
In Ulster County
May is Lyme Disease Awareness Month
May is the month when many people who get Lyme
disease are exposed to it. Nymphal deer ticks are active from May through July,
and it is the bite of these small ticks (as opposed to adult deer ticks active
in fall) that lead to most Lyme infections.
However, ticks can be active year round when temperatures are above 40
degrees.
Ticks and Lyme disease
The New York State Department of Health (NYSDOH)
and local health departments continue to investigate the spread of Lyme disease
throughout New York
State. Lyme disease is a
bacterial infection caused by the bite of an infected deer tick. Untreated, the
disease can cause a number of health problems. Patients treated with
antibiotics in the early stage of the infection usually recover rapidly and
completely. During the years of 2000 through 2010, more than a quarter of a
million cases of Lyme disease have been confirmed in the United States and over
50,000 in New York State according to the Centers for Disease Control (CDC).2
The NYSDOH and local health departments also
investigate several other tick-borne diseases, including babesiosis,
ehrlichiosis (both human granulocytic anaplasmosis and human monocytic
ehrlichiosis) and Rocky Mountain spotted fever. These tick-borne diseases are
most frequently found on Long Island and in the lower Hudson Valley
region. The number of cases of these diseases is much smaller in comparison to
the cases of Lyme disease but their numbers are also increasing.
What is Lyme Disease?
Lyme disease is caused by bacteria transmitted by
the deer tick (Ixodes scapularis). Lyme disease may
cause symptoms affecting the skin, nervous system, heart and/or joints of an
individual.
Who gets Lyme disease?
Lyme disease can affect people of any age. People
who spend time in grassy and wooded environments are at an increased risk of
exposure. The chances of being bitten by a deer tick are greater during times
of the year when ticks are most active. Young deer ticks, called nymphs, are
active from mid-May to mid-August and are about the size of poppy seeds. Adult
ticks, which are approximately the size of sesame seeds, are most active from
March to mid-May and from mid-August to November. Both nymphs and adults can
transmit Lyme disease. Ticks can be active any time the temperature is above
freezing. Infected deer ticks can be found throughout New York State.
How is Lyme disease transmitted?
Not all deer ticks are infected with the bacteria
that cause Lyme disease. Ticks can become infected if they feed on small
animals that are infected. The disease can be spread when an infected tick
bites a person and stays attached for a period of time. In most cases, the tick
must be attached for 36 hours or more before the bacteria can be transmitted.
Lyme disease does not spread from one person to another. Transfer of the
bacteria from an infected pregnant woman to the fetus is extremely rare.
What are the symptoms of Lyme disease?

In 60-80 percent of
cases, a rash resembling a bull's eye or solid patch, about two inches in
diameter, appears and expands around or near the site of the bite. Sometimes,
multiple rash sites appear. The early stage of Lyme disease is usually marked
by one or more of the following symptoms: chills and fever, headache, fatigue,
stiff neck, muscle and/or joint pain, and swollen glands. If Lyme disease is
unrecognized or untreated in the early stage, more severe symptoms may occur.
As the disease progresses, severe fatigue, a stiff aching neck, and tingling or
numbness in the arms and legs, or facial paralysis can occur. The most severe
symptoms of Lyme disease may not appear until weeks, months or years after the
tick bite. These can include severe headaches, painful arthritis, swelling of
the joints, and heart and central nervous system problems.
When do symptoms appear?
Early symptoms usually appear within three to 30
days after the bite of an infected tick.
Does past infection with Lyme disease make a person immune?
Lyme disease is a bacterial infection. Even if
successfully treated, a person may become reinfected if bitten later by another
infected tick.
What is the treatment for Lyme disease?
Early treatment of Lyme disease involves
antibiotics and almost always results in a full cure. However, the chances of a
complete cure decrease if treatment is delayed.
What can I do to prevent Lyme disease?
Deer ticks live in shady, moist areas at ground
level. They will cling to tall grass, brush and shrubs, usually no more than
18-24 inches off the ground. They also live in lawns and gardens, especially at
the edges of woods and around old stone walls. Deer ticks cannot jump or fly,
and do not drop onto passing people or animals. They get on humans and animals
only by direct contact. Once a tick gets on the skin, it generally climbs
upward until it reaches a protected area.
