Ticks and Tick Diseases

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     There has been a dramatic increase in tick-related diseases over the last ten years. Doctors don’t know if the diseases are actually increasing or whether we are more aware of them now and therefore diagnose them more often. Before 1976, no one diagnosed Lyme disease because we didn’t know about it. Rocky Mountain Spotted Fever was known because it can cause a severe illness in children but other common tick-related diseases were rarely talked about and almost never diagnosed. An old saying in medicine is that a doctor doesn’t make a diagnosis of a disease that he doesn’t think of. Three of the common tick diseases are carried by deer ticks, so the increase in the deer population could also be causing increased disease. People are living in and hiking through rural areas more often, which also gives them more exposure.

     Most of the diseases that are transmitted by tick bite are mild and don’t cause much more than fever. In fact, if someone has a fever between spring and fall, especially a fever that lasts longer than a normal viral fever (See “Fever” articles) or a fever with no other symptoms, they may very well have a tick-related disease.  Lyme disease can cause a round, red rash – commonly on the head, neck, arms, and legs – that gradually expands. It can also cause joint pain, headaches and weakness of the nerves and muscles in the face with eyelid or mouth droop. Rocky Mountain Spotted Fever can cause meningitis, shock and death.

     Making the diagnosis of tick-caused disease is difficult because the blood tests used to diagnose these diseases are complex, hard to interpret and often don’t turn positive until weeks after the tick bite. It is also hard to distinguish between a new infection and a previous infection.

     Recommendations to prevent infections transmitted by tick bite are often impractical. It is difficult to keep children in long sleeves and long pants tucked into the socks. The most important thing parents can do is to find and remove the ticks early. It is thought that a tick needs to be attached to the skin for longer than 72 hours in order to transmit disease. A tick that is not engorged with blood and is walking on the child is not a risk. When a child is outside, use DEET-containing insect repellant products. They can be 10 – 30% concentration and should be used in any child over 2 months of age. After being outside, children should have a shower or bath to wash off the DEET and then be closely inspected by the parent. If uncertain whether an insect is a tick or not, bring it to the child’s caregiver for identification. If the tick is firmly attached to the child’s skin, have your caregiver remove it if you are uncomfortable doing so. The latest home remedy is to soak a cotton ball with liquid soap, swab the tick with it a few times and then leave the cotton ball on the tick for awhile. I don't know if it actually works. At one time, there was a vaccine for Lyme disease, but it is no longer available.

     Treatments used for the diseases caused by tick-bite are antibiotics. Amoxicillin is commonly used for Lyme and Doxycycline is effective for most of the other diseases. Doxycycline is a tetracycline-type antibiotic and doctors worry that it can cause staining of teeth, but when it is used in the right dose, it has not been found to stain permanent teeth and, for diseases like Rocky Mountain Spotted fever, it could be life-saving.