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Tick Season and Seniors -- Know What to Look For

For the last two springs, the coronavirus took all the headlines along with stories about the vaccine, masks, and social distancing. The normally joyful arrival of spring was met with what seemed like a house arrest for seniors, some self-imposed, some required by the rules of contact. This year, however, it looks like we may be able to enjoy the arrival of warm weather. And although the pandemic may finally be in the rearview mirror, the regular pests still exist that pose disease risks for our seniors -- and one of those pests is the tick.

An active tick season according to experts

"After what seems like a winter that lasts forever, we all look forward to shedding the heavy coats and getting outside into the warm weather," said certified elder law Attorney RJ Connelly III. "Unfortunately, the months of March and April are when seniors need to start being concerned about ticks. And this year, it looks like we may have a record number of these disease-carrying pests around thanks to the mild winter."


Contrary to widely held belief, ticks do not typically die in the winter (although they can if the temperatures go below 14 degrees for an extended period), instead, they go into dormancy, waiting for the warmth to re-emerge so they can begin their blood-sucking ways. On March 25, the Providence Journal had an article on the expected tick season this spring.


The Toughness of Ticks

Ticks have been around for centuries. In fact, tick fossils have been found in New Jersey (no New Jersey jokes, please) dating back some ninety million years. The highest numbers of ticks are found on the East Coast, especially in the New England area and the Midwest regions of the country.

90 plus million year old tick on a dinosaur

Ticks, as small as they are, can pack quite a wallop in their bites and while these illnesses are unpleasant for anyone who acquires them, for seniors, the risks can be especially dangerous. The major reason for this is that as we age, our immune system begins to weaken, increasing our vulnerability.


Ticks can be infected with a plethora of bacteria, viruses, and parasites. Some of the most common diseases spread by these insects include Lyme disease, babesiosis, ehrlichiosis, Rocky Mountain spotted fever, anaplasmosis, Southern Tick Associated Rash Illness, Tick-Borne Relapsing Fever, and Tularemia. We will take a closer look at these in a bit.


Obviously, the best way to avoid these illnesses is not to get bitten, but staying indoors during the summer months, especially after the lockdown we have experienced, is not an option for most and offers its own health risks, so the next best thing is to understand tick behavior and how best to avoid contact with them.

"Ticks do not jump, fly, or fall on people but they do have a unique way of finding their blood meal...sitting with their front legs extended, they grab onto their victims as they walk by."

Ticks do not jump, fly, or fall on people but they do have a unique way of finding their blood meal. Ticks perch themselves on tall grass or low-hanging brush awaiting a host to come along. Sitting with their front legs extended, they grab onto their victims as they walk by. They also can sense heat and detect carbon dioxide, which we exhale as we breathe. Once a tick is on you, they quickly seek a place to attach and feed. Ticks can find a spot anywhere on you, but they are particularly fond of areas around the neck, head, underarms, and groin.

After grabbing the host, they find a warm place to feed

The CDC recently analyzed data trends for all nationally notifiable diseases caused by the bite of an infected mosquito, tick, or flea. The number of cases has tripled since 2004 and those caused by ticks have doubled. Of the tick-borne illnesses, 82% were cases of Lyme disease, a bacterial infection that causes a rash and flu-like symptoms that can spread to the joints and nervous system if left untreated.


The increase in tick-related illnesses may have many explanations, but the most likely reason is that we are now much more aware of the symptoms of tick-borne diseases and therefore seek treatment. Another reason that has been offered is that increased travel by people and animals means that these parasites which were once isolated in certain pockets of the country have now taken hold in new areas.


Tick Carried Diseases and Seniors

In any case, being aware of the diseases carried by ticks and the symptoms of these illnesses must be taken seriously, especially for seniors. Let's take a look at them.


The "bull's eye" rash of Lyme Disease

Lyme disease

Lyme disease is the most worrisome due to the number infected and is transmitted to humans through the bite of infected black-legged ticks. Typical symptoms include fever, headache, fatigue, and a characteristic skin rash called erythema migrans. If left untreated, the infection can spread to joints, the heart, and the nervous system. Lyme disease is diagnosed based on symptoms, physical findings (the tell-tale bulls-eye rash), and the possibility of exposure to infected ticks from animals or being in high-risk areas like brush and woodlands.

The results of Babesiosis

Babesiosis

This is a rare disease caused by a microscopic parasite, Babesia microtia, which infects red blood cells. It is spread to humans also through the bite of an infected black-legged tick. It is typically spread by the young tick which is small and difficult to spot. Most cases occur in the Northeast and Midwest. Although rare, the number of cases reported continues to increase. Most people who get babesiosis do not develop any symptoms, but some people with weaker immune systems — the elderly, very young, and immunocompromised individuals (those with conditions like AIDS, Lupus, etc.) — may experience mild flu-like symptoms which could aggravate these pre-existing conditions.

Skin rash caused by ehrlichiosis

Ehrlichiosis

This is a term for a group of bacterial diseases transmitted to humans from ticks — primarily the lone star tick. Most cases occur in June and July in the Midwest and South. The symptoms are like the flu — fever, muscle aches, nausea, chills, headache, fatigue — and they usually appear within one or two weeks after being bitten by an infected tick. People over the age of fifty are at a higher risk of contracting the illness. If treated early, it can be cured however if medical intervention does not occur, there is a fatality rate of up to 3%.