- In
tick-infested areas, your best protection is to avoid contact with soil,
leaf litter and vegetation. However, if you garden, hike, camp, hunt,
work, or otherwise spend time in the outdoors, you can still protect
yourself:
- Wear
light-colored clothing with a tight weave to spot ticks easily.
- Wear
enclosed shoes, long pants and a long-sleeved shirt. Tuck pant legs into
socks or boots and shirt into pants.
- Check
clothes and any exposed skin frequently for ticks while outdoors and check
again once indoors.
- Consider
using insect repellent. Follow label directions.
- Stay
on cleared, well-traveled trails. Avoid contacting vegetation.
- Avoid
sitting directly on the ground or on stone walls.
- Keep
long hair tied back, especially when gardening.
Tick Life Cycle
Deer Tick Life Cycle
The deer tick passes through four life stages
(egg, larva, nymph, adult), over a two year period
Egg to Larvae
Eggs are fertilized in the fall and deposited in
leaf litter the following spring. They emerge as larvae in late summer of that
year, seeking their first blood meal. The tiny larva crawls around the forest
floor and onto low-lying vegetation looking for an appropriate host. Their
first host is generally a mouse or other medium-sized mammal or bird. Once
attached, the larvae embed their mouth parts and feed for several days. If the
host is infected with a disease such as Lyme, the tick may be infected during
this feeding. The larvae then drop off their host into the leaf litter where
they molt into the next stage, the nymph, remaining dormant until the following
spring.
Larvae to Nymph
During the spring and early summer of the next
year the nymphs end their dormancy and begin to seek a host. Nymphs are
commonly found on the forest floor in leaf litter and on low lying vegetation.
Their host primarily consists of mice and other rodents, deer, birds and
unfortunately humans. Most cases of Lyme disease are reported from May through
August, which corresponds to the peak activity period for nymphs. This suggests
that the majority of Lyme disease cases are transmitted
by nymphal deer ticks. After feeding for several days the nymph ticks drop off
to the forest floor.
Nymph to Adult
Over the next few
months the nymph molts into the larger adult tick, which emerges in fall, with
a peak in October through November. Both male and female adults find and feed
on a host, then the females lay eggs sometime after
feeding.
Adult ticks wait for host animals from the tips of
grasses and shrubs approximately one meter above the ground. When an animal or
person brushes by the vegetation, they quickly let go and climb onto the host.
Adult ticks feed on their host for five to seven days. The female will become
engorged with blood, providing nourishment for her developing eggs. After
feeding and mating, the female tick drops into the leaf litter where she lays
thousands of eggs. She will become dormant as the temperature drops below 40°
F.
Tick Facts
Ticks can only crawl; they cannot fly or jump.
Ticks found on the scalp have usually crawled there from lower parts of the body.
Some species of ticks will crawl several feet toward a host. Ticks can be
active on winter days when the ground temperatures are above 45 degrees
Fahrenheit.
There are two groups of ticks, sometimes called
"hard" ticks and "soft" ticks. Hard ticks, like the common
dog tick and Deer tick, have a hard shield just behind the mouthparts
(sometimes incorrectly called the "head"); unfed hard ticks are
shaped like a flat seed. Soft ticks do not have the hard shield and they are
shaped like a small raisin. Soft ticks prefer to feed on birds or bats and are
seldom encountered unless these animals are nesting or roosting in an occupied
building.
The most commonly encountered ticks in New York State are the deer tick, American dog
tick, and lone star tick.
How to Remove a Tick
You find a tick attached to you or your child!
Now what?
Don't
panic. Not all ticks are infected, and your risk of acquiring Lyme disease is
greatly reduced if the tick is removed within the first 36 hours after
attachment.
Remove the tick promptly and properly:
- Using
tweezers, grasp the tick as close to the skin as possible.
- Gently
pull the tick in a steady, upward motion.
- Wash
the area with a disinfectant.
- When
trying to remove the tick:
- DO
NOT touch the tick
with your bare hands.
- DO
NOT squeeze the body of the tick as this may
increase your risk of infection.
- DO
NOT put alcohol, nail polish remover or
Vaseline on the tick.
