Tick Talk Published Aug. 26, 2021 By Tech. Sgt. Jeffrey Grossi 910th Airlift Wing Public Affairs YOUNGSTOWN AIR RESERVE STATION, Ohio -- Summer may be on its last legs, but tick season is still kicking in Ohio and much of the northeastern United States. Although ticks in their younger, nymphal stage are at their peak in May and June, adult ticks are in their prime during the fall and early spring. With recent winters being relatively mild compared to previous years and with high numbers of quality hosts, ticks are remaining active for longer periods throughout the year, resulting in increased rates of tick-borne illnesses. What this means for the Reserve Citizen Airmen of YARS is a demand for vigilance when training in grassy or woodland areas and when spending quality time with family and friends in the great outdoors. In order to defend oneself against this nearly invisible enemy, some barely the size of a poppy seed, one must know thy enemy. Lt. Col. Karl Haagsma, the chief entomologist for the 757th Airlift Squadron here, allows us to get inside the mind of these eight-legged assassins. “Ticks are not insects; rather, they are arachnids,” said Haagsma. “They are in the same family at mites. They have the head, thorax and abdomen fused into one body region, unlike insects that have three distinct body regions. Larval ticks have three pairs of legs and are quite small. This contrasts their adult form which has four sets of legs and can be quite robust, especially after completing a blood meal. Population size is highly dependent on environmental conditions and quantity of hosts. Their populations tend to ebb and flow from year-to-year and ¬can be found in pretty much any temperate or tropical region.” On the surface, they may be seen as a base nuisance; but the truth is, they can play a far more insidious role when looking for a meal. “Ticks vector (transmit) disease by serving as reservoirs for bacterium,” said Haagsma. “The bacterium are incorporated in their saliva, which is injected into the bitten host.” Some diseases transmitted by ticks are anaplasmosis, babesiosis, ehrlichiosis and the rare but serious Powassan disease. There are many other diseases for which ticks can be a vector, but none are so widely known as Lyme disease. According to the Centers for Disease Control and Prevention’s recent surveillance data, approximately 30,000 cases of Lyme disease are reported each year; however, recent estimates using resources outside the data of state health department records estimate approximately 476,000 case per year with nearly all cases spawning from the northeast. Most cases are reported in June and July with February being the least active month. In order to prevent getting bit, the CDC has a few tips before you go outdoors and after you come indoors. First, know where to expect ticks. Anywhere heavily wooded or grassy can be an environment for the pest. Activities like hiking, hunting, gardening and walking the family dog are common recorded activities for picking up the pest. Second, wear long-sleeved shirts and pants that are treated with 0.5% permethrin. Permethrin is an insect repellent that individuals can use to pre-treat their clothing and gear. Where run of the mill DEET sprays may wear off in a few hours, permethrin is rated to last approximately six weeks or six washings. It repels ticks and insects but can also kill them, adding extra protection. Reserve Citizen Airmen at the 910th most likely have already used permethrin treated clothing without knowing it as some uniforms come pretreated. The tag on the inner left breast of the blouse lists whether or not it has been treated. Most stores with a hiking or camping section usually keep this item on the shelves or it can be purchased online. Even if individuals employ the first two methods, the CDC recommends individuals check themselves, each other, their gear and their pets for ticks after coming inside from potentially infested areas. Be sure to check: under the arms, in and around the ears, behind the knees, in and around the hair, between the legs, around the waist and even inside the belly button. Individuals should also shower within two hours after coming indoors. Ticks, once making contact with a host, often roam the body before chowing down. Though a shower may be minimally effective if a tick has embedded in the skin, it can knock loose those that are still roaming the body. In the event a tick is found embedded, remain calm. Depending on the geographical area, as many as 50% to less than 1% of ticks carry disease, according to Johns Hopkins Medicine. To avoid contraction of a disease there are specific ways ticks should be removed. “As it often takes a significant amount of time for the disease to be effectively transmitted from vector to host, ticks should be removed as soon as practicable,”¬¬¬¬ said Haagsma. Meaning, don’t try to claw them