It seems as though the mild winter that we experienced in New England has finally delivered us a parting gift. I’m not talking about a freak Spring snowstorm…I’m talking about ticks! Over the past week the leadership at the MIT outing club has beaten the issues of ticks and Lyme disease prevention to death after we received reports from our membership of overwhelming numbers of ticks in the White Mountains of New Hampshire. This made me feel like I should convey our conclusions to the KayakDave readership considering that a number of our recommended trips launch from Cape Cod. The woods, marshes, and beaches of the Cape and Islands are an endemic area for various tick-borne illnesses. I believe that there’s the possibility that this will be a tick season for the ages.
Two things that I took out of the recent MITOC discussion: 1) People take these illnesses seriously and 2) with some people concern may be tipping toward fear and paranoia. I agree that tick borne illnesses should be taken seriously but I don’t believe that they should be feared to the point that they keep you inside. What I do believe is that people traveling in the back country or in endemic areas should be able to recognize the signs and symptoms of tick-borne illness and be armed with the appropriate strategies to prevent infection.
It’s a well-known fact that various tick species carry disease. What’s not often appreciated is that Lyme disease is just one of a handful equally debilitating ailments that ticks may carry. In New England, these include: Lyme disease, Babesiosis, and Anaplasmosis. Let’s hit on the hallmarks of each of these:
Lyme disease is the most common tick-borne illness in the US. In New England, the bacteria responsible for Lyme are carried by the deer tick. Often, the first sign of Lyme disease usually occurs about a week after the bite when a red, bulls-eye-shaped rash appears around the bite site. Flu-like symptoms including muscle aches, fatigue, low fever, chills, loss of appetite, nausea, vomiting, headache, and abdominal pain follow the rash and last for weeks to months. If Lyme is left untreated then the disease may progress to include facial paralysis (Bell’s Palsy), cardiovascular involvement, nervous system disorders, and/or arthritis.
Babesiosis is a tick-borne illness that is especially prevalent in Southeastern MA, Cape Cod and the Island of Nantucket. The disease is caused by a parasite that is carried by the deer tick and invades the human red blood cell. Babesiosis presents with symptoms of weakness, fatigue, and loss of appetite followed by fever and muscle aches. It’s important to note that a rash is rare with pure Babesiosis infection but co-infection with Lyme is disease is possible given that the carrier ticks are the same for both diseases.
Anaplasmosis is caused by infection of white blood cells by bacteria carried by deer ticks and black-legged ticks in New England. The onset of symptoms is typically within 1-3 weeks of infection and includes fever, headache, fatigue, and muscle aches. If left untreated, anaplasmosis can progress to a more serious disease involving the kidneys, nervous system, lungs and blood.
Prevention and Treatment:
The signs and symptoms of tick-borne illness may seem scary but these diseases are highly preventable and carry a very good prognosis if treatment is initiated in the early stage. The best prevention strategy involves keeping ticks off of you, performing a thorough tick-check for those that get past your best defences, and reporting signs and symptoms of tick-borne illness to your doctor.
The incidence of tick-borne illnesse peaks in the summer and early autum months. This just happens to coincide with the peak season for outdoor activities and is not to say that you couldn’t become infected at other times of the year. In general, ticks like to hide out in tall grass (like beach or marsh grass) or in low-lying brush. There they wait for a mammal to brush on by to pick them up for a tasty snack. At this point they search for a warm area and borough in. Inoculation takes on the order of 1-3 days once the tick embeds itself and starts to feast. The best way to prevent getting a tick on you is by wearing a combination of long-sleeve clothing and tick repellant. Always consider wearing long pants and gaiters when traveling in tick country. Tick repellants with DEET work well to keep ticks off. Sawyer Brand tick repellant has received rave reviews from the outdoor enthusiasts at MITOC.
Unfortunately, the species of ticks that most often carry disease are very small and easy to miss at first glance. For instance, deer tick nymphs are about the size of a pencil tip and adults are only about the size of a sesame seed. Therefore, it’s imperative that you do a thorough tick check anytime you venture into tick territory. Remember that ticks like to embed themselves in warm, moist places so take time to check your arm pits, thighs, groin, and scalp. If you find a tick then carefully remove it making sure to get both the body and head. It’s often best to perform these checks periodically during the day and very thoroughly before tucking in at night when traveling in the backcountry. It’s also helpful to check each other’s hard-to-see places so tap into those primordial, chimp-like grooming instincts!
Finally, if you see that tell-tale bulls-eye rash or experience any of the flu-like symptoms shortly after your outdoor excursion then you should see your doctor to get checked out. They may decide to run a simple blood test to confirm or rule out any tick-borne illness. Early treatment offers very good prognosis as it’s much easier to nip these diseases in the butt early on. For someone who has spent a weekend pulling ticks off of themselves and is concerned that they may have missed one then it’s certainly acceptable to see your doctor and ask for the test. Most insurance companies will not cover a tick-borne panel but the $250 is certainly worth the peace of mind or the early diagnosis.
Our so-far fantastic New England spring may be the start of a tick season for the ages but I hope that the great weather may be enjoyed more fully now that you’re armed with the knowledge to recognize and prevent tick-borne illness!