- DO
NOT put a hot match or cigarette on the tick in
an effort to make it "back out."
- DO
NOT use your fingers
to remove the tick.
These methods do not work and only increase the
likelihood the tick will transmit Lyme disease to you. Applying alcohol, nail
polish remover, or a hot match can irritate a tick and cause it to regurgitate
its gut contents into your skin. The gut contents of a tick can contain the
Lyme disease-causing bacterium.
While removing a tick, if the tick's mouthparts
break off and remain in your skin, don't worry. The mouthparts alone cannot
transmit Lyme disease, because the infective body of the tick is no longer
attached. The mouthparts can be left alone. They will dry up and fall out by
themselves in a few days, or you can remove them as you would a splinter.
After cleaning the area, watch the site of the
bite for the appearance of a rash 3 to 30 days after the bite. The rash will
usually be at least 2 inches in diameter initially and will gradually expand to
several inches in size. Rashes smaller than the size of a quarter are usually a
reaction to the bite itself and do not mean you have Lyme disease.
If you develop this type of rash or flu-like
symptoms, contact your health care provider immediately. Although not routinely
recommended, taking antibiotics within three days after a tick bite may be
beneficial for some persons. This would apply to deer tick bites that occurred
in areas where Lyme disease is common and there is evidence that the tick fed
for more than one day. In cases like this you should discuss the possibilities
with your doctor or licensed health care provider.
Ulster
County Department of Health Tick Identification Service


Tick identification services are
available through the Ulster County Department of Health. The Tick
Identification Service will tell you the species of the tick, whether it is
engorged with blood and, if so, how long it may have been feeding. The Tick
Identification Service will also report whether the mouthparts are present (if
not, they may have remained in the skin and need to be removed, as you would a
splinter). There is no charge for this service.
The Tick Identification Service will not tell you whether the tick is infected with disease-causing organisms. Once you send a tick to
be identified it will not be returned. If you wish to have a tick identified,
place it in a sealed container such as a film container or plastic bag. If you choose to mail the specimen, please
note "Tick Enclosed" on outside of envelope. Include your name, phone number,
and address with the specimen. You may also hand deliver or bring the tick to:
Ulster
County Department of Health
Tick I.D. Service
c/o Environmental Division
300 Flatbush Ave.
Kingston, NY
12401
For more information on tick-borne diseases, contact Ulster County Department of Health at (845) 334-5527.
Creating a Tick-Free Zone Around Your Home
While deer ticks are most abundant in wooded
areas, they are also commonly found in our lawns and shrubs. There are a number
of measures homeowners can take to reduce the possibility of being bitten by a
tick on their property.
Ticks and their primary hosts - mice, chipmunks
and other small mammals - need moisture, a place away from direct sunlight and
a place to hide. The cleaner you keep the area around the house, the less
likely your chances of being bitten by a tick.
Although it may not be possible to create a
totally tick-free zone, taking the following precautions will greatly reduce
the tick population in your yard.
- Keep
grass mowed.
- Remove
leaf litter, brush and weeds at the edge of the lawn.
- Restrict
the use of groundcover, such as pachysandra in areas frequented by family
and roaming pets.
- Remove
brush and leaves around stonewalls and wood piles.
- Discourage
rodent activity. Clean up and seal stonewalls and small openings around
the home.
- Move
firewood piles and bird feeders away from the house.
- Manage
pet activity; keep dogs and cats out of the woods to reduce ticks brought
into the home.
- Use
plantings that do not attract deer (contact your local Cooperative
Extension or garden center for suggestions) or exclude deer through
various types of fencing.
- Move
children's swing sets and sand boxes away from the woodland edge and place
them on a wood chip or mulch type foundation.
- Trim
tree branches and shrubs around the lawn edge to let in more sunlight.
- Adopt
dryer or less water-demanding landscaping techniques with gravel pathways
and mulches. Create a 3-foot or wider wood chip, mulch, or gravel border
between lawn and woods or stonewalls. Consider areas with decking, tile,
gravel and border or container plantings in areas by the house or
frequently traveled.
- Widen
woodland trails.
- If
you consider a pesticide application as a targeted treatment, do not use
any pesticide near streams or any body of water, as it may kill aquatic
life or pollute the water itself.
