Tick Talk: Local nurse talks about tick season in Vermont
This story is produced and presented by The University of Vermont Medical Center
Summertime in Vermont and the Northeast brings green pastures, tall grass, warm weather, and ticks. Most tick-borne diseases are transmitted early in summer months like May, June, and July, but the season really lasts all the way into fall. Early in the season is the most important time to take extra precautions to prevent those tick bites.
Read or listen to the interview below about tick-borne diseases and how to prevent them with Michelle Bell, registered nurse at the University of Vermont Medical Center.
Can you tell us a little bit about ticks, what they are and why do they like us?
Michelle Bell: Ticks lurk around waiting for a host to feed on. They need to feed in order to mature into an adult state. Most of that happens during the warmer months, May, June, and July, but they are around all year long. They are looking for a host any time the temperature is above freezing.
What are the most common places for us to find ticks?
Michelle Bell: They live in grassy, brushy, or wooded areas and they also can live on pets. So it's important to check your pets. Ticks can jump on your pet and bring them inside the home and crawl around wherever they please. Especially if your pet is treated, the tick might jump on your pet and then if they hop on your bed or something like that at nighttime, the tick will jump right off and can attach to you.
What do we do if we find out that we have a tick? What would it look like? How would we know if we even have one on our body or on our pet?
Michelle Bell: Initially, they're really small. They can be one or two millimeters, the size of a poppy seed. As they engorge with blood they get bigger so you do need to check regularly. Check your pets every day, check yourself every day, if you're outdoors in your yard, in the woods, you want to check in the warm areas like under your armpits, behind the ears, in and around the hair, around the waist, in your navel, behind the knees, between your toes. You look for an insect, a little black or dark brown spot that doesn't come off easily.
Once I find this little thing that I think might be a tick, what do I do?
Michelle Bell: If you're checking yourself regularly, that will alert you as to how long it might have been there. So you don't need to immediately run to the doctor's, but you can remove it yourself or if you need help you could have a friend or a relative remove it. What you don't want to do is try to pull it with your fingers, because they can be infected with bacteria and they store it in their mid-gut, so if you pull it with your fingers there's a possibility that you might squeeze the bacteria out into the skin. So it's really important to use tweezers. Fine-tipped tweezers are the best, and what you want to do is clean the tweezers with alcohol, then grab the tick as close as possible to the skin. Then you want to pull it straight out with continuous force, pulling it straight up and out. You don't want to twist it or turn it, you want to remove it as completely as possible, and you don't want any parts to squeeze out. But if for any reason there's any part of the tick left behind, your skin will extrude it. Sort of like when you have a splinter in your skin and it just extrudes it on its own.
What about some alternative methods for tick removal besides using tweezers, some of the other things we've heard about.
Michelle Bell: Well, some people believe that you can paint the tick with nail polish or petroleum jelly or use heat to make the tick detach from your skin, but the important thing to remember here is that you need to remove the tick as quickly as possible. The tick needs to be removed before you have a chance of contracting any bacterial infection.
And how about any disposal of that tick once you actually get it removed?
Michelle Bell: You should put the tick in alcohol and place it in a sealed bag or container and wrap it tightly in tape. Another method would be to just flush it down the toilet.
After that, what should I do with the area of the skin that's left behind after the tick has been successfully removed?
Michelle Bell: You should disinfect that area so you want to wash it with soap and water or you can clean it with alcohol and apply an anti-bacterial topical.
We hear a lot about Lyme disease being associated with ticks, particularly in the New England area. Are there particular signs of Lyme disease once we've had a tick bite, whether we've known it or not, that we should look for?
Michelle Bell: Within the first three days you might have a rash. The rash is red and patchy or it can look like a bull's eye where you have a central reddened area surrounded by a clear area, and then a more expansive reddened area. And it could range from reddish to purple. This can occur anywhere between three and 33 days.
You can also develop flu-like symptoms like headache, aches and pains, muscle aches, joint pain, fevers and chills. Because of this, after having a tick bite it's important to pay attention to what's going on with your body for several weeks after.
Also, if you've been checking regularly for ticks, and you do find that you have one attached, you'd more or less know how long it's been attached. So normally you do receive treatment if it's been attached for more than 36 hours. The treatment would involve going to your primary care physician where they would prescribe you an antibiotic.
And is the antibiotic something that we take for a short duration or is it something that you have to take for a lifetime? How does that work?
Michelle Bell: It all depends on how long you've had the tick attached. If you have found the tick and it's been attached for more than 36 hours, and you consult with your physician, they can prescribe you prophylactic medication within 72 hours.
However, sometimes you don't get the rash, sometimes you don't know that you have contracted Lyme disease or any other tick-borne disease. If you have any flu-like symptoms in the weeks after having a tick bite you might go to your physician and explain to them that you had one and these are your current symptoms and they will determine what type of treatment you need at that time. But there's several different types, and you can have residual effects from having Lyme disease that can go on for a long period of time.
That being said, are there any tips or tricks that you might recommend of ways that we can avoid ticks in the first place?
Michelle Bell: If you're planning to be outdoors, one thing that you can do is you can treat your clothing or you can treat your gear if you're going camping. They do have on the market Permethrin 0.5% spray that you can spray your garments or gear with. You would hang them up to dry and this would provide protection through several washings.
It's really important when you're out taking a hike or walking in wooded areas that you walk in the center of the trails because you need to keep in mind that the ticks are lurking around on brush and leaves and grass, just waiting for a host and as you pass by and brush the leaves or the foliage they just latch onto you.
You want to make sure you're wearing light colors because that makes it easier to see the ticks if they’re on your clothing. You also want to wear long sleeves, long pants, and tuck your pants into your socks or your boots. And when you return home you want to check your clothing for ticks. It's recommended by the CDC that you take a shower within two hours of returning home, and use that opportunity to check your skin and use mirrors to look everywhere and make sure that you haven't been bitten by a tick and that none are latched on.
You also want to remove your clothing and put it in the dryer, on high, for ten minutes. If the clothes are damp or wet, you want to dry them first and then stick them in the dryer for ten more minutes on high. If they need to be washed, you want to use hot water because the other temperatures will not kill the ticks.
Other things that you can do include using a tick repellent such as DEET up to 30%, Picaridin, IR3535 (the chemical that's found in the Skin So Soft), oil of lemon eucalyptus, and PMD. When choosing a tick repellent, you want to make sure not to use repellents on babies younger than two months old, and you shouldn’t use the oil of lemon eucalyptus or the PMD on children under three years old. If you have any questions on what insect repellents to use on your children, you should consult with their pediatrician.
There's also a helpful search tool on the EPA website that, depending on how long you plan to be out and whether you want to protect yourself against ticks or mosquitoes, or ticks and mosquitoes, you can enter the information into the tool and it will recommend what you should be using.
What are some other ways that we can prevent ticks from getting on our bodies when we're outside? Are there things that we can do in our environment to help?
Michelle Bell: There's landscaping techniques that you could use in your own yard such as removing leaf litter and clearing tall grasses and brush around the homes and the edges of the lawn. You could place a three foot wide barrier of wood chips or gravel between lawns and wooded areas to restrict tick migration into the recreational areas.
You should mow your lawn frequently and keep it short. You can stock your wood neatly and in a dry area. Also, keep your playground equipment and decks and patios away from yard edges and trees. And discourage unwelcome animals such as deer and raccoons and stray dogs from entering your yard by using fencing. You should also remove old furniture and mattresses and trash from the yard that might give ticks a place to hide.
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