Ticks : What you need to know

Ticks : What you need to know

September 01, 2020

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Ticks are a worry as they can transmit various diseases. These can be a frustrating simply because the initial bite can often be missed only to be followed by a number of concerning symptoms- either immediately or delayed.


The most common tick borne illness in the US is Lyme disease. It is endemic in various parts of the country. Ticks are the carrier for the bacteria that causes Lyme disease. They transmit it to humans through a bite and the bacteria can proceed to cause a rash, and impact the heart, central nervous system, the joints, as well as leading to significant fatigue. These symptoms can occur immediately or delayed- even by months. 


The range of other tick borne illnesses include:  babesiosis, ehrlichiosis, Rocky Mountain Spotted Fever, anaplasmosis, Southern Tick-Associated Rash Illness, Tick-Borne Relapsing Fever, Tularemia, Colorado tick fever, and Q fever. 


Tick borne illnesses are considered to be on the rise. However in practice I also suspect that they are increasingly recognized in recent years given the nonspecific nature of the delayed symptoms. I routinely find ticks on patients when performing annual skin cancer screenings. They do not always have evidence of rashes or symptoms however there is an ongoing source of exposure in gardeners and others that enjoy outdoor recreation. 


When returning indoors, especially if you live in an area endemic to Lyme disease, it is important to perform head to toe tick checks. Start in the scalp and feel through the hair for any ticks. Feel with your fingers across your neck, face, back, chest, abdomen, arms and legs. Feel through the folds of the arms and knees while paying special attention to the lower back and back of neck. Ticks can be tiny- as small as a poppy seed. Feeling for them is better than just looking for them. 


Look for unexplained rashes. They do not always have symptoms. Some people expect them to feel like a mosquito bite when in fact many have no itching associated. If you have a persistent scab or bump that doesn’t seem to heal or you keep picking at it, it may be worth a check with your dermatologist to make sure a tick isn’t stuck! 


Although it is true that identifying the tick can be helpful as specific ticks are more likely to transmit specific diseases. However, we are learning more about co-infections and possible exposures to multiple ticks given outdoor activities that make this more likely. I strongly recommend focusing on the symptoms that you experience to guide treatment. 


It is common to find that patients either did not have a rash or do not recall a rash. The rash is more a sign of an exposure. However the rash can disappear with or without treatment. If no treatment is undertaken, the secondary and tertiary Lyme symptoms can occur where it impacts other organs in the body. 


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