Ticked Off

With all the notable people and animals who call South-Central Pennsylvania home, the most unwelcome are deer ticks, dog ticks, and the occasional Rocky Mountain wood tick.

Of the 14 different tick-borne diseases listed on the Center for Disease Control’s website, four are of prime concern for this part of the state. (The other diseases come from ticks not found in our neck of the woods.)

Tick-Borne Diseases
For Pennsylvania, the most common tick-borne disease is Lyme disease, with approximately 7,400 cases per year.

Ehrlichiosis resembles Lyme disease, has a low incidence of occurrence, and it is treated using the same approach.

Southern Tick-associated Rash Illness (STARI) presents similar symptoms to Lyme disease, although the cause and treatment are unknown.

Rocky Mountain Spotted Fever (RMSF) has a low incidence but is on the watch list because of its potential fatally outcome.

“Ticks can be easy to miss. An adult tick is the size of a sesame seed or smaller. In its nymph stage, it’s the size of a poppyseed,” Robert Glorioso, M.D., Spring Garden Family Practice, said. “Half the time, a patient doesn’t recall a tick bite.”

Symptoms
Tick-borne diseases present flu-like symptoms: fever, body aches, and fatigue.

For patients affected with Lyme disease, 80 percent get a red bulls-eye rash 2 inches or larger in diameter. Lyme disease’s incubation is between three and 30 days. STARI patients get a similar bulls-eye rash.

For RMSF patients, typical symptoms include fever, headache, abdominal pain, vomiting, muscle pain, and (maybe) a distinct rash resembling measles. The rash may develop after a few days, or it may never develop. RMSF could be fatal if not treated within a few days after onset of symptoms.

Treatment
“If you remove a tick within 36 hours, there’s no chance of disease,” Glorioso said. “If a deer tick attached itself more than 36 hours, one dose of doxycycline should prevent Lyme disease.”

As with any disease, it’s best to treat early.

“For RMSF, doxycycline is the first line of treatment for adults and children of all ages and is most effective if started before the fifth day of symptoms,” Glorioso said. “The illness is severe, with patients ending up in the ER.”

According to Glorioso, Lyme disease generally responds to 14 to 21 days of antibiotics. Doxycycline is administered to patients ages 8 and older. Amoxicillin is safe for patients under age 8. If Lyme disease is caught later, IV antibiotics may be prescribed.

Less common complications for Lyme disease have been known to develop months later, such as arthritis, Bell’s palsy, or heart block conduction.

“There is a controversy over chronic Lyme disease. The CDC does not recognize it, although a small percentage of patients have problems persisting longer than six months,” Glorioso said. “Some doctors give repeated courses of antibiotics to patients [who have long-term Lyme disease symptoms]. This is not effective, other than a placebo,” Glorioso said. “I recommend giving the initial treatment, then waiting for symptoms to resolve over time.”

Healthcare practitioners who do recognize chronic Lyme disease use an alternative approach, unlike those who stand by traditional medical directions. Their approach is scientific but follows a different standard from the medical community.

They use a multifaceted plan of attack to boost the immune system, sometimes integrating homeopathic treatments as part of their respective treatments. Lyme disease patients are evaluated on a case-by-case basis, with recommended remedies tailored for each Lyme disease sufferer. Visit www.ilads.org/lyme/treatment-guidelines.php for more information.

Prevention
“Do a thorough tick check after being in the woods. Use a mirror,” Glorioso emphasized. “At that point, they’re just crawling around on you.”

Ticks thrive in thick undergrowth, leaves, woodpiles, and where rodents nest. They also tend to stay out of the sun and gravitate toward humid areas. You’ll want to especially check your ears.

Ample clothing coverage helps deter ticks. Wear long sleeves, long pants, and tuck pants into socks. Use insect repellents containing 20 to 30 percent DEET on skin or clothing. Spray permethrin on clothing only.

In the 1990s, a Lyme vaccine was available on the market. The demand for it was low, as were sales, and some of the more objectionable side effects spurned lawsuits. Although it was hailed as fairly effective, it was voluntarily taken off the market.

In 2016, there is currently nothing available and no forecast of a manufacturer willing to risk producing a new line of Lyme vaccines.

Homeopathic Tick Repellents
The anti-chemical movement has given increasing popularity to natural alternatives. Natural elements claiming to be most distasteful to ticks are cedarwood, tea tree, citronella, lavender, peppermint, and lemongrass.

Though herbs and essential oils are thought to be successful tick deterrents, the medical community cannot formally evaluate their effectiveness.

Companies with natural products make these scents available in body sprays, lotions, deodorants, soaps, shampoos, and lip balms. You can also find glass bottles of essential oils for dabbing behind ears. BW

Editor’s note: Visit Gina Napoli’s website at www.soapotherapy.com and check out her line of natural products.