August 2024
Block Island has two types of ticks that can transmit diseases to humans: deer ticks and lone star ticks. Black-legged, or deer ticks (Ixodes scapularus) and lone star ticks (Amblyomma americanum) are both capable of transmitting disease. The deer tick carries Lyme disease, Babesiosis, Anaplasmosis, and Ehrlichiosis. Symptoms of these diseases include fever, chills, malaise, joint pain, headache, and other neurological symptoms such as a Bell’s palsy, or nerve palsy of the face. The lone star tick carries several diseases, including Ehrlichiosis and Rocky Mountain spotted fever, but is most known for transmitting STARI (Southern tick associated rash illness) and Alpha-gal syndrome, which causes individuals to develop allergic symptoms to red meat.
Ticks carry bacteria and parasites in the saliva glands in their mouths. Ticks attach to your body with their mouth parts intending to obtain a blood meal from you. A tick must be attached, or embedded, in your skin for at least 24 hours to transmit most tick-borne infections, including Lyme disease. In fact, it typically takes a minimum of 36 hours to transmit Lyme disease to a human. This is why checking your body for ticks after being outdoors is so important. If you have pets that go outdoors, they are also a source of tick exposure for you and your family.
We all worry about Lyme disease, but the risk of transmission is quite small! The risk of acquiring Lyme from an observed tick bite is only 1-3%, even here in New England, where tick bites are common. The risk becomes greater when the tick has been present for at least three days (72 hours). When you have a tick bite it is important to remove the tick as soon as possible. To do this, grasp the tick as close to the skin as possible with a pair of tweezers. Pull back firmly, using steady pressure. It is not recommended to twist or jerk quickly. After removal wash your hands and bite area with warm soapy water. Any remaining mouth parts will be expelled on their own and should be left alone. Attempting to remove them can cause unnecessary trauma to the skin and is unnecessary in preventing infection. Observe the removed tick or bring it with you to your appointment for your provider to inspect. A tick must be engorged, or full of blood, to have transmitted disease. A flat tick, or one that is easily removed, will not have had time to infect you.
If you have a bite from an engorged tick or remove a tick that has been on you for more than 36 hours, based on your last time outdoors, you can be prescribed a one-time dose of doxycycline to prevent Lyme disease transmission. Doxycycline is the only antibiotic that has been tested and found effective for this treatment but must be taken within 72 hours of tick removal to be effective. There is no benefit to testing for Lyme disease at the time you are bitten. Even people who become infected will not have a positive blood test for two to six weeks after infection.
The presence of Lyme infection gives about 80% of those infected a rash called erythema migrans, or EM rash. This rash looks like a bull’s eye and may be in a single location, though 10-20% of people can have multiple target-like lesions. The remaining 20% of people who have Lyme infection will not have any rash. If it is going to develop, the EM rash can occur within a week, but up to a month after infection.
Many people have been given incorrect information about Lyme disease. For example, some people are concerned that Lyme disease becomes untreatable if antibiotics are not given early in the course of illness. However, this is untrue. Even later symptoms of Lyme disease can be effectively treated with the correct antibiotics.
The best prevention against acquiring tick illnesses is to prevent tick bites. Effective ways to do so are to walk on trails where the grass has been cut, tuck clothing into socks and spray them with 0.5% permethrin, and to check for ticks after your walk.
Visit https://web.uri.edu/tickencounter/ for more information about tick-bite protection and tickborne disease prevention. If you do have a tick encounter, check out https://web.uri.edu/tickencounter/tickspotters/ to learn how to submit a tick photo to get free tick ID by a tick expert along with guidance on best next actions.
– Laurie Anderson, APRN-C, CDOE