For more information about the Neighbor Notification Law click here.
Ulster County Parcel Viewer is a useful tool that can be used for identifying neighbors when complying with the Neighbor Notification Law that requires advanced notice of certain pesticide applications to occupants of neighboring dwellings with abutting property lines.
Click for Instructions on using the Ulster County Parcel Viewer.
Biological Control of Ticks1
Ticks have relatively few natural
enemies, but the use of predators, parasite, and pathogens has been examined
for tick control. Anecdotal reports suggested that guinea-fowl or chickens may
consume ticks and impact local tick abundance.
Insect parasitic nematodes have been studied as possible biological
control agents. Several
fungi have been shown pathogenic to Ixodes scapularis. A
perimeter treatment of existing commercial formulations of the fungus Beauveria
bassiana and with Metarhizium anisopliae at residential sites has
been used to control Ixodes scapularis in small experimental studies.
For more information about biological control of
ticks visit: http://www.ars.usda.gov/is/AR/archive/mar98/tick0398.htm.
Stafford III, Kirby C. 2007. Tick Management Handbook: An Integrated Guide for Homeowners, Pest Control Operators, and Public Health Officials for the Prevention of Tick-Associated Disease. 78 pp.Connecticut Agricultural Experiment Station Bulletin1010 http://www.ct.gov/caes/lib/caes/documents/publications/bulletins/b1010.pdf

Always read and follow
pesticide label directions and precautions
Tick and Insect Repellents: Deciding on Their Use
There are many different products on the market,
with different ingredients, concentrations and effectiveness. The most
effective contain DEET, permethrin (only to be applied on clothing), picaridin
or oil of lemon eucalyptus. If you decide to use one, be sure to follow label
directions and apply repellent carefully.
About Insect Repellents
DEET (the label may say
N,N-diethyl-m-toluamide) comes in many different
concentrations, with percentages as low as five percent or as high as 100
percent. In general, the higher the concentration the higher the protection,
but the risk of negative health effects goes up, too. Use the lowest
concentration that you think will provide the protection you need.
Picaridin (also known as KBR3023) and oil of lemon
eucalyptus were registered for use in New York State
in 2005. Both repellents have been shown to offer long-lasting protection
against mosquito bites but there are limited data regarding their ability to
repel ticks.
Products containing permethrin are for
use on clothing only, not on skin. Permethrin kills ticks and
insects that come in contact with treated clothes. Permethrin products can
cause eye irritation, particularly if label directions have not been followed.
Animal studies indicate that permethrin may have some cancer-causing potential.
Permethrin is effective for two weeks or more if the clothing is not washed.
Keep treated clothing in a plastic bag when not in use.
If you decide to use any kind of repellent,
carefully read and follow all label directions before each use. On the labels,
you will find important information about how to apply the repellent, whether
it can be applied to skin and/or clothing, special instructions for children,
hazards to humans, physical or chemical hazards and first aid.
Children, Pregnant Women and Repellents
Children may be at greater risk for adverse
reactions to repellents, in part, because their exposure may be greater.
- Keep
repellents out of the reach of children.
- Do
not allow children to apply repellents to themselves.
- Use
only small amounts of repellent on children.
- Do
not apply repellents to the hands of young children because this may
result in accidental eye contact or ingestion.
- Try
to reduce the use of repellents by dressing children in long sleeves and
long pants tucked into boots or socks whenever possible. Use netting over
strollers, playpens, etc.
- As
with chemical exposures in general, pregnant women should take care to
avoid exposures to repellents when practical, as the fetus may be
vulnerable.
Considerations
When thinking about using a repellent, consider a
combination of things, including where you are, how long you will be outside
and how bad the bugs are, and if those bugs carry disease. Every situation is
different. Use the following questions to make a "profile" that fits
your situation - this may help you decide if you want to use a repellent, and
if so, which kind.
What type of pest are you concerned about?
Ticks may be more difficult to repel than
mosquitoes. Repellents provide some protection against ticks, as does wearing light-colored,
long-sleeved shirts and long pants, with bottoms tucked into socks and boots.
When will you be outside? Where will you be?
