PHOTO: An image of a female lone star tick
BY LANDON WOODROOF
For many residents of Brentwood and surrounding cities, warmer weather means more time spent outdoors.
This unfortunately means more time being exposed to disease-carrying ticks.
In recent weeks there have been media reports from different parts of the country stating this summer could up to be a particularly active one for ticks and for tick-borne illnesses such as lyme disease. There have also been some posts on local social media where residents have mentioned finding ticks in their backyards.
While experts consulted by the Brentwood Home Page said it was too early to tell precisely how acute tick season would be in Tennessee this year, they did stress the importance of being aware and prepared for the health risks posed by ticks.
Dr. William Schaffner is an infectious disease specialist at Vanderbilt University. He said that there are three steps everyone should take when it comes to ticks.
The first step should be taken before engaging in outdoor activities.
“The key elements are really very simple,” he said. “Remember what you’re going to do and get some tick-repellent at your local supermarket or drug store and…make sure that as you look at the can it actually states that it is designed to repel ticks. It will contain a compound called DEET and that is the active compound. It’s safe and it’s very effective. You ought to use it and make sure your kids use it when they go out.”
The CDC states that repellant with at least 20 percent DEET content is good.
The second step is for after those activities are done.
“Number two when you come back from having your fun out there or your yard work, do a tick check,” he Schaffner said. “Look on your own body particularly in all the crevices, in your groin, under your arms, below your belt.” He suggested that you have someone else check your scalp, your back and other places that you cannot easily inspect.
The third step need only be taken if you actually find a tick.
“Number three, if you find a tick, remove it gently and steadily,” Schaffner said. “The approved method is to take some tissue like kleenex, fold it, grasp the body of the tick firmly, but not too hard, and then a steady firm withdrawal. Don’t jerk it because you may pull the body off the tick and leave the head intact. Most of the time that tick will come out and disengage very easily.”
Dr. Steve Murphree is a biology professor at Belmont University. He has a special interest in entomology and recommends using tweezers for tick removal.
“Get a hold of them as close as where they’re embedded to your skin as you can, turn them up at a 90-degree angle, and slowly pull until they come out,” he said.
Murphree said that if you pinch too forcefully and leave parts of the tick still embedded in your skin that your immune system will rid your body of the tick bits, but that it could take one or two months.
“You want to get the whole tick out in one piece if you can,” he said.
The things you should absolutely avoid when it comes to removing ticks are some of the old wives’ tale removal remedies. “All these things you hear about like a smoldering match or fingernail polish…none of those things really work to get the tick out,” he said.
Although it is impossible to say for certain how severe tick season will be in Tennessee this year, experts did point to a number of factors that could be considered predictive.
“Certainly there are things that would indicate this could be a good year [for ticks],” Dr. Stephen Wright, a microbiologist at Middle Tennessee State University, said. “It’s been mild, it’s been wet, however we have to wait until a little bit later in the year until we get too far into it. If it really heats up and gets dry and hot, the tick numbers might fall.”
Murphree said even if tick season is heavy, the Middle Tennessee area does have some good natural control measures, one of which you might see strolling across your lawn late at night.
“One of the few good things about opossums is that they do like to eat ticks,” he said.
TICK-BORNE ILLNESSES OF TENNESSEEE
The possible ill effects to Tennesseans’ health from a busy tick season are numerous. Ticks carry a number of infectious diseases, several of which are severe.
In Tennessee, the most common tick-borne illness is one with a bit of a misleading name.
“People tend to think that Rocky Mountain spotted fever occurs only in Rocky Mountain states,” Wright said. “We have the Appalachians but that’s pretty far form the Rocky Mountains. Turns out it was first reported in Montana so it was designated Rocky Mountain spotted fever, but the majority of cases occur in the “Rocky Mountain” states of Tennessee, North Carolina, Georgia has a few cases.”
Tennessee is second in the nation in terms of number of diagnosed cases of Rocky Mountain spotted fever per year.
A recent news release from the Tennessee Department of Health spotlighted the danger of the illness, stating that there were 581 cases of it in Tennessee in 2016. Furthermore, the release said that Rocky Mountain spotted fever has caused 16 deaths between 2004 and 2014.
The disease can be easy to catch early on due to the distinctive spotted rash it leaves on the infected.
“The thing that helps is the rash is so definitive,” Wright said. “This one is kind of unique because the rash so often appears on the palms of the hands and soles of the feet. We don’t usually see rashes on those parts of the body.”
Ehrlichiosis is another bacterial infection passed by ticks in Tennessee. Symptoms of it include fever and muscle aches. Antibiotic treatment is sufficient for ehrlichiosis and Rocky Mountain spotted fever if caught early.
Lyme disease is not so much of a threat in Tennessee, although cases do occur.
“Documented lyme disease acquired in the state of Tennessee is unusual,” Schaffner said. “Lyme disease is not present uniformly across the country.” The most heavily impacted areas areas are in the northeast and the upper midwest.
The CDC lists 20 suspected incidents of the disease in Tennessee in 2015. That compares with 1,302 probable cases that year in Massachusetts, 668 in Connecticut and 631 in Minnesota.
