Ticks: The Second Spike

When the weather begins to cool, many of us begin to think that the health risks associated with summer—sun burns and heatstroke—are slowly disappearing. In many cases, they are. But the risk of contracting the diseases carried by ticks is still high until after frosts set in.  In fact, the prevalence of tick-borne diseases is almost as high in mid-October as it is in mid-May, when they are most active. The fall spike in tick activity relates to the adult ticks seeking their final meal before their long winter nap.

Here’s what you need to know to get through this second spike in tick season without contracting one of the diseases they carry, like Lyme disease and anaplasmosis.

Avoid tick bites by steering clear of wooded and bushy areas and those with tall grass or leaf litter. If you enjoy hiking, walk in the center of the trail. Use a repellent that contains 20 percent or more DEET, picaridin, or IR3535 on exposed skin, and follow the directions on the package. You can also treat your clothing with permethrin, which both repels and kills ticks. It is very effective against tick bites and poses no threat to humans. It is often marketed as “clothing and gear” spray. One treatment, following the directions on the package, will likely take you safely through the end of the season.

Your next line of defense is to keep those ticks that found you from biting you. Change clothes when you come inside. Wash them in hot water and tumble dry. If possible, bathe or shower within 2 hours of coming indoors, as well.

Conduct a thorough tick check. The most common type of tick in Vermont and the surrounding area, and the one that carries most of our tick-borne illnesses, is the black-legged tick. They are adults in the fall and are at their largest, which should make them easier to spot. Although, even a large adult tick is still pretty small. The body is only about the size of the letter “d” in the word dime on an actual dime. So look carefully. They can hide in and behind ears, under arms, in the groin, and behind the knees. Check yourself, have a family member check your back and other areas that are difficult to see, and check your children carefully.

If you find a tick on your skin, remove it immediately. In most cases, you have at least 24 hours to find and remove a feeding tick before it transmits an infection. Use pointy tweezers or an aftermarket tick-removal device. Grab the tick as close to the skin as possible, and pull it straight upwards. Do not use any lubricants or hot objects. Leaving mouthparts in your skin does not increase the chance of infection. (They will come out on their own.) Disinfect the area with alcohol or other disinfectant. Identify the tick using online resources, if possible. Then flush it down the sink or toilet.

Know the symptoms. Only just over half of Vermont’s black-legged ticks carry Lyme disease. Those carrying the other common tick-borne diseases measure around 5 percent. So just because you have been bitten does not mean you will be infected. At the same time, many of those who get a tick-borne illness diagnosis don’t recall having been bitten. So, it's important to know the symptoms and watch for them.

Symptoms of Lyme and anaplasmosis are similar. They include flu-like symptoms, like fever and fatigue; head, neck, and joint aches; and enlarged lymph nodes. Usually the symptoms come on suddenly. Only about 25 percent of people who are diagnosed with Lyme disease get the characteristic "bull's eye" rash. If you do notice symptoms, call your doctor right away. Symptoms treated early are less likely to make any long-term impact.

Maintaining high awareness of ticks in the environment is the best way to keep from getting infected with the diseases they carry this fall.

Donna Barron, RN, is the infection preventionist at Southwestern Vermont Medical Center, part of Southwestern Vermont Health Care, in Bennington.