Guard Yourself Against Ticks

What a spring we’re having! For the most part, the weather has been fabulous. Many of us are already taking advantage of it and spending lots more time outside, and that’s good for us and for our children, right? Well…the answer is “mostly.”

There is one issue that we have heard about so often over the years that unless we personally are affected, or know someone close to us who is, we don’t really pay much attention to it. That is Lyme Disease. I am NOT going to provide a long treatise on this subject but will let you see some communications that came across one of the online birding groups to which I belong. All those who belong to this group spend a great deal of time outdoors. Sometimes it may be just on a path or road, or in their own backyards. Sometimes they are bushwhacking through the grass or a forest. The point is that these people know this issue personally, and their communication can possibly save you years of distress. The following emails are presented as anonymous and are unedited except where some wording might identify someone. 

This all came about because a list administrator posted a very brief message about being careful regarding ticks. These emails are from all over the region and are in chronological order, with the names replaced with XXXXXXX. This is long but VERY WELL WORTH YOUR TIME TO READ ONCE. You may wish to save this on your computer for reference. With this knowledge, and the experience you gain by seeing what others have been through, you can protect yourself and your loved ones. 

PRINCETON, NJ: Birders need to be aware that warnings are being raised about Lyme Disease this year in NJ and the northeast. The warm winter and cyclic population changes are  expected to produce high tick numbers. Lyme Disease is treatable if detected in  time, but can leave you disabled if it isn't treated. Please be informed about  the risk, and take precautions to prevent tick bites. Also protect your pets,  who can carry the ticks into your home. Here are some articles to start with: 
http://green.blogs.nytimes.com/2012/04/04/bracing-for-a-hungry-tick-season/
http://www.caryinstitute.org/press_2012-03-15.html
http://www.ilads.org/lyme_disease/about_lyme.html

XXXXXXX reminds me that there are other diseases carried by ticks. We lost XXXXXXX, a valued member of the birding community, to Ehrlichiosis a few years ago after a Big Day. His wife and sister asked that information about his illness be shared with the birding community: 
http://forums.njpinebarrens.com/threads/tick-bite-kills.2469/ 

In addition to Lyme and Ehrlichiosis, Babesiosis and Bartonella are also known to be carried by New Jersey ticks. A single tick can carry multiple infections.  Here's a list: http://www.cdc.gov/ticks/diseases/ 

I also had a message from XXXXXXX, a Brit planning to come to NJ for the World Series of Birding; he is asking for suggestions for avoiding Lyme. If anyone has good ideas, please post them. Actually, I learned the hard way; I'm an example of someone who didn't get treated in time, and got stuck with apparently permanent neurologic effects. (Which is why I occasionally get boring on the subject.) So here comes my list: 

1. Don't go off the trail when birding. Ticks hang on shrubbery and grass, so if you can avoid brushing the plants you will give ticks fewer chances to grab you. (You will also avoid tromping on ground nesting birds, wildflowers, etc.) 

2. Many people find that spraying with repellents helps. Some recommend permethrin sprays, but these require careful handling and I'm not sure they're  available in NJ any more. I don't think DEET (the chemical in most sprays) makes much difference with ticks, but it will definitely help with the other biting insects in NJ in May, so go ahead, just don't get it in your eyes or on your binoculars... 

3. Cover up—boots, socks, long pants, long sleeves, hat.

4. As soon as you get in from the field, shower. No matter how tired you are after 24 hours in the field. Tick larvae are no bigger than a pinhead, and you  won't see them just by inspecting your body. Also, put your field clothes, hat, etc., in a plastic bag and don't wear again until they've been laundered in HOT water. 

5. Watch yourself closely and be aware of how you feel. If you get a rash spreading from a central bump, or if you get a mild "flu" with headache, muscle aches, any fever, lethargy (with or without a known tick bite, with or without a rash), don't just figure you're tired and it will go away. Get checked right away by a doctor. Tell him/her you were/are often exposed to New Jersey wild areas with strong chances of a tick-borne infection. You should be given 3-4  weeks of doxycycline (200Mg twice a day) minimum. Doxy is generic, cheap and effective; it may upset your stomach but that's better than having one of these diseases. 

