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Chapter 22
TICK-TRANSMITTED DISEASES
Recommendations are considered Category 1A, except where indicated Category 2, by
the WMS Panel of Expert Reviewers.
I.
GENERAL INFORMATION
Ticks vector many serious infections, more than any other North American arthropod,
although in number of infections mosquitoes spreading West Nile virus are
surpassing them. The more common infections transmitted by hard ticks (Ixodidae)
include Lyme disease and Southern tick-associated rash illness (STARI), Rocky
Mountain spotted fever, ehrlichiosis, babesiosis, tularemia, and Colorado tick fever.
These ticks also cause tick paralysis, a noninfectious disorder. Soft ticks (Argasidae)
vector relapsing fever.
Several measures lessen the likelihood of being bitten by a tick or acquiring a tick
borne illness. Light-colored clothing allows ticks to be more easily seen. Long-
sleeved shirts and long pants, particularly with trousers tucked inside high socks, help
keep ticks away. Contact with brush should be avoided, if possible.
Permethrin applied to clothing kills ticks so effectively it appears to repel them. A
repellent containing DEET, which is essentially entirely safe when used as directed,
may be applied to exposed skin. A concentration of DEET no greater than 30 percent
is recommended, and has recently been approved for children older than two months
by the American Academy of Pediatrics. Microencapsulated and polymerized
preparations remain on the skin longer and less of them is absorbed.
Close examination, preferably unclothed, is a significant element of tick avoidance,
but is not practical with youth groups where reliance on the prevention of tick bites
by the protective effects of permethrin treated clothing is preferable. Examination
once every twenty-four hours is sufficient because hard ticks require more time to
become attached and transmit infections. These ticks may not attach for several hours
after initial skin contact and can be easily removed. Showering or bathing may
remove unattached ticks. Once attached, tick removal is more difficult, but must be
removed without delay. .
The most widely recommended method of tick removal is to grasp it as close as
possible to the point of attachment with sharp-pointed tweezers, and pull gently. The
mouthparts may not be removed with the rest of the tick, but are usually extruded
later, although they may become infected. Remaining mouthparts do not transmit
infections. Do not crush the tick. Clean the wound with soap and water and disinfect
the tweezers. More efficient that using sharp-pointed tweezers is to use any of three
commercial tick removal tools: The Original Tickked Off
TM
, The Pro-Tick
Remedy
TM
, and the Tick Plier
TM
, also called the Tick Nipper
TM
.
