by Dr. Andrea Berry, D.O.
Family Medicine, Mid-State Health Center

Spring is here at last, and the long hot days of summer are just around the corner!  Unfortunately, along with the warm weather comes tick season in New England.  April to September is peak season for ticks and it is during this time that protecting ourselves and our pets from ticks becomes most important.  Ticks survive by eating blood from their human and animal hosts, and can pass infections between humans and animals.  Ticks are notorious for spreading Lyme disease, but they can cause other infections as well.

There are two species of ticks common to New Hampshire.  The American Dog Tick (Dermacentor variabilis) is the most common.  Dogs are the primary host for this tick, and although the tick may also bite humans or other mammals, it is not able to transfer Lyme disease to humans.  The Blacklegged Tick (Ixodes scapularis), commonly referred to as the Deer Tick, is the species of tick responsible for the transmission of Lyme disease to humans and animals.  This tick is widely distributed in the northeast.  The Blacklegged Tick feeds on larger mammals and will bite humans on occasion.  The number of Deer Ticks in NH has increased in the last several years, and as many as 60% of the Deer Ticks in NH carry Borrelia burgdorferi, the bacteria that causes Lyme Disease.  According to the Centers for Disease Control and Prevention (CDC), NH is one of the top states for reported cases of Lyme disease.

The best way to protect yourself from tick bites is to avoid wooded and brush areas with high grass.  If you are heading into wooded areas, walk in the center of trails and use products with DEET or permethrin to repel ticks from attaching to you or your clothing.  Use repellents that contain 20% or more DEET on the exposed skin for protection that lasts up to several hours.  Be sure to always follow the product instructions.  Parents should apply this product to their children, making sure to avoid hands, eyes, and mouth.  If you are spending a lot of time in wooded areas, use products that contain permethrin on clothing.  Treat clothing and gear, such as boots, pants, socks and tents.  It remains protective through several washings. Pre-treated clothing is available and remains protective for up to 70 washings. Pet owners should use caution when using permethrin in a household with cats, as it can be toxic in certain circumstances. Speak with your veterinarian if you have questions about safe application of permethrin products or clothing in a cat-owner’s household.

When returning indoors, be sure to check yourself thoroughly for ticks.  If at all possible, take a bath or shower soon after coming indoors (preferably within two hours) to wash off repellent and more easily find ticks that are crawling on you.  Conduct a full-body “tick check” using a mirror to view all parts of your body, when you return from being outside.  Parents should check their children for ticks 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.  Ticks can ride into your house on clothing and pets and potentially attach to a person later, so carefully examine pets, coats, and day packs.  Tumble clothes in a dryer on high heat for an hour to kill remaining ticks.

Even when you don’t go outside, your pets do.  To reduce the chances that a tick will transmit disease to you or your pets, check your animals for ticks daily, especially after they spend time outdoors.  If you find a tick on your dog or cat, remove it right away.  Ask your veterinarian to conduct a tick check at each exam.  In addition to monthly topical preventive medications available for your pets, you should also discuss the Lyme vaccine with your vet. 

If you find a tick attached to your skin, remain calm.  The most important way to prevent Lyme disease transmission, even if a tick is attached, is early and complete removal.  There are several tick removal devices on the market, but a plain set of fine-tipped tweezers will remove a tick effectively. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.  Pull upward with steady, even pressure.  Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin.  If this happens, remove the mouth-parts with tweezers.  If you are unable to remove the mouth easily, leave it alone and let the skin heal.  After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol or soap and water.  Avoid folklore remedies such as painting the tick with nail polish or petroleum jelly, or using heat to make the tick detach from the skin.  Your goal is to remove the tick as quickly as possible–not wait for it to detach.  If you are worried about trying to remove the tick yourself, call your healthcare provider for guidance.

The symptoms of Lyme disease are generally vague, and include low-grade fever, joint pain, fatigue and headache.  Symptoms may appear along with the development of a classic, red, bulls-eye rash that typically appears anywhere from three to thirty days after the initial bite, though not everyone develops the rash.  The blood tests available for Lyme detection take time (typically six weeks or more) to become positive after infection, but if you experience these symptoms, especially with a recent tick bite or rash, you should see your healthcare provider for an evaluation.  

For more information including photos, visit tickfreenh.org or visit midstatehealth.org and click on Health & Wellness and select Health Information and Education.

Source: Centers for Disease Control and Prevention, Lyme Disease.