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Public Health Column for the Times-News

Check every crevice; note every bite

Published: Wednesday, June 3, 2015

Health Department columnist

Most childhood memories are delightful and pleasing, but occasionally you remember an incident from your childhood that scars you for life. I'm thinking of the time I felt something inside my belly button.

I must have been around 5 years old, but the event remains fresh to this day. My mother was talking on the phone in our kitchen when my finger felt a small object in my belly button. Though I tried to peer into the crevice, the angle made it hard to see what was attached. I needed my mom!

High-pitched screams interspersed with heavy sobs and flowing tears sent her running to my aid. The look on her face when she examined what I was pointing to told me all I needed to know. It was bad.

I've never found another tick in my belly button since that day, but I've not stopped checking. It's that time of year when we all need to take the extra minutes for more than a quick scan to make sure our bodies are not providing food for these blood-sucking arthropods — especially the American dog tick, the lone star tick and the blacklegged tick.

In North Carolina, the American dog tick is known to transmit the bacterium Rickettsia, which causes Rocky Mountain spotted fever (RMSF), the most commonly reported tick-borne illness. This tick is found statewide and comes out as early as March and can persist through September.

It's a fairly large tick that moves slowly and is easy to spot when you see it crawling on your clothing or skin. Its bite is painless, so you may be unaware that you've been bitten. It will often hide in your clothing or gear and crawl out later to bite you overnight or the next day.

The lone star tick is the main cause of tick bites in North Carolina and is the primary vector (carrier) for ehrlichiosis in the United States. This tick moves quickly and is an aggressive biter. Since the bite is generally painful or itches, you can detect it quickly. In addition to ehrlichiosis, lone star ticks are known to cause other human disease, including tularemia and STARI (Southern tick-associated rash illness), and are being studied as a possible carrier for RMSF and their connection to meat allergies.

Last and maybe the least in size but not impact is the blacklegged tick, the vector for Lyme disease in North Carolina. Yes, Lyme disease does occur in North Carolina.

Though the blacklegged tick is commonly referred to as the “deer tick” in other states, that name is misleading here. Blacklegged ticks are only one of many species of ticks that feed on deer. Blacklegged ticks are also associated with anaplasmosis and babesiosis, two other potentially serious human diseases.

The adults are active on warmer days during the winter. They are slow-moving and prefer large mammals as hosts, such as deer. During the summer months, the nymphs are active and most likely to transmit disease. Their small size and generally painless bite makes prevention and detection especially important.

The good news is that many of these infections can be prevented by using basic personal control measures and prompt detection after being outside:

  • Wear long pants and long-sleeved shirts. Tuck your pant legs into your socks and tuck shirt-tails into pants.
  • Use a tick repellent for an additional layer of protection. Pre-treat clothing with insecticidal products but carefully follow the directions.
  • Check your clothing and gear, especially along seams and pockets.
  • Look for ticks before and after showering. Pay particular attention to your scalp, back and groin. Use a mirror to check areas that you cannot easily see. While you're checking, don't forget to include your children and any pets.

While it is possible to be bitten by a tick and not know it, most tick bites can be detected. If you are bitten, quick removal of the tick can reduce the chance of infection.

If you find a tick attached to your body, carefully remove the tick by grasping it with fine-tipped tweezers as close as possible to your skin. Apply a steady, gentle pull until it releases. Note the date you removed the tick.

It's also a good idea to save the tick for identification in case you become ill later. To save the tick, place it in a sealable container or plastic bag and put it in your freezer. Write the date of the bite on the bag. If you develop symptoms, this could be important information to share with your doctor.

Although ticks are a natural part of our environment, the bacteria and viruses they carry do cause serious infections. The majority of diagnoses occur from June through September. From 2010 through 2014, an annual average of 427 cases of Rocky Mountain spotted fever, 88 cases of ehrlichiosis and 127 cases of Lyme disease were reported, according to the N.C. Department of Health and Human Services.

According to the Centers for Disease Control and Prevention, many tick-borne diseases can have similar signs and symptoms. If you have been bitten by a tick and develop symptoms within a few weeks, contact your health care provider.

The most common symptoms are:

  • Fever/chills: With all tick-borne diseases, patients can experience 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. The severity and time of onset of these symptoms can depend on the disease and the patient's personal tolerance level.
  • Rash: Lyme disease, Southern tick-associated rash illness (STARI), Rocky Mountain spotted fever (RMSF), ehrlichiosis and tularemia can result in distinctive rashes.

A daily scan of body will be your best defense, especially if you spend time outside. Remember to check all your orifices and crevices and don't forget your belly button.

More information about ticks and tick-borne diseases can be found at http://epi.publichealth.nc.gov/cd/diseases/ticks.html and the health department's website, www.hendersoncountync.org/health, under the Communicable Disease link.

Kimberly Horton is the communications manager at the Henderson County Department of Public Health. She can be reached at khorton@hendersoncountync.org.

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