It’s Tick Time

The weather is warm, the grass is growing and it’s the time of year when the ticks appear.  Tick-borne disease has increased significantly over the last decade.  Some ticks can carry pathogens that can cause human disease.  We are all familiar with Lyme disease but there are many others.  Rocky Mountain Spotted Fever, Anaplasmosis, Babesiosis, Erlichiosis, Rickettsiosis, STARI, Tularemia, and tick-borne relapsing fever are emerging and making people, especially children, sick.  Some of these are relatively new tick-borne diseases and we expect to identify more.

When should you worry about tick-borne disease?  Please remember that not all ticks will carry pathogens that can cause human disease. – actually most tick bites do not result in transmission of disease.  For example, only about 2-3% of all persons bitten by Ixodes scapularis ticks in endemic areas will develop Lyme disease.  There can be secondary infections and allergic reactions at the site of a tick bite.  The allergic reaction is caused by a reaction to proteins in the tick’s saliva.  Sometimes a local skin infection will need to be treated at your local Pediatrics office with an antibiotic, topical or oral.  The allergic reactions can be treated with an antihistamine, again topical or oral.

Here are some signs and symptoms of tick-borne illness that should make you think about seeing your doctor in Riverhead, NY:

The most common symptoms of tick-related illnesses are:

Fever/chills: All tick-borne diseases can cause fever at varying degrees and time of onset.

Aches and pains: Tick-borne disease symptoms include headache, fatigue, and muscle aches. With Lyme disease you may also experience joint pain.

Rash: Lyme disease, Southern Tick-associated Rash Illness (STARI), Rocky Mountain spotted fever (RMSF), Ehrlichiosis, and Tularemia can result in distinctive rashes:

  • In Lyme disease, the rash may appear within 3-30 days, typically before the onset of fever. The Lyme disease rash is the first sign of infection and is usually a circular rash called Erythema Migrans or EM. This rash occurs in approximately 70-80% of infected persons and is usually at the site of a tick bite. It may be warm, but is not usually painful. Some patients develop additional EM lesions in other areas of the body several days later.
  • The rash of (STARI) is nearly identical to that of Lyme disease, with a red, expanding "bull’s-eye" lesion that develops around the site of a lone star tick bite. Unlike Lyme disease, STARI has not been linked to any joint pains or neurologic symptoms.
  • The rash seen with Rocky Mountain Spotted Fever (RMSF) varies greatly from person to person in appearance, location, and time of onset. About 10% of people with RMSF never develop a rash. Most often, the rash begins 2-5 days after the onset of fever as small, flat, pink, non-itchy spots on the wrists, forearms, and ankles and spreads to the trunk. It sometimes involves the palms and soles. The red or purple, spotted rash of RMSF is usually not seen until the sixth day or later after onset of symptoms and occurs in 35-60% of patients with the infection.
  • In the most common form of Tularemia, a skin ulcer appears at the site where the organism entered the body. The ulcer is accompanied by swelling of lymph glands, usually in the armpit or groin.
  • In about 30% of patients (and up to 60% of children), Ehrlichiosis can cause a rash. The appearance of the rash can vary widely.

Tick-borne diseases can result in mild symptoms treatable at home to severe infections requiring hospitalization. Although easily treated with antibiotics, these diseases can be difficult for physicians to diagnose. However, early recognition and treatment of the infection decreases the risk of serious complications.

Prevention is key!!!

Try and avoid contact with ticks.  Avoid wooded and bushy areas with high grass and leaf litter.  Walk in the center of trails. We want you and your children to avoid ticks altogether.

Insect repellants are effective and safe.  Use repellents that contain 20% DEET (N, N-diethyl-m-toluamide) on the exposed skin for protection that lasts up to several hours. You can also use products that contain Permethrin on clothing. You can treat clothing and outdoor gear, such as boots, pants, socks and tents. It remains protective through several washings. Pre-treated clothing is available and remains protective for up to 70 washings.

Other repellents registered by the Environmental Protection Agency (EPA) may be found at

Bathe or shower as soon as possible after coming indoors to wash off and more easily find ticks.  Tick checks are a must.  Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and especially in their hair.

Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and backpacks. Putting clothes in a dryer on high heat for an hour can kill remaining ticks.

It’s important to be able to be active and enjoy the beautiful outdoors we have on Long Island.  Just remember to be “tick smart”.  Prevention is the best medicine.


Content source: Centers for Disease Control and Prevention

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