Watch closely: More than one tick-borne disease in Upper Midwest

There are three types of ticks in our area, and two are responsible for disease. Only females in the nymph and adult stage can pass the infection. The most common tick is the wood or dog tick (top photo); luckily, diseases transmitted by this tick are very rare in our area. Ticks carrying disease are the deer (second photo), black-legged, or bear tick, and a new one of concern called the lone star tick (third photo). The lone star tick normally is present in the south but is slowly migrating to our area. If you see this tick, you should report it to public health.

Which infectious diseases are transmitted by the black-legged tick?

Only immature ticks (nymphs) and adult females can pass on infectious agents that cause disease. In our area, Lyme disease is the most commonly found tick-borne disease. Anaplasmosis, babesiosis, and a newly-described form of ehrlichiosis can also result from a bite by a black-legged tick. These disease can occur alone or with Lyme disease and are associated with more severe symptoms than Lyme disease. The lone star tick also carries a form of ehrlichiosis but has similar symptoms.

How long does the tick have to be attached to infect a person?

It depends on the infective agent. For Lyme, the tick needs to be at least partially engorged with blood and/or attached for at least 36 hours. However, the bacterium causing anaplasmosis has been shown to be transferred within 24 hours and possibly before the blood meal. Since there is a high rate of co-infections in our area, it is best to come in to see your provider and, of course, bring the tick with you for identification.

What if I didn’t see the tick that caused a bite?

• Your health care provider will determine if the bite is typical of a tick bite.
• You may be asked to watch the area for expanding redness (greater than size of a quarter).
• If you see your provider within 72 hours and live in a highly endemic deer tick area, you may be treated with a one-day dose of antibiotic treatment 

When do I have to see a health care provider?

• If you are sure it is a wood tick, you do not need to see a health care provider.
• If you are not sure of the identification, bring the tick to your clinic visit in a sealed zip-close bag or on a piece of tape for proper identification. 
• If you have identified a bull’s-eye rash around a tick bite and/or have symptoms, including fever, muscle aches, fatigue or headache, you need to come in to be assessed and may require treatment with antibiotics.                               

After a tick bite, how long do I need to observe the area for a rash or onset of symptoms?

It is suggested that you observe the area of a tick bite for 30 days. If you see a rash expanding larger than a quarter or have the symptoms previously described within that time, you need to see a health care provider.

How do I remove the tick?

• Use a tweezers to grip the tick as close to the skin as possible. Avoid squeezing the contents of tick.
• Pull upward slowly. The black-legged tick has a cement-like substance in the saliva.
• If mouth parts are left, leave them there. They will be expelled on their own.
• Wash your hands and the bite area with soap and water.

How do I avoid getting tick bites and associated infections?

• Avoid wooded and bushy areas with high grass. Stay in center of cleared trails.
• Use effective tick repellents such as DEET, and apply according to the label instructions. Avoid direct skin applications, if possible. Permethrin also is effective against ticks and lasts for days to weeks, but should only be applied to clothes and not directly to the skin.
• Wear long sleeves, long pants and long socks to keep ticks on the outside of clothing. Light clothing will help you spot ticks. 
• Tuck shirts into pants and pants into shoes or socks to keep ticks on the outside of clothing. If outdoors for an extended period of time, tape pant legs where pants and socks meet so that ticks cannot crawl under clothes.
• Perform daily tick checks after being outdoors in areas where ticks are present. Remove any ticks from clothing, gear and pets before going inside. Inspect all parts of the body carefully, especially the armpits, scalp, neckline and groin. Take a shower or bath as soon as possible to wash off any ticks that are still crawling on you. Tumble clothes in a dryer on high heat for an hour to kill remaining ticks.