don't seem to resolve after a course of antibiotics, your provider may decide to refer you to the integrative tick-borne disease program at our facility. Groups like ours specialize in clinical detection and understanding of commonly missed infections.

           ...But even though we're sure you're a fun person to work with, we prefer you
                                             Stay Safe and DON'T FEED THE TICKS! 

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