Summer Tick-borne Disease Prevention Tips

Each year, hundreds of Americans become ill due to tick-borne illness.  The Centers for Disease Control and Prevention estimate that ticks cause nearly 17,000 illnesses in the United States annually.  In 2003, 183 cases of tick-borne illnesses were reported to the Oklahoma State Department of Health. These illnesses were due to three tick-borne diseases: Rocky Mountain spotted fever, ehrlichiosis, and tularemia. Many other Oklahomans likely were treated for symptoms of illness following a tick bite, but did not have testing done to specifically diagnose their disease.

As Oklahomans prepare for summer outdoor activities, the Oklahoma State Department of Health offers the following important information on these tick-borne diseases.

Rocky Mountain Spotted Fever (RMSF)

ß RMSF is the most prevalent tick-borne illness in Oklahoma.
ß RMSF is transmitted by the American dog tick. The American dog tick is brown in color and approximately one-eighth inch in size. The female tick is lighter than the male tick and has a light-colored bib from below its head and halfway down its back.

ß Ticks usually need to be attached 4 to 6 hours to transmit disease-causing bacteria.
ß RMSF has a higher disease rate in children.
ß  Symptoms may occur within 1 to 14 days after a tick bite, begin suddenly and include fever, headache (often severe), muscle aches, a rash of small red  bumps or blotches on the arms or legs (usually starting at the site of the tick bite and extending toward the trunk), and vomiting, abdominal pain and/or diarrhea.

ß Recommended treatment for RMSF is with doxycycline (tetracycline antibiotic).
ß If appropriate treatment is delayed or not given, the case fatality rate is up to 25 percent.
ß In 2002 in Oklahoma, there were 99 cases of RMSF reported, and in 2003, there were 138 cases.

Ehrlichiosis

ß Ehrlichiosis is considered an "emerging infectious disease".
ß It is probably under diagnosed because physicians do not routinely test for this tick-borne illness.
ß Ehrlichiosis is transmitted by the Lone Star tick. This tick is dark brown in color and approximately one-eighth inch in size. The female Lone Star tick is dark brown with a distinct white spot on its back. The male is smaller with isolated white spots on its back.

ß Symptoms of this disease are similar to RMSF except there is no rash. The disease may also cause a dangerous decrease in white blood cells and platelets (blood clotting cells).

ß Treatment is with doxycycline.
ß Ehrlichiosis can be fatal if not treated, or misdiagnosed.
ß In 2002 in Oklahoma, there were 13 cases of ehrlichiosis reported, and in 2003, there were 36 cases.

Tularemia

ß Tularemia is caused by bacteria.
ß Exposure can occur from a variety of sources, but an infected tick bite is the most common route in Oklahoma.
ß Symptoms following an infected tick bite often include high fever, pain and swelling of lymph node in area of tick bite.  Lymph node may ulcerate and drain. 

ß Treatment for tularemia is with antibiotics.
ß In 2002 in Oklahoma, there were 10 cases of tularemia reported, and in 2003, there were 9 cases.

When participating in outdoor activities this summer, the Oklahoma State Department of Health recommends following these simple personal tick prevention precautions:

  • Wear light-colored clothing to make ticks easier to see.
  • Wear long-sleeved shirts and long pants tucked into socks to deprive ticks of attachment sites.
  • Wear closed-toe shoes, not sandals.
  • Hikers and bikers should stay in the center of trails to avoid grass and brush.
  • Check for ticks AT LEAST once per day, particularly along waistbands, in the armpits and groin area.
  • Use a tick repellent with DEET on skin and clothing according to directions.
  • Use a tick repellent with permethrin ON CLOTHING ONLY and according to directions.

If you do happen to find a tick attached to you, remove as follows:

      • Use tweezers, or fingers wrapped in tissue, to grasp the tick as close to the surface of the skin as possible. Try not to twist or jerk the tick as you pull.
      • Use gentle, steady pressure to pull the tick from the skin.
      • DO NOT squeeze the body of the tick at any time while it is attached - you can release disease-causing organisms into the bite wound.
      • DO NOT squeeze the body of the tick to kill it after it has been removed - you can force disease-causing organisms out of the tick and onto/into your skin.
      • DO NOT use matches, gasoline or nail polish remover as methods of tick removal.
      • Note the date of tick removal on your calendar.
      • Wash clothing and inspect your body for additional ticks - don't forget the back and the scalp!

If you experience high fever, headache, tiredness, muscle aches, or a rash after a tick bite, or if you have not noticed a tick bite but have been outdoors and have these symptoms, contact your physician immediately. For more information on tick-borne diseases, see the OSDH Communicable Disease Division Fact Sheets on the Web at: www.health.state.ok.us/program/cdd