6. If you get a rash, take a photo of it and take notes of the date and any other symptoms. (This will be useful in the future if symptoms return, because the antibiotics don't always seem to clear the infection the first time.) 

7. There is no vaccine for Lyme Disease (in humans), and you do not become immune after having it once. 

8. If you find a tick attached to yourself, remove it with pointy tweezers and swab the area with alcohol. Do not burn, smother, or squeeze it. Save the tick in a plastic baggie or pill bottle if you want to have it tested for infection. 

http://njlabs.com/TickTest/index.cfm 

9. Check http://www.tickencounter.org/tick_identification to learn what a wide variety of ticks look like, and for more protection methods. 

10. Good luck and have fun, in spite of the ticks!!

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SANDYSTON, NJ: Hi, all – 

I'm a (bird) bander and I and every other bander I know in NJ has or has had Lyme at some point in their lives. I'm on yet another several-month course of  antibiotics for a flare. Here is my Lyme information. 

1. RUBBER BOOTS. Don't leave home without them, preferably up to the knee. You're much, much less likely to get ticks on you if you wear them. I used to  get several tick bites every single time I banded (Sussex Co., NJ) and now I only get one every couple of weeks. Similarly and obviously, wear long pants and sleeves and always keep your hair up! 

2. As soon as you get home, remove your clothes and do a thorough tick check, preferably with someone else helping you. Contrary to popular belief, a tick only needs to be attached for a short time to transmit Lyme. If you find a tick, do not squeeze the tick and pull it out with your fingers. Use a fine-tipped pair of tweezers or one of those plastic tick removers, otherwise, you may be squeezing the Lyme spirochete into yourself. 

3. A much lower percentage of people than previously thought actually get the bulls-eye rash, so don't rely on it as an indicator. However, if you do get it, see your doctor immediately. Three weeks ofdoxycycline will cure you completely. The vast majority of people I know with Lyme, including me, did NOT get the rash, and none of us were cured without months of antibiotics (two took a few months of IV antibiotics) and some of us haven't been cured in years. If you didn't have the rash and test positive for Lyme, make sure your doctor is "Lyme-literate," the term used by ILADS, and doesn't expect a month of doxy to cure you! Most doctors are pretty clueless on Lyme so if you think you may be infected, make sure you find a doctor who is knowledgeable on the subject. If you have many Lyme symptoms, don't give up after one negative ELISA test from an uneducated doctor. One of my friends got a negative ELISA and her doctor wouldn't give her a second or the most sensitive Western Blot (always request this test!), but she luckily found a more informed doctor, the W Blot came back positive, and after 1.5 years of treatment for a heart condition brought on by Lyme, she is cured! 

4. A much more common symptom than the rash is joint pain, especially of the knees. Several weeks after infection, it is very common to get rashes on various parts of your body, so that is also a clue. A low-grade fever, fatigue, exhaustion, and/or flu-like symptoms also point to Lyme. 

5. DEET is a miracle. I get infinitely less ticks if I use a high-DEET solution like Off! Deep Woods. 

6. As mentioned by Laurie, there are other serious tick-borne illnesses out there. If you get very ill after time out in the woods, please see a doctor and request testing for Bartonella, Ehrlichiosis, Babesia, and Lyme. You can be co-infected with several of these at the same time as well. 

I'm happy to talk to anyone off-list about Lyme. I know more about it than I would have liked to but at least I can help others with my knowledge now. :) 

PRINCETON, NJ: Thanks for the lyme postings.. my daughter had ehrlichiosis 2 years ago and it was very scary... symptom was a horrible headache.. she couldn't lift her head off the pillow... took her to emergency where they did diagnose it and started her on antibiotics.... we all have to be alert! 

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SOMERSET, NJ: Years ago I was president of a nonprofit devoted to getting people, women in particular, involved in the outdoors. I arranged for a presentation by a man named XXXXXXX, who was conducting research at the Center of Vector Biology in the Department of Entomology at Rutgers involving tick-borne diseases. He gave a talk, "Tick, Tick, Tick - Medically Important Ticks of New Jersey." He discussed the species of ticks found in NJ, their life cycle, and the risks they present to human health and ways to reduce those risks, as well as research about ticks that was being conducted in NJ. Folks were kind of creeped out when they learned about the topic of the presentation, but those who overcame their "creeped-outness" and attended really thought his presentation was interesting and helpful, and that they were more "tick savvy" than before. I saw XXXXXXX briefly at the Wild Outdoor Expo last September, but I don't know what he is doing now. He may be a potential meeting speaker if folks would like to investigate. 