Some pests are more active at certain times. For
example, some mosquitoes are most active between dusk and dawn. Ticks may be
active at any time of day. Some places are more likely to have higher activity
too. Mosquitoes generally live in areas with brush and trees. Ticks prefer
areas with tall grass, brush and trees.
How long will you be outside?
Are you doing some gardening, going on a hike,
camping for a week? The longer you are out, the more protection you may need.
Some people exposed to high numbers of ticks and mosquitoes for long periods of
time use a two-part approach. With this approach, about 33 percent DEET in a
controlled release formula is applied on exposed skin, and clothing is treated
with permethrin. If, on the other hand, you are going to do some yard work or
have a picnic during mid-day when mosquito activity is low and you decide to
use an insect repellent, DEET concentrations as low as five percent may provide
sufficient protection from mosquito bites for up to about four hours.
Remember!
If you decide to use a repellent, use only what and how much you need for your
situation.
Lyme Disease and Pets
Lyme
disease is not limited to humans. Veterinarians have reported Lyme in both dogs
and cats. Just as with humans, it is important for animals to avoid tick bites
and receive prompt treatment for Lyme disease.
Tick Bite Prevention:
- When
walking or exercising your pet outdoors, try to keep it away from grassy
or wooded areas and leafy debris.
- Check
your pet regularly for ticks, especially after any trips through grassy or
wooded areas. Comb through your pet's hair thoroughly.
- If
you find a find a tick, remove it promptly.
- Consult
your veterinarian about treating your dog or cat with tick-killing
pesticides (acaricides) or using tick collars. There are many pesticides
aimed at preventing tick bites, but some people and animals may be
sensitive to the chemicals they contain.
- There
is currently a Lyme disease vaccine available for dogs. However, there are
varying opinions on its effectiveness. Consult your veterinarian about the
vaccine.
If you find several ticks on your dog, you
may wish to discuss an insecticidal bath with your veterinarian or
groomer.
Symptoms of Lyme Disease in Pets:
Symptoms of Lyme disease in animals are similar to
the symptoms in humans. Although you will not see a skin rash on your pet, they
can experience a range of symptoms:
- In
dogs: Some infected dogs do not experience any symptoms of Lyme disease.
Symptoms include lethargy, arthritis (displayed as joint pain, shifting
from foot to foot, and lameness), fever, fatigue, and kidney damage.
Symptoms can become chronic.
- In
cats: While there is some debate about whether cats suffer from Lyme
disease, cats are thought to be highly resistant to the disease.
Treatment of Lyme Disease in Pets:
As with humans, animals are generally treated for
Lyme disease with certain antibiotics. However, you should consult your
veterinarian about proper treatment of your pet.
Important Considerations for Pet Owners:
Pet owners are at an increased risk for tick encounters, especially those who have animals that are permitted to go in and out of the home. Ticks that have not embedded in the animal may drop off in the home and will continue to seek a blood meal. For this reason, it is not advisable to let pets sleep in the same bed with family members.
Lyme Disease in Ulster County
(Click to see the Hudson Valley
Lyme Rate Profiles for 2005-2007 per 100,000 population)

Links for More Information
New York State Department of Health
http://www.health.state.ny.us/diseases/communicable/lyme/
Infectious Diseases Society of America's Guidelines for Treatment of Lyme Disease
http://www.journals.uchicago.edu/doi/full/10.1086/508667
International Lyme And Associated Diseases Society (ILADS)
http://www.ilads.org/
Lyme Disease Network
http://www.lymenet.org/
University of Rhode Island, Tick Encounter Resource Center
http://www.tickencounter.org/prevention/top_ten_things
Columbia University Medical Center: Lyme and Tick Borne Diseases Research Center
http://www.columbia-lyme.org/
Fordham University Tick Index
http://www.fordham.edu/academics/office_of_research/research_centers__in/the_louis_calder_cen/fordham_tick_index_29785.asp
CDC-Ticks
http://www.cdc.gov/ticks/index.html
Lyme Disease Diagnostic Center at New York Medical College
http://www.nymc.edu/LDDC
Babesiosis
What is babesiosis?
Babesiosis
is a rare, severe and sometimes fatal tick-borne disease caused by various
types of Babesia, a microscopic parasite that infects red blood cells. In New York
State, the causative
parasite is Babesia microti.
