DHSS Press Release

AVOIDING TICK BITES PREVENTS VARIETY OF DISEASES

Tick bites are responsible for a variety of human illnesses. These include tularemia, Lyme disease, Rocky Mountain spotted fever and ehrlichiosis. Prompted by a recent death in Delaware due to a tick-borne disease, Delaware's Division of Public Health (DPH) reminds residents to take the following protective measures to avoid tick bites when going to potentially tick-infested areas:

• Wear light colors to allow you to see any ticks crawling on your clothing.
• Tuck your pants legs into your socks so ticks cannot crawl up inside your pants.
• Apply repellants to discourage tick attachment. Repellents containing permethrin can be sprayed on boots and clothing and will last for several days. Repellents containing DEET can be applied to the skin but will last only a few hours before reapplication is necessary. Wear insect repellent containing less than 30 percent DEET for adults, less than 10 percent DEET for children. Use DEET with caution on children. Application of large amounts of DEET on children has been associated with adverse reactions.
• Upon return from potentially tick-infested areas, search your entire body for ticks. Use a hand-held or full-length mirror to view all parts of your body. Remove any tick you find on your body.
• Check children for ticks, especially in the hair. Additionally, ticks may be carried into the household on clothing and pets. Both should be examined carefully.

Tick removal

• Use fine-tipped tweezers or shield your fingers with a tissue, paper towel or rubber gloves. Avoid removing ticks with bare hands whenever possible.
• Grasp the tick close to the skin surface and pull upward with steady, even pressure. Do not twist or jerk the tick. This may cause the mouthparts to break off and remain in the skin. If this happens, remove mouthparts with tweezers.
• Do not squeeze, crush, or puncture the body of the tick since its fluids (saliva, body fluids, gut contents) may contain infectious organisms.
• After removing the tick, thoroughly disinfect the bite site with an antiseptic or soap and water, and wash your hands with soap and water.
• Save the tick for identification in case you become ill. This may help your health care provider make an accurate diagnosis. Place the tick in a plastic bag with a piece of paper showing the date of the bite. Place the bag in your freezer.
• Consult your health care provider if infection occurs.
• Home remedies such as petroleum jelly or hot matches do not make a tick detach from skin. Such remedies may irritate the tick, causing it to release additional saliva or gut contents, increasing the chances of infection.

Tick-borne Diseases in Delaware

Tularemia has been reported in every state except Hawaii and is carried by rabbits, hares and rodents. Humans are infected from tick bites, by handling infected animal carcasses, and by eating or drinking contaminated food or water or infected fluids that become airborne. In Delaware, the ticks that transmit tularemia are the American dog and lone star tick. During 2000-2002, four confirmed cases of tularemia were reported in Delaware. A 17-month old Sussex County child died of tularemia in June 2003. Tularemia symptoms include sudden fever, chills, headache, muscle aches, joint pain, dry cough, weakness and pneumonia. Other symptoms depend on how a person was exposed to the tularemia bacteria, and can include skin ulcers, swollen lymph glands and sore throat. Up to 40 percent of those with advanced tularemia may die if untreated.

Lyme disease causes more than 16,000 infections in the United States each year. In Delaware, an average of 189 confirmed cases of Lyme disease were reported per year from 2000-2002. Symptoms include a characteristic "bull's-eye" rash, fever, malaise, fatigue, headache, muscle aches and joint aches. Occasionally, chronic joint, heart and neurological problems may occur. Lyme disease is rarely, if ever, fatal. In Delaware, Lyme disease is transmitted by the deer tick.

Nationwide, 250-1,200 cases of Rocky Mountain spotted fever (RMSF) were reported annually during the past 50 years, with over half of RMSF infections from the south Atlantic region. No confirmed cases of RMSF were reported between 2000 and 2002 in Delaware, but 55 cases were reported between 1995 and 1999. Symptoms of RMSF include fever, nausea, vomiting, severe headache, muscle pains and appetite loss, followed by rash, abdominal pain, joint pain and diarrhea. RMSF can be a severe disease, and many patients require hospitalization. Approximately 3-5 percent of cases are fatal. In Delaware, RMSF is transmitted by the American dog tick.

Ehrlichiosis can be a severe illness, especially if untreated, with 50 percent of patients requiring hospitalization. Symptoms include fever, headache, malaise, muscle aches, nausea, vomiting, diarrhea, cough, joint pains, confusion and occasionally rash. Four confirmed cases of ehrlichiosis were reported in Delaware during 2000-2002. It is estimated that 2-3 percent of patients may die from the infection. In Delaware, ehrlichiosis is transmitted by the lone star and the blacklegged tick.

It may take several hours of attachment before a disease is transmitted from a tick to a person. Individuals who are infected with tick-borne diseases may be treated with antibiotics. Early assessment and diagnosis are key to appropriate treatment and improved outcomes. People who have been bitten by a tick but do not have symptoms do not require treatment, but they should monitor their health closely and contact a physician if needed.

For more information contact DPH at 888-295-5156, or consult the Centers for Disease Control and Prevention (CDC) website at http://www.cdc.gov/ncidod/diseases/list_tickborne.htm.

Delaware Health and Social Services is committed to improving the quality of the lives of Delaware's citizens by promoting health and well-being, fostering self-sufficiency, and protecting vulnerable populations.