Schaffner said that the majority of suspected lyme cases in Tennessee tend to be in East, rather than Middle or West Tennessee.
The reason for the relative paucity of lyme disease in Tennessee has to do with the types of ticks we have here in the state. Tennessee has mostly dog ticks and lone star ticks, Murphree said. According to the CDC, a main carrier of Rocky Mountain spotted fever is the dog tick. Lone star ticks are largely responsible for ehrlichiosis.
Lyme disease, however, is caused predominantly by blacklegged ticks, also known as deer ticks. Those are fairly uncommon in Tennessee.
“I got to tell you we’ve looked, and I’m gonna say about 10,000 ticks we’ve collected, and so far I have yet to find my first true lyme disease tick,” Wright said.
One tick-borne illness found in Tennessee shares certain characteristics with lyme disease. It is called southern tick-associated rash illness, or STARI.
According to the CDC, STARI can cause a circular rash similar to those found on many people infected with lyme disease. It is generally, however, less severe and has not been known to cause chronic illness in people like lyme disease has.
Another, lesser-known illness believed to be linked to lone star ticks presents itself in a rather unusual and unpleasant way.
Some people after having been bitten by a lone star tick become severely allergic to red meat. The condition is called alpha-gal syndrome and, according to a report from Vanderbilt University in 2016, the number of cases have increased dramatically in Tennessee in the recent past.
“Just five years ago, the number of patients diagnosed and treated for alpha-gal was minimal,” a 2016 article on the Vanderbilt University Medical Center site states. “Allergists at [Vanderbilt’s Asthma, Sinus and Allergy Program] are currently treating about 172 patients at the ASAP Clinic, a 7.5 percent increase from earlier this year.”
According to the article, some humans contract the allergy after being exposed to a certain molecule that ticks pick up from feeding on deer. The allergic reaction usually occurs three to six hours after consuming red meat and results in anaphylaxis
“Hives, swelling of the lips, eyes, tongue, throat, respiratory issues, vomiting, diarrhea, increased heart rate and low blood pressure are common reactions to alpha-gal,” the VUMC article says.
Murphree said he knows three people that have been diagnosed with alpha-gal. He thinks more than any other illness, it might have the ability to make some people become more tick-aware.
“If you want to scare a good ole boy deer hunter tell him they’re gonna get a tick bite and no longer eat red meat,” he said. “Not much will scare those fellows but that will.”
WHAT TO DO IF BITTEN
If you are bitten by a tick, it is important to find it and remove it as soon as possible.
Removing the tick quickly may actually prevent illness from being transmitted. According to the CDC, for instance, lyme disease is usually not passed along until a tick has been attached to the skin for 36 to 48 hours. Schaffner said similarly that Rocky Mountain spotted fever and ehrlichiosis take some to be transmitted.
Murphree suggests that if you do pull an embedded tick off of you, it is good practice to put it in a zip-close bag along with a moistened piece of cotton and put the bag in the freezer. By doing this, a doctor can test the tick to see if it is disease-carrying. If you do develop any signs of possible tick-related illness, it is important to visit a doctor and let them know.
Despite the health hazards associated with ticks, Murphree hopes that the insects will not stop people from taking advantage of the spring and summer weather.
“People should just get out and enjoy the outdoors and take these precautions,” he said.
TICKS AND PETS
Pets are a main tick transmitter, spreading the parasites to their owners or owner’s living space. As part of the reporting for this story, the Home Page spoke to Dr. Tom Bradford of Bradford Animal Hospital in Brentwood.
He said he had seen an increase in the number of ticks showing up on pets in recent weeks.
“There’s been an uptick,” he said with a smile, to the laughter and groans of his staff.
Like the other people consulted for this story, though, he said it was difficult to make a blanket statement about whether this year would be worse than previous ones. “I think the jury’s out on it right now,” he said. “I think in a few weeks we’ll know. They’re just getting started good right now.”
Dogs and cats can get many of the same tick-related diseases as humans, Bradford explained. Those include Rocky Mountain spotted fever, ehrlichiosis and lyme disease.
There is one disease that occurs in Brentwood and some surrounding areas, though, that only infects cats. Called cytauxzoonosis, the illness is transmitted to cats from ticks who have fed on bobcats.
“It’s a really nasty disease,” Bradford said. “Nolensville’s a real hot spot for it.”
Cats with cytauxzoonosis have high fevers, often refuse to eat and may appear jaundiced.
“I would say every year we see a handful of cases maybe,” Bradford said, usually between five and ten.
The advice that Bradford gives to pet-owners eager to keep their animals free from tick-borne illnesses is similar to the advice for humans.
“Brentwood is a nice lush environment, and we have a lot of green space,” Bradford said. “Lawns are a little less tick-infested than pastures or woods. Just be sure to put on the tick and flea control agent of your choice and be sure and check your pets when you come back from those kinds of areas. If you can get it off of them the sooner the better.”
A complete list of steps to protect yourself from ticks can be found on the CDC website.