Who gets babesiosis?
Babesiosis
is seen most frequently in the elderly or in immunocompromised individuals.
Cases of this disease have been primarily reported during spring, summer and
fall in coastal areas in the northeastern United
States, especially Nantucket
Island off the coast of Massachusetts and on Long Island in New York. Cases have also been reported in Wisconsin, California,
Georgia, Missouri
and some European countries. Babesiosis can be more severe in people who have
had their spleen removed.
How is babesiosis transmitted?
Babesiosis
is transmitted by the bite of an infected deer tick, Ixodes scapularis. Transmission can also occur
via transfusion of contaminated blood.
What are the symptoms of babesiosis?
The
disease can cause fever, fatigue and hemolytic anemia lasting from several days
to several months. Infections can occur without producing symptoms.
When do symptoms appear?
It
may take from one to eight weeks, sometimes longer, for symptoms to appear.
Does past infection with babesiosis make a person immune?
It
is not known whether past infection with babesiosis can make a person immune.
What is the treatment for babesiosis?
While
many people do not become sick enough with babesiosis to require treatment,
there are effective therapies, usually either a combination of quinine and
clindamycin or a combination of atovaquone and azithromycin. It is possible to
become infected with babesiosis and Lyme disease at the same time, so be sure
to seek medical attention if you become ill after a tick bite.
What can be done to prevent babesiosis?
When
in tick-infested habitat - wooded and grassy areas - take special precautions
to prevent tick bites, such as wearing light-colored clothing (for easy tick
discovery) and tucking pants into socks and shirt into pants. Check after every
two to three hours of outdoor activity for ticks on clothing or skin. Brush off
any ticks on clothing before skin attachment occurs. A thorough check of body
surfaces for attached ticks should be done at the end of the day. If removal of
attached ticks occurs within 36 hours, the risk of tick-borne infection is minimal.
Repellents
can be effective at reducing bites from ticks that can transmit disease. But
their use is not without risk of health effects, especially if repellents are
applied in large amounts or improperly. Repellents commonly available to
consumers contain the active ingredients DEET (N, N-diethyl-m-toluamide),
picaridin (also known as KBR 3023), oil of lemon eucalyptus, permethrin, or
botanical oils. DEET products have been widely used for many years, but have
occasionally been associated with health effects. Skin reactions (particularly
at DEET concentrations of 50 percent and above) and eye irritation are the most
frequently reported health problems. Picaridin and oil of lemon eucalyptus have
been shown to offer long-lasting protection against mosquitoes but there are
limited data regarding their ability to repel ticks. Products containing
permethrin are for use on clothing only, not on skin. Rather than acting as a
repellent, permethrin kills ticks and insects that come in contact with treated
clothes. Permethrin can cause eye irritation. Insect repellents containing
botanical oils, such as oil of geranium, cedar, lemongrass, soy or citronella
are also available, but there is limited information on their effectiveness and
toxicity. If you decide to use a repellent, use only what and how much you need
for your situation. In addition:
- Be sure to follow label
directions.
- Use repellents only in
small amounts, avoiding unnecessary repeat application. Try to reduce the
use of repellents by dressing in long sleeves and pants tucked into socks
or boots.
- Children may be at greater
risk for reactions to repellents, in part, because their exposure may be
greater. Do not apply repellents directly to children. Apply to your own
hands and then put it on the child.
- Do not apply near eyes,
nose or mouth and use sparingly around ears. Do not apply to the hands of
small children.
- After returning indoors,
wash treated skin with soap and water.
Babesiosis
in Ulster County
(Click to see the Hudson Valley Babesiosis
Rate Profiles for 2005-2007 per 100,000 population)
Ehrlichiosis: Human Monocytic Ehrlichiosis, Human Granulocytic
Anaplasmosis
What is ehrlichiosis?
Ehrlichiosis
is a tick-borne disease which can be caused by either of two different
organisms. Human monocytic ehrlichiosis (HME) is caused by Ehrlichia chaffeensis, which is
transmitted by the lone star tick (Amblyomma americanum). Human granulocytic anaplasmosis (HGA),
previously known as human granulocytic ehrlichiosis (HGE),
is caused by Anaplasma
phagocytophilia,
which is transmitted by the deer tick (Ixodes scapularis). In New
York State, most
cases of ehrlichiosis have been reported on Long Island and in the Hudson Valley.
