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The Princeton Longevity Center Medical News

Enjoy the Summer- But Don't Let it Get Under Your Skin

By David A Fein, MD

Summer is coming.  The weather is getting warmer, the flowers are growing and the days are getting longer.  After all those cold and dark winter months, its time to enjoy being outdoors.   But danger lurks in the lawns, meadows and bushes.  This is also the time of year when the ticks come out to feed, making outdoor activities in most of the northeast a high risk for Lyme Disease and other tick-borne illnesses.  Fortunately, a few simple precautions can dramatically decrease the risk of a potentially serious infection for you and your family.

Lyme Disease is the most common tick-borne disease in the North America.   Although it has been reported in 49 of the 50 U.S. states, it is most prevalent in the northeast and mid-atlantic states.  Lyme Disease is caused by a bacteria, Borrelia burgdorferii, that on the East Coast is mainly carried by the Deer Tick.  While this tick does feed on deer, it is a common misconception that keeping deer out of an area will have a major effect on the tick population or the risk of getting Lyme Disease.  With a good understanding of the life cycle of the Deer Tick and ways to reduce the percentage of ticks in your area that are carriers of the bacteria, you can dramatically reduce the risk of Lyme for your family.

The Deer Tick feeds once in each of the 3 stages of its two year lifecycle.  Ticks usually lay their eggs in the early Spring.  When these hatch, the larval ticks feed for the first time on small rodents, including the white-footed field mouse.  The mouse is an excellent reservoir for the Borrelia bacteria.  Mice can carry this bacteria in their blood stream for extended periods without becoming seriously ill.  So, most of the Deer Ticks that pick up the Lyme bacteria do so while feeding on mice during their larval stage.

The ticks feed again as nymphs and for the last time as adults.  The peak feeding season for the nymphs is often in the Fall months.  Nymphal ticks will usually feed on just about any mammal or bird, although rodents are the preferred choice.  Feeding on deer is more common with adult ticks.  But, the deer are simply innocent victims, just like humans.  Deer do not effectively carry Borrelia in their bloodstream so they are not generally the source of infection for the ticks.  Additionally, since the ticks usually feed on deer in the adult stage and then do not feed again, ticks that have fed on a deer are unlikely to look for humans as another target.

Several studies have shown that eliminating deer from an area is not effective either at reducing the tick population or the percentage of ticks that carry Lyme.  This makes sense given that there are numerous other animals present for the ticks to feed on and that the infection is acquired from other animals long before the ticks are interested in biting a deer. Conversely, the absence of deer from your area is not a predictor of either the tick population or the risk of acquiring Lyme Disease.
In some areas of New Jersey the Deer Tick population has been found to exceed 3 ticks per square yard.  That works out to more than 10,000 ticks per acre.  In some areas, as many as 90% of the ticks are carrying the Lyme bacteria.  And, Lyme Disease is not the only infection that can be spread by these ticks.  Babesios, Ehrlichiosis and some viral infections have also been found in Deer Ticks.

So what can you do to try to limit your risk?

There are three basic strategies for reducing your Lyme Disease risk:

1. Minimize your exposure to tick bites.

2. Limit the tick population in your area

2. Decrease the percentage of ticks that are carrying Lyme

Reducing your exposure to ticks is likely to be the easiest and most effective precaution

  • Wear a tick repellant on your clothing and footwear that contains DEET.  The higher the level of DEET, the more effective it will be.  We do NOT recommend applying DEET to bare skin, especially for children. It may be absorbed through the skin and can be toxic.

  • Wear long pants whenever the weather permits and either tuck your pants into your footwear or socks or put a rubberband around the cuffs.  Ticks usually are found a few inches above ground level and then try to climb upwards.  Wearing light-colored clothing and keeping them away from skin as they climb will make it easier to see them before they attach.  

  • You should also immediately put your clothes in a dryer on high heat for 10 minutes when you come inside.  This will kill any ticks that may be hiding there

  • Do a careful tick checks whenever you come in from being in an area of potential exposure. First take a shower to wash off any ticks that are not attached.  Then look for ticks that remain.  They particularly like constricted areas, such as skin folds and under elastic clothing.  Be sure to check behind the knees, under the arms, on the back, etc.

    The nymph ticks are very small and you have to examine every square inch of skin to be sure you have found any attached ticks.  The nymphs may be not much bigger than the period at the end of this sentence.  The adults are easier to see.

  • Removing ticks promptly is the single most effective step in preventing infection.  It generally requires about 24 hours from the time it starts feeding for the bacteria in the tick’s gut to migrate to the salivary glands and then be injected into the wound.  Finding and properly removing ticks in the first hours of feeding dramatically reduces the odds of becoming sick.

    If you find a tick, it should be removed with very fine tipped tweezers as close to the skin as possible. Squeezing the body of the tick can cause immediate infection as it injects the bacteria-laden contents of the gut into the wound.  Removing them with your fingertips is not recommended.  You should also avoid anything that can cause the tick to constrict.  Burning ticks with a match, dousing them with alcohol or other chemicals, or otherwise irritating the tick before it is out of the skin should be avoided 

    When removing adult ticks it is common for some of the mouth parts to remain in the skin.  These parts are barbed like a fishhook and often break off when the rest of the tick is pulled off.  If there appears to be a black spot in the skin at the site of the bite it can be removed with a fine needle as if it was a splinter.


    Deer Ticks are generally found in brush at about 6-18 inches above the ground.  Keeping your yard clear of unnecessary overgrowth can help to reduce the tick population.  Ticks rapidly dehydrate and die with exposure to direct sunlight.  So, keeping your grass short is also helpful. 

  • Guinea hens are particularly voracious tick eaters.  If your yard is conducive to keeping guinea hens, this will reduce the tick population.  Unfortunately, many people have found that the guinea hens quickly become victims of owls and hawks

  • Removing potential habitats for small rodents is also helpful in reducing not only the tick population but also the percentage of ticks that may be infected.  Eliminate woodpiles and other areas that can serve as nesting locations for mice.  Fencing that keeps small animals out of your yard may also help to reduce the number of ticks.

  • Permethrin is an insecticide that is very effective at killing ticks, particularly in the larval stage.   It is considered safe for human exposure.  This can be sprayed outdoors to reduce tick populations.

  • The most effective use of Permethrin is intended to reduce the exposure of ticks to the Lyme bacteria.  Sold at many garden centers, Damminix Tick Tubes are cardboard tubes filled with cotton balls impregnated with Permethrin.  Mice use the cotton as nesting material, coating their skin with the insecticide.  This effectively keeps the ticks from feeding on the mice and picking up the Lyme bacteria.  While it is unlikely to reduce the overall tick population, if a large enough area is consistently treated with this product, you may be able to substantially decrease the percentage of ticks in your area that carry Lyme.  Effective treatment usually means putting tubes out in the Spring and Fall over an area of at least several acres.  Getting your neighbors involved in a consistent program can effectively protect everyone, especially the kids who are playing in the neighborhood.

    Damminx Tick Tubes can also be ordered online at www.ticktubes.com
     


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