[at-l] When a tick bites in the wilderness.

[stephensadams at hotmail.com (Steve Adams)]

Chris,

Reference your post, dated 5-21-03, asking, “... how do you check yourself 
for the bulls-eye rash of a deer tick on your back and head?”

I don’t know.  It would be helpful to have someone, in front of whom you 
don’t mind being naked, check you - - all over.  This could of course become 
an object of some trail humor, earning you an interesting trail name.

I have included alterations excerpted from an article appearing in the New 
York Times, [NYTimes.com (nytdirect@nytimes.com)], dated 5-20-03, “Fighting 
Lyme Disease, With a Pinhead as the Enemy,” by Jane E. Brody.  I altered the 
article, primarily through re-arranging and selective deletions, to narrow 
it’s focus to the interests of Appalachian Trail Hikers.

**********

Behavioral measures intended to prevent Lyme disease are incomplete and 
impractical.  Studies have NOT demonstrated that wearing protective clothing 
makes a difference in the risk of developing Lyme disease.  Many people take 
chances that no Lyme-carrying ticks will bite them or that antibiotics will 
cure them.

The Centers for Disease Control and Prevention reports on only a minority of 
Lyme disease cases, which are at a record high:  nearly 18,000 people a year 
are infected.
"Short of a vaccine, I don't see how we will control this disease.”  Says 
one expert.

Lyme-infected deer ticks, usually no bigger than the head of a pin, now 
reign unchecked from Maryland to Massachusetts.

Small mammals like the white-footed mouse are hosts for immature ticks, and 
deer are hosts and dispersal systems for adult ticks.  The deer population 
is exploding, with nothing more than a short hunting season to curb their 
numbers.

The main carrier of Lyme disease is the nymph of a tick (Ixodes scapularis 
or Ixodes pacificus) that is no bigger than the head of a pin and able to 
crawl unnoticed through the tiniest of openings, establish a resting site on 
the skin and start feeding on blood without creating the slightest sensation 
to warn of its presence.

The Lyme disease bacterium, a spirochete called Borrelia burgdorferi, lives 
in the midgut of the tick and when a feeding tick spits out the water from 
its blood meal, it can transfer the bacterium into its host.

Not until the immature tick has fed for a while and become engorged with 
blood is it likely to be noticed, even by those who do daily body checks.  
Seventy percent of people who contract Lyme disease don't recall being 
bitten.

What you should wear to reduce the chances that a tick will find its way 
onto your skin:  long socks (preferably white); long light-colored pants, 
with pant legs tucked into the socks and taped shut; long-sleeved shirt, a 
hat and closed shoes.  The light-colored clothing gives you a better chance 
of detecting a crawling tick.

You can also use a tick repellent containing about 20 percent to 30 percent 
DEET on clothing and exposed skin, but not the face.  Though most products 
suggest re-application every two to three hours, a new product, Cutter Tick 
Defense, contains two additional agents that the company says enhance the 
degree and length of effectiveness of DEET as a tick repellent for up to six 
hours.  (The product is also said to repel mosquitoes and biting flies.)

While DEET can be used safely on children occasionally — say, when taking a 
hike in the woods — it is not wise to use it daily.

Another option:  Spray clothing with Permethrin, which kills ticks upon 
contact.  This must never be used on bare skin, and it is not advisable for 
routine use on children's clothing.

After returning from an area likely to be infested with ticks, an immediate 
shower and scrubbing with a washcloth is recommended.  Clothing should be 
washed in hot water after being removed at the door.

When hiking or camping, stay on wide, well-trodden paths in mature woods.

Protect and check pets that wander outdoors.  Consider giving furry dogs a 
close shave from spring through fall so that you can more easily detect 
crawling ticks.  Monthly applications of tick treatments for dogs during the 
entire tick season can help as well.

Do daily body checks, looking closely at hairy areas and junctures between 
clothing and skin (sock and underwear lines, for example).  Removing 
attached ticks within a day can prevent infection.  Using fine-pointed 
tweezers, grasp the tick gently nearest the skin and pull it straight out; 
do not twist.  Wash your hands and clean the site with disinfectant.

**********

I have heard the “bulls-eye rash,” with which you specifically expressed 
concern, is no longer a reliable indicator.  Any shape rash can result from 
a Lyme-infected deer tick’s bite.  Rashes can result from non-Lyme-infected 
bites, and from non-deer-tick bites.

I live in Virginia, south of the region listed in this article.  At the 
height of the season, I will pick more than 100 ticks off my dog and more 
than 100 additional ticks off myself during each of our daily walks.  I seem 
to have developed an allergy to tick bites.  I recognize when one of the 
little devils is feeding - - it hurts - - and pick him/her off.  My hope is, 
I pick ticks off well before the 24 hour clock has expired.  Or, before the 
tick spits out the water from its meal into me.  (It does nag at me that the 
unpleasant sensation I perceive may result from the ticks water injection 
into me.)

My method is, every morning, before taking a shower, I inspect myself, using 
the bathroom mirror.  It is not unusual to discover ticks which weren’t 
previously detected.  I reiterate the advice I first gave, it would be 
helpful to have someone, in front of whom you don’t mind being naked, check 
you - - all over.  It will probably be less embarrassing than being caught 
"admiring" yourself with a mirror.

Steve

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