out with only fingernails in the field on first sight. Instead, find a way to apply steady, even pressure to the tick and pull directly upward without twisting. Haagsma continued, “The best way is to use forceps to grasp the stylets (piercing mouthpart) in skin, and gently pull, taking care not to leave stylets in the skin. Also, there are devices you can buy specifically for tick removal. Those seem to work pretty well.” Once a tick is removed you should wrap it in toilet paper and flush it down a toilet to ensure it is no longer in the household or office area. It is not advised to crush a tick between the fingertips or simply flick it away indoors as you could infect yourself or provide the pest a chance to infect others. Another option is to contain the tick using a plastic bag or small container to ensure it will not escape or get lost, then send it to a facility to be tested for the various diseases they carry. “Usually ticks can be sent into the state public health department. But that depends on the state and the level of priority,” said Haagsma. The diseases transferred by ticks can vary by location. “Rocky Mountain spotted fever is more endemic to the western regions of the U.S. and Lyme disease more so here,” said Maj. Matthew McRoberts, a pediatrician assigned to the 910th Medical Squadron. “There are other illnesses that are not exactly vector-borne that could be the result of ticks too: localized infections, cellulitis abscess and some other stuff. But Ohio is definitely within the area where Lyme (disease) is considered endemic.” Where most people may be familiar with the term ‘pandemic’ after living through 2020, ‘endemic’ refers to a disease or a condition found regularly among a particular population or geographic area. Although a variety of ticks can act as a vector of various diseases, there is one tick in particular responsible for transmitting Lyme disease to human beings. “There is a very specific tick–the deer tick¬–which transmits the spirochete bacteria that causes Lyme disease,” said McRoberts. “That bacteria usually comes from deer. So from my understanding the tick feeds on deer, then feeds on us and we get passed on the disease because they fed on the two species. So you aren’t going to get it from every tick bite and you aren’t going to get it from every tick. It’ll be only from ticks with the ability to feed on both species.” In the event a tick is found or a bite wound is suspected to be originating from a tick, be sure to monitor it for an extended period of time. Those exposed can take photos of the bite on their phone using a reference item that won’t change in size, like a coin, or outline the mark in pen in order to accurately monitor any changes it undertakes. “The typical signs do not show up immediately after the tick bite. It usually shows up after 30 days. The classic history for most pediatrics is what we call the erythema migrans or EM rash, which is a target lesion that looks like a bullseye. As it spreads it clears in the middle which gives you a white ringing around the bite. The first rash occurs near where a tick bit you. But as the disease spreads, multiple round lesions can appear in other places.” It is important to note not everyone is fortunate enough to receive such a telltale sign of Lyme disease. Approximately 15% of individuals who have contracted the disease receive no physical manifestation of the EM rash. Other symptoms include nonspecific fatigue, body aches and headaches. Commenting further on symptoms, McRoberts said, “It’s going to feel like you have a viral illness, but you won’t have a fever, runny nose or congestion. You’re just going to feel run down and tired.” If left untreated symptoms can evolve past the feeling of being under the weather. Later stages of Lyme disease can grow quite dangerous and affect the neurological system and even the heart. “Those people can often have more severe symptoms like joint pain, facial palsy where a side of their face will go numb, heart effects and severe spinal type headaches and meningitis,” McRoberts warned. “So it can get pretty severe. It just depends on how far it’s disseminated throughout the body. Once it enters the bloodstream, that’s when it can get into other bodily systems. If you have any question that you may have a target lesion, it’s better to get evaluated early on rather than later.” The treatment for Lyme disease and other bacterially-transmitted infections was officially discovered in 1928–antibiotics–and has been widely used ever since. “Our first line is amoxicillin or doxycycline, depending on the patient,” said McRoberts. “A typical course is roughly 21 days.” Although the danger ticks present is a reality for Ohio and the Reserve Citizen Airmen who reside or work here, vigilance can afford the enjoyment of nature and help the 910th Airlift Wing remain, “Combat ready NOW...for tomorrow's fight!”