• Knowledgebase: Information on Specific Illnesses

    Here you will find discussions of specific illnesses and their management.

    11. Tell me about Ticks - Top

    This article is from WNC Parents magazine, October 2001, by Dr Horwitz.

    1. How big a concern are ticks during the fall months? Actually, tick bites are a concern from April through September. In the United States there are between 400 and 800 cases of Rocky Mountain Spotted Fever reported each year, and in 1999 there were 16,273 cases of Lyme Disease. In a recent study, 29% of ticks tested positive for the germ that causes Lyme Disease, and 5% tested positive for Rocky Mountain Spotted Fever.

    Most tick bites, regardless of how long the tick is attached, do not result in an infection. However, tick bites should be prevented because these are very serious infections.

    2. What Methods are most effective in preventing contact with ticks? The best protection against tick-borne illness, is to stay away from places where ticks live. Ticks like to live in tall grass and thickets. If you plan to participate in an activity in an area where ticks are likely to live, such as picking blackberries, you should:

    -wear long pants tucked into boots

    -wear a long sleeve shirt

    -apply an insect repellent containing DEET sparingly and avoiding the face

    -wash off insect repellent with soap and water as soon as possible after the outing

    3. I am concerned about Lyme Disease. What are the risks of contracting this disease from a tick bite? It is hard to estimate the risk of contracting Lyme Disease from a tick bite. The Ixodes tick (Deer Tick) that carries the disease is so small that most people with Lyme Disease do not recall being bitten by a tick. However, while cases of Lyme Disease do occur in North Carolina, it is still a very uncommon infection here.

    4. What types of ticks carry the diseases? The tick that carries Lyme Disease are in the Ixodes family, sometimes known as "Deer Ticks". These ticks can be as small as the tip of a pencil lead. They are most commonly found in the Northeast- from Massachusetts to Maryland, Wisconsin and Minnesota, and less frequently in other states including North Carolina. Rocky Mountain Spotted Fever is carried by the Dog Tick- the kind that we see very often in North Carolina.

    5. What is the best way to remove a tick once it has embedded itself in the skin? Most experts agree that the best way to remove a tick is to grasp it with a tweezers close to the skin and gently pulled straight out without twisting. If fingers are used to remove ticks, protect them with tissue and wash them afterwards. Avoid squeezing the body of the tick. Do NOT try to smother the tick in Vaseline, or to burn the tick with a hot match head. Inspect the site to make sure the head of the tick has been completely removed. Cleaning the skin with soap and water and applying Neosporin is a good idea if the skin is irritated or bleeding. There is no need to save the tick.

    6. What symptoms should I look for in my children and myself to tell if a tick bite may have caused contact with Lyme Disease? The first sign of Lyme Disease is often a characteristic rash called erythema migrans at the site of the tick bite. It starts as a red bump or patch and spreads outward to form a ring often with normal color in the middle. This rash can reach six inches in size. Along with the rash, infected persons may experience fever, headache, neck stiffness, muscle aches, and sore joints. Later on in the illness, persons may complain of recurrent joint pains, particularly in the knees. The first symptoms can start any time from three to thirty days after the bite.

    7. What is the best thing to do if I think a family member has contracted Lyme Disease? Any person who has these symptoms, especially if they know they were bitten by a tick, should see their doctor as soon as possible. Early treatment of the infection with antibiotics can prevent the more severe, late symptoms.

    8. What are the symptoms of Rocky Mountain Spotted Fever? This illness usually starts with a rash as well. However, the rash of Rocky Mountain Spotted Fever starts as tiny red dots on the ankles and wrists that progress towards the body over time. However, up to twenty percent of people never develop the rash. Along with the rash comes fever, severe headache, muscle aches, confusion, and nausea. The symptoms start from two to fourteen days after the tick bite.

    - Updated: August 25, 2001

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    • James L Horwitz, MD

    David C. Thomas, MD

    Barbara Lindberg, PNP