Who gets ehrlichiosis?
Anyone
can get ehrlichiosis, although the majority of known cases have been in adults.
People who spend time outdoors in tick-infested areas from April until October
are at greatest risk for exposure.
How is ehrlichiosis transmitted?
Ehrlichiosis
is transmitted by the bite of infected ticks, including the deer tick and the
lone star tick. Ehrlichiosis cannot be spread from person to person.
What are the symptoms of ehrlichiosis?
The
symptoms of HME and HGE are the same and usually include fever, muscle aches,
weakness and headache. Patients may also experience confusion, nausea, vomiting
and joint pain. Unlike Lyme disease or Rocky Mountain spotted fever, a rash is
not common. Infection usually produces mild to moderately severe illness, with
high fever and headache, but may occasionally be life-threatening or even fatal.
When do symptoms appear?
Symptoms
appear one to three weeks after the bite of an infected tick. However, not
every exposure results in infection.
What is the treatment for ehrlichiosis?
Tetracycline
antibiotics are usually rapidly effective for ehrlichiosis. Because these
antibiotics can cause dental staining in children, physicians should consult an
infectious disease expert when treating children.
What can be done to prevent ehrlichiosis?
When
in tick-infested habitat - wooded and grassy areas - take special precautions
to prevent tick bites, such as wearing light-colored clothing (for easy tick
discovery) and tucking pants into socks and shirt into pants. Check after every
two to three hours of outdoor activity for ticks on clothing or skin. Brush off
any ticks on clothing before skin attachment occurs. A thorough check of body
surfaces for attached ticks should be done at the end of the day. If removal of
attached ticks occurs within 36 hours, the risk of tick-borne infection is
minimal.
Repellents
can be effective at reducing bites from ticks that can transmit disease. But
their use is not without risk of health effects, especially if repellents are
applied in large amounts or improperly. Repellents commonly available to
consumers contain the active ingredients DEET (N, N-diethyl-m-toluamide),
picaridin (also known as KBR 3023), oil of lemon eucalyptus, permethrin, or
botanical oils. DEET products have been widely used for many years, but have
occasionally been associated with health effects. Skin reactions (particularly
at DEET concentrations of 50 percent and above) and eye irritation are the most
frequently reported health problems. Picaridin and oil of lemon eucalyptus have
been shown to offer long-lasting protection against mosquitoes but there are
limited data regarding their ability to repel ticks. Products containing
permethrin are for use on clothing only, not on skin. Rather than acting as a
repellent, permethrin kills ticks and insects that come in contact with treated
clothes. Permethrin can cause eye irritation. Insect repellents containing
botanical oils, such as oil of geranium, cedar, lemongrass, soy or citronella
are also available, but there is limited information on their effectiveness and
toxicity. If you decide to use a repellent, use only what and how much you need
for your situation. In addition:
- Be sure to follow label
directions.
- Use repellents only in
small amounts, avoiding unnecessary repeat application. Try to reduce the
use of repellents by dressing in long sleeves and pants tucked into socks
or boots.
- Children may be at greater
risk for reactions to repellents, in part, because their exposure may be
greater. Do not apply repellents directly to children. Apply to your own
hands and then put it on the child.
- Do not apply near eyes,
nose or mouth and use sparingly around ears. Do not apply to the hands of
small children.
- After returning indoors,
wash treated skin with soap and water.
Ehrlichiosis
in Ulster County
(Click to see the Hudson Valley Ehrlichiosis Rate Profiles for 2005-2007 per 100,000 population)
Ulster County Resources:
Mid-Ulster Lyme Support Group:
Meet the 4th Wednesday of the month, 7:00-8:30 pm, Hudson Valley Sudbury School, 84 Zena Road, Woodstock. Contact March Gallagher
(845) 705-2622.
New Paltz Lyme Support Group:
Meet the 1st Monday of the month, 7:00-9:30 pm, 127 Springtown Rd., New Paltz. Contact Beverly 646-258-9600 or BPhoenix4@gmail.com