MARLTON, NJ: Been there, done that. I was fortunate that my case was caught early enough that a 3-week course of a megadose of an oral antibiotic knocked it out. 

I want to iterate what someone else mentioned: not everyone gets the rash. I didn't, and my doctor ran a whole battery of other tests (& I even had my ob/gyn do an ultrasound to check for ovarian cancer) before I convinced him to order the blood test for Lyme. At least he was gracious enough when it came back positive to say, "The patient is always right." 

You know your own body best. If you think you might have Lyme, insist on being tested. 

Now that we live in the Pine Barrens with a WMA outside our door, my wife and I have our doctor routinely test us for Lyme, babeosis (sp?) and other tick borne diseases. So far, so good. I don't know why a doctor would be reluctant to order the tests. 

WHITING, NJ: A few years ago, I read that you should use a lint roller on your clothes and body, the Ticks will stick to them.

Showering won't remove deer ticks that are embedded. I had some on me for 3 or 4 days before I realized that they were on me. Also, deer ticks like to embed in the more embarrassing parts of your body. Deer ticks can be as small as than the period at the end of this sentence. And to make it even more frustrating to find them, they look amazingly like freckles. 

BERNARDSVILLE, NJ: From Morris Township website which is consistent with other reports: "In New Jersey, 40-45% of adult black-legged ticks are infected with Lyme disease spirochetes, while nymphs are infected at about one-half that rate. Larvae are rarely infected. The lone star tick and the American dog tick also require an extended period of attachment for transmission to occur, but research on this and infection rates are not well defined."
Source - http://www.morristwp.com/dept_health_ticks.asp

BERNARDSVILLE, NJ: I deal with ticks in hiking, mountain biking, and birding. I like what's already been posted. Really good ideas and info on how to deal with the little suckers.

I will add this: To me it makes little sense to protect myself in the woods and then get into my car and drive home. The lint roller suggestion is used to avoid this. If possible work with a partner to lint roller yourself before getting in the car. When hiking in heavily tick infested areas I have extra clothes in the car and plastic bags with Permethrin in them. I change into clean clothes and the hiking gear goes into the bag. Any tick surviving the ride home gets a half hour dryer ride on hot, if not the full wash and dry treatment.

I usually don't like using chemicals on me or my clothes but will use Permethrin at times. Usually, I just stay out of the tick's prime habitat of high grass and low shrubbery.

Lastly, if you find an embedded tick don't panic!!! Most likely the tick does not carry Lyme or other tick borne disease. Most ticks are not carriers.  Check the bite location for rash and don't write off lack of energy as a day of the blahs. The biggest hassle of getting bitten is that you now have to pay attention to how you feel. Just do it!!! It could make a difference.

Coincidentally, the day after I began preparing this piece, a related article appeared in the Home News Tribune. You can find it here. It’s worth reading.

I will add one last, brief story. About 25 years ago, shortly after we had moved to New Jersey, friends came out to visit with their then 3- or 4-yearold-son. We spent a nice summer afternoon in the backyard, as did their son. He NEVER strayed near the woods and only stayed on the nicely manicured grass and the patio. After dinner, I noticed something black on his neck near the hairline. It was a tick, the larger of the two kinds we find here. It was greatly swollen, having already gorged itself with blood. We removed it easily. Fortunately, he had no repercussions from the bite. This only shows that you MUST be vigilant and always check yourself, each other and your children. 

Is there reason to be concerned? YES! Is there reason to avoid the woods, hiking trails or even your garden? NO…not if you’re aware and informed!

Take these emails to heart and stay safe. This doesn’t mean avoiding the outdoors…just being smart about it. 

If anyone has anything helpful to add, PLEASE write it in the ADD A COMMENT section, below. Also, please pass this page along to anyone you know who likes just being out-of-doors, or enjoys such activities as hiking, mountain biking, looking for wildflowers, watching or photographing birds, dragonflies or butterflies. You may be doing that person a great favor.

Thanks,
Rich

This column originaly appeared in Richard Wolfert's Nature Notes.