Lifestyle

Avoiding those pesky ticks

By Elizabeth Eddy
Published: July 11, 2008

Lyme disease continues to spread throughout Massachusetts, so residents must try to avoid tick bites whenever possible to prevent this sometimes serious illness.

Fifteen years ago, deer ticks were confined to certain areas in the Bay State, including Cape Cod, the Islands and the Connecticut River Valley, but they have since expanded to many other regions, says Dr. Bela Matyas, medical director for the epidemiology program of the Massachusetts Department of Public Health.

More ticks mean more Lyme disease, and Matyas reports significant increases in the number of cases in Norfolk and Middlesex counties, and says "all of eastern Massachusetts is now considered high risk."

Numbers have been significant in Essex County, especially Ipswich and Cape Ann, for some years. The unwelcome presence of deer ticks is attributable to several critical elements, including an increase in the deer and mouse populations and hospitable surroundings for all three species.

Deer find ample shelter and food in brushy, overgrown farmland, so they have resettled this region.

"And when this happens, the Lyme disease risk follows in a couple of years," Matyas said.

This dense undergrowth is also an ideal place for ticks to reproduce and provides cover for white-footed mice, which serve as a reservoir for the bacteria that causes Lyme disease.

"The mice, deer and the ticks need the same vegetation to thrive, and this kind of environment describes most of Massachusetts," Matyas said. "You have the perfect habitat for all three animals, which come together quite happily in quite large numbers."

Warmer temperatures have also supported a larger range and population of deer ticks, so Southern New Hampshire is reporting more cases each year, and "there is a northward migration of the risk," Matyas said. And though the severe cold of northern New Hampshire and Vermont is not conducive for harboring large tick populations, much of New England is now inhabited by deer ticks.

"It's out there and widespread, so you don't have to travel to Martha's Vineyard to get Lyme disease," Matyas said.

Although tick season traditionally lasts from spring until fall, ticks can become active whenever the temperature rises above freezing, so as weather patterns change and become warmer, ticks will become problematic year round.

"You can get Lyme disease at any time of year," Matyas said. "The milder winters are allowing humans to be exposed."

There were 3,300 confirmed cases of Lyme disease last year in Massachusetts. Forty-six of them were in Gloucester, with 13 new cases so far this year in the city. This means Lyme disease is the most prevalent of the vector-borne diseases, and follows influenza and chlamydia as the most common infectious disease in the commonwealth.

Although Lyme disease usually produces an acute illness that can be successfully treated with antibiotics, cases that are not properly diagnosed or treated in a timely manner can result in long-lasting, negative health effects.

Lyme disease can harm joints, the nervous system and the heart, so patients may suffer lingering arthritic and neurological effects even after the active infection has been eliminated, if the damage has already occurred.

There is no vaccine available for humans, so tick bites should be avoided whenever possible to prevent illness. Although no one wants to encounter ticks, people do not have to eschew the outdoors to stave off Lyme disease.

"You do have some control over this," Matyas said, if some basic precautions are observed to stay safe. When in woodsy areas, for example, wear tall, light-colored socks and sturdy shoes for walking, as well as long pants and long sleeves when weather permits. It is also helpful to tuck pant legs into the top of the socks so ticks can't reach the skin.

Established, hard-packed hiking and biking trails should be followed, not shortcuts through the brush, which are the favorite haunts of deer ticks.

Tick repellents such as DEET can be used on the skin (although many prefer more organic remedies) as can Permethrin, which should be used exclusively on clothing. All such compounds must be applied according to the manufacturer's recommendations for use.

No chemicals are needed if a tick patrol is faithfully conducted, since most local areas are fairly infested with these insects, a daily tick check for adults, children and pets should become routine.

If ticks are found clinging to the body, they should be removed promptly with tweezers, which is a key precaution because a tick bite does not have to result in illness. It takes 24 to 48 hours for a deer tick to transmit the Lyme bacteria through a bite, so checking the skin each day for ticks will prevent this from occurring. It is important to check every inch of skin, and ask for assistance to check hard to view areas.

The presence of ticks can be minimized around the home with prudent maintenance. Ticks love high grass and moist areas with plenty of cover, so lawns and bushes should be trimmed and features such as leaf and wood piles moved away from the house. Likewise, tree branches should be trimmed so they don't sweep against the house and outdoor furniture and play areas should be located on mown grass or crushed stone.

A tick barrier of stone can also be installed at the edge of the property or in front of brushy areas to discourage ticks from entering human domain. Likewise, doghouses and runs should be limited to the lawn and not placed in such settings.

Gloucester public health nurse Sunny Robinson notes, "Every year we see more and more cases of Lyme disease and more and more people who get really sick because they haven't noted the tick on them, or thought it wasn't a deer tick because they didn't get a rash. Not everyone gets that red, ringed, spreading rash. I really wish I could get people to do daily tick checks after they have been in the woods or brushy areas! We'd prevent so much misery."

She also noted that all the health departments on Cape Ann will be posting warning signs this summer about avoiding ticks and mosquitoes.

"Maybe these warnings, put right at the edge of the wooded areas in which we all walk, will help," she concluded.

For more information, including leaflets to share with your neighbors, call the Gloucester Health Department at 978-281-9771.

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This article is part of a regular, every other week, health education column provided by the Gloucester Health Department.