It is spring and the flowers, black flies and ticks are blooming in Vienna! Flowers and black flies rarely cause significant health problems, but deer ticks can. They can transmit Lyme disease by transmitting the Lyme bacteria when they attach to their victim. They can also transmit the rarer diseases called ehrlichiosis and babesiosis. Vienna used to be on the edge of the deer tick/Lyme disease infestation area which was the southern New England states and southern Maine. But with recent warm winters, the deer tick population has increased substantially so that it is now much more common to see tick bites here. And Lyme disease increases will probably be soon follow.
Deer ticks are smaller than the common dog tick and lack the white "racing stripes" down the back of the latter(see Maine CDC ID card) the size of apple seeds; but the nymphs, more common this time of year, are as small as poppy seeds, that is until they attach and fill with blood to 10 times that size over several days. The longer a tick stays on a person, the more likely they are to contract Lyme disease if the tick is a carrier. If they are on less than 24 hours, disease rarely follows; most patients with the disease have had a tick on for over a week.
The disease itself usually causes a circular (usualy over 3 inches in diameter),non-tender rash, called erythema chronicum migrans, which looks like a red "ringworm" rash around a bite site. Fever (60%), aching body and joints (90+%). headache (65%) also commonly accompany the disease which follows the bite 1-2 weeks later. If not treated, later complications involving heart, nerves, brain, and joints can occur weeks and months later.
So how can you avoid these troubles without moving to Northern Canada? First the most important thing to do is use DEET containing bug dope to discourage their climbing on you. Secondly, you should check yourself and your children for ticks every day in the summer when they have been outside. This can be hard in difficult places to see, like the back side of your knees or trunk. I thought I'd grown a big skin tag behind my knee for several days until I looked with a mirror and saw it was a tick.
If you find a tick,and it's not swollen,and you are pretty sure it hasn't been on for more than a couple days, just remove it and your chances of Lyme are very small. Slow steady pressure to pull it off usually works. Don't try to burn it off; and be careful with tweezers (I use my leatherman) to gently tug for the minute or two it takes to get the tick to release. Leaving the head in the skin still leaves the risk of infection.
If it is engorged (swollen) and may have been on for several days, then taking a single dose of doxycycline, a prescription you can call and ask your doctor for, will reduce your chances of getting Lyme if the tick was infected from 3% to 0.6%.
If you develop a rash ring around the bite site or a place where you weren't aware you'd been bitten, then you should be given a course of antibiotics for 2-3 weeks, doxycycline/tetracycline for most, amoxicillin or cefuroxime for pregnant women and children. The downside of these alternative antibiotics is that they don't also cover the rare co-infections with ehrlichiosis and babesiosis. You will probably need to see a medical clinician to do that, but ask for an urgent appointment. The rare late complications are also treated with antibiotics after being proven due to Lyme by blood test immune titers.
So use bug dope. Check yourself and the kids. Pull ticks off before they get engorged. And get antibiotics if you develop the characteristic rash or other symptoms.
Dan Onion
Vienna Health Officer