Tick bites, disease risk up this year

FINDLAY — Tick bites — which can transmit Lyme disease — are up this summer from a year ago, Physicians Plus Urgent Care in Findlay reported this week. "We're definitely seeing an increase in tick bites. This is the time of year for them," said Jen Campbell, physician assistant at Physicians Plus. "But in addition to seeing the peak season, we're also just seeing more tick bites in Ohio in general versus last year, which means that the incidence in tick-borne diseases has also been increasing." Lyme disease is the most feared disease. The tick which transmits it is the black-legged tick, or deer tick. Initial symptoms of Lyme infection can be fever, chills, headache, fatigue, muscle and joint aches, and swollen lymph nodes. Untreated it can cause severe headaches and neck stiffness; loss of muscle tone in the face or drooping on one or both sides of the face; arthritis with severe joint pain and swelling; intermittent pain in tendons, muscles, joints and bones; heart palpitations; dizziness or shortness of breath; inflammation of the brain and spinal cord, nerve pain, shooting pains, numbness or tingling in the hands or feet, the Centers for Disease Control and Prevention (CDC) reported. No documented cases of Lyme disease have been seen yet in Hancock or in Hardin County yet, Campbell said. Bull's-eye lesion "But there's been a lot of suspicious cases," she said. "I've seen an increase in the number of the target (or bull's-eye) lesions or the erythema migrans lesions after a tick bite, which is one of those things that indicates the possibility for Lyme." The target, or bull's-eye, lesion looks like it sounds: a red center, surrounded by a clear circle, surrounded by an outer red circle. "Some of the patients we're seeing, they don't get labs drawn afterwards to tell us for sure that that was Lyme that we started treatment for," Campbell said. "And also sometimes those labs don't show positive anyhow, even though the suspicion is quite high once you see that target lesion." If someone has the target lesion, they should get medical attention immediately. "The sooner we treat a suspected Lyme, the less chance we'll have of some of those long-term Lyme complications that you see," she said. "Years down the road it can cause neurological symptoms, joint symptoms. Definitely if you see that target, don't hesitate, get a second opinion. Be seen by a medical provider." Prevention There are preventive measures people can take to reduce their tick exposure. Avoid wooded and brushy areas with high grass and leaf litter. Walk in the center of trails. One can tuck in their pant legs. People can get exposed to ticks while walking their dog, gardening or simply being in their own yard or neighborhood. Insecticide containing 0.5% permethrin can be applied to clothing and gear. Permethrin remains protective through several washings. Other insect repellents are also suggested by the Centers for Disease Control and Prevention (CDC). Some should not be used on children under 3 years of age. The prevention continues when you come indoors: • Check your clothing and gear for ticks, and remove any you find. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed. If the clothes require washing first, hot water is recommended. Cold and medium temperature water will not kill ticks. • Examine your pets. • Showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease and may be effective in reducing the risk of other tickborne diseases, the CDC reported. Showering may help wash off unattached ticks and it is a good opportunity to do a tick check. • Conduct a full body check, including your own "backyard." Use a hand-held or full-length mirror to view all parts of your body and your child's: under the arms; in and around the ears; inside belly button; back of the knees; in and around the hair; between the legs; around the waist. In general the greatest risk of disease transmission occurs if the tick is embedded in the skin for over 36 hours, Campbell said. Careful removal "If a tick has been on them for 36 hours or more, and engorged, and it looks like a black-legged tick or a deer tick, we want to start that medication for prophylaxis within 72 hours," she said. "If we miss that window, it's fine. We're just going to keep an eye out for symptoms and then we can initiate treatment if any symptoms do occur." Removal of a tick that is embedded in your skin must be done carefully. "Don't panic, just go ahead and take fine-tipped tweezers and grab as close to your skin as possible because that's where that head and the mouth parts are inside you," Campbell said. "Grasp that, and, slowly, but firmly kind of pull it straight away from where (the tick is) embedded." Yanking or pulling quickly could leave the tick's mouth parts inside. "If the mouth parts are embedded, that's fine. You may bleed a little bit. That's no big deal. Just clean the area with some alcohol afterwards," she said. If you cannot remove the tick's mouth parts from your skin, your body will eventually push out the foreign material, Campbell said. She recommended you wash the area regularly, so when the remaining material is pushed out by the body you do not get a secondary bacterial infection.