Because ticks are cold-blooded, they are a big problem during the warm weather, and right now there are even more ticks than usual because the mild winter left so many alive. 

Ticks need to stay moist, so they do well around shrubs, tall grass, bushes, forested areas, stone walls, and wood piles. They dry out in the sun, so you don’t have to worry about them at the beach or on sidewalks or ball fields – unless you must chase a ball into the wooded area around the field. If you’re weeding or mowing, it’s best to keep long pants tucked into socks and wear shirts with long sleeves. If there’s any chance that your child has been playing where there are ticks, you need to examine every square inch. For kids who are too old to let mom or dad examine them, a mirror and a flashlight come in handy. There is only one way to remove a tick that is attached. An instrument-like tweezer surrounds the mouth parts as close to the skin as possible. Pull straight up until the tick is removed. Don’t worry if a piece of the mouth parts remains. Digging for them is unnecessary and may cause an infection. People talk about rubbing the ticks with soap or alcohol or burning the tick. Just pull it out. Anything that allows the tick to back out on its own risks allowing the tick to infect you, and obviously squeezing the tick is also a bad idea. 

Basically, ticks are fussy, and it can take them a while to position themselves and take their meal. A tick that is around for less than three days is very unlikely to cause a problem with most of the illnesses we worry about. More on that later, but the point is that we don’t give antibiotics as prevention unless you don’t know how long the tick was in or it’s more than two days since the last time you were in an area where you could pick up a tick. Ticks cement themselves in, and after the meal is finished, they squirt out chemicals that let them withdraw their mouthparts. That’s when they also send infectious diseases into your body. If the tick is swollen, you probably need a short course of antibiotics. This treatment is called prophylaxis. That means we’re preventing disease. 

So what diseases are we talking about? There are many. One that is very rare is tick toxicosis (in English, it’s a funny name for a serious problem). Some ticks have chemicals that are so toxic that they can cause paralysis. Fortunately, if you find the tick and remove it early enough, the problem resolves. Many kinds of ticks can cause this disorder. This is not strictly speaking an infectious disease but rather a kind of poisoning. 

A recently described infectious disease caused by a tick is called Powassan virus disease. Fortunately, very rarely, it has been seen in upstate New York. This year there have been two cases. One was in Maine and one in Pennsylvania. The danger is that, unlike other tick-borne illnesses, the virus is transmitted almost instantaneously with the attachment of the tick. The virus causes a brain disease that is often fatal. People in New England and the Great Lakes Region should be aware of the danger of contact with ticks. 

There is a tick called the lone star tick. It has a white dot on its back and was described in Texas, the Lone Star State. Unfortunately, this tick has made its way from Texas and Oklahoma up the Eastern United States to New England. It can transfer a chemical that stimulates an allergy to red meat! It sounds ridiculous, but it’s not funny to the people who have suddenly developed this problem. 

Another tick disease is called Rocky Mountain Spotted Fever, but it’s mostly seen in the Southeastern United States. It shows up in Connecticut very rarely, usually in people who traveled to the endemic area and came here. It’s caused by an organism called rickettsia. Because it’s rare, the rash and fever are often not recognized as being from this disease. It can be treated with antibiotics, but if the disease is not recognized, it can be fatal. 

The most common diseases from ticks are ehrlichiosis, not seen here much, anaplasmosis, which is also less common in the Danbury area, babesiosis, which is a problem for the elderly and immune-compromised, and finally Lyme Disease.

Lyme Disease should get a lot of attention because it’s very common. If you remove the tick on time, you are safe. That’s why people who spend time outdoors should do tick checks every day. Unfortunately, the nymph stage of the black-footed (deer) tick can be very small and already infectious. They will walk up your body until they find a hiding place like your groin or underarm or behind your ear. The famous bull’s-eye rash can get to be 6 inches across before the bacteria spread throughout your body, but you may never see the rash when it’s in your hair or behind you. Other symptoms include fever, fatigue, joint swelling, neck stiffness, and headache. There are others. For example, facial palsy, which is a loss of movement on one side of the face, is an important one. Antibiotics can treat Lyme Disease, but symptoms may persist after treatment. There is a test for Lyme Disease, but once it’s positive, it may stay positive for months or years. That means making decisions about treatment can be very difficult if symptoms don’t completely disappear. Lyme Disease can lead to a post-infectious state called chronic fatigue syndrome, which can last for years. There is a new vaccine that should be available soon. 

You can imagine that doctors hate ticks and tick-borne diseases. So many of these problems can be avoided by personal surveillance. You won’t know you have a tick unless you look!

Robert B. Golenbock, MD, is currently retired. He has cared for children in the Danbury area for 43 years, including at the Center for Pediatric Medicine. The CPM is located at 107 Newtown Rd, #1D, Danbury, CT, 06810. For more information, please call (203) 790-0822 or visit https://centerforpediatricmedct.com.