Anaplasmosis

Like ehrlichiosis, it is caused by a different type of bacteria and spreads to humans also by the black-legged tick and the western black-legged tick. Most cases occur during the summer months in upper Midwestern and Northeastern states.


The symptoms are also like a flu-like illness and appear within one to two weeks after being bitten. Some people may have very few symptoms, and others may develop severe symptoms such as hemorrhaging, kidney failure, or breathing problems. Again, the young and seniors are most at risk.

Worse than Lyme disease?

Powassan (POW) Viruses

This is a rare virus spread to humans from the black-legged tick. POW virus primarily occurs in the Northeast or Great Lakes region, particularly in Minnesota and Wisconsin. Many people who contract the POW virus do not have any symptoms, but those who do may experience a fever, headache, vomiting, mental confusion, memory loss, or seizures.


If left untreated, the POW virus can spread to the central nervous system and lead to encephalitis or meningitis. Unfortunately, there is no medication or vaccine to treat or prevent the POW virus. About half of those who survive the POW virus will have permanent neurological problems, and 10% of the encephalitis cases caused by POW are fatal, according to the CDC.

Spotted fever

Spotted Fever

Spotted fever rickettsiosis is a term for a group of diseases caused by spotted fever group rickettsia, a type of bacteria. These are spread to humans by either mites or ticks — specifically, the Gulf Coast tick and Pacific Coast tick. Since 2010, there have been about 3,000 cases each year with a fatality rate of less than 1%. These mostly occur during the summer months in the South and Southeastern states.


The first sign of a spotted fever is an eschar, or a deep brown scab on the tick bite, which can take up to a week to appear. Once the eschar forms, patients may experience flu-like symptoms. All spotted fevers are treated with doxycycline. These infections can range from mild to life-threatening if left untreated. The most serious of these groups of tick-borne diseases is the Rocky Mountain spotted fever (RMSF), which causes fever, headache, and rash. In severe cases, RMSF can result in permanent damage to blood vessels in the limbs, hearing loss, paralysis, or mental disabilities.

Rabbit fever

Tularemia - Rabbit Fever

An infection caused by the highly contagious Francisella tularensis bacterium, can be spread to humans from the dog tick, wood tick, or lone star tick. Tularemia is also known as rabbit fever because it can infect and kill rabbits, hares, and rats. There are around 200 cases in people reported each year, primarily in the states of Kansas, Oklahoma, Missouri, and Arkansas. It can also spread to humans from contact with infected animals or exposure to aerosolized bacteria, which can happen if someone accidentally runs a mower over an animal that died of the disease. The symptoms of tularemia depend on how the bacteria entered the body.


If the tularemia is contracted from an infected tick bite or from handling an infected animal, patients can develop glandular tularemia, which causes swollen lymph nodes in the armpits or groin. Sometimes, this is accompanied by an ulcer at the location of the tick bite or the site where the bacteria enter the body. The infection can be treated with multiple antibiotics and most patients will make a full recovery.

The Heartland Virus - virus like symptoms

Heartland Virus

Thought to be transmitted by the lone star tick, and it's usually found in parts of the Midwest and Southern US. States, where the tick is most common, include Arkansas, Missouri, Indiana, Tennessee, Kentucky, and North Carolina. It was first discovered in 2009 and there have been several cases each year — including two people who have died. The virus causes flu-like symptoms, such as fever, fatigue, muscle aches, headaches, and diarrhea. There is no medicine or vaccine to treat or prevent the Heartland virus.

Woman dying from bourbon virus

Bourbon Virus

This is a part of a group called thogotoviruses, and it's new on the radar. There have only been a few cases so far, mostly in the South and Midwest, and some of these patients died. The virus is thought to spread through the bite of an infected tick, but the exact way it infects people is still unknown, according to the CDC.


People who become infected with the Bourbon virus may develop flu-like symptoms as well as nausea and vomiting. They may also have low white blood cells and platelet counts.

Red Meat Allergy

A bite from the Lone Star tick can cause people to develop an allergy to red meat, including beef and pork. The Lone Star tick has been implicated in initiating the red meat allergy in the US and again, this tick is found predominantly in the Southeast from Texas to Iowa, into New England.


Ticks - Small but Powerful

Black-legged, American Dog and Lone Star Ticks

These ticks are common in the southern New England states (Connecticut, Rhode Island, Massachusetts) and are becoming common in the northern New England states of Vermont, New Hampshire, and Maine.


About 25% to 33% of Blacklegged (deer) ticks in New England may bear and transmit serious illnesses we spoke of earlier, including Lyme disease, Babesiosis, and Anaplasmosis. Think about those odds -- these ticks have a one in three chance of carrying diseases.


American Dog ticks, which are larger than Black-legged ticks and thus easier to spot and remove, do not carry and transmit the same diseases as do Black-legged ticks. However, Dog ticks may carry and transmit Tularemia and Rocky Mountain Spotted Fever.


The Turkey Tick

The Turkey Tick or Northeastern Water Tick, the female of this species bears a white spot on its back. They can carry a variety of Ehrlichia diseases, among others. Wild turkeys are a common host for this insect, earning it the nickname Turkey Tick.


Asian Long-horned Tick

Asian long-horned tick preys primarily on livestock and wildlife and isn’t yet considered a threat to humans in the United States, but the operative phrase here is "isn't yet considered".

"There is no evidence [that pets can spread tick-borne illnesses to humans except for tularemia] ...however ticks can certainly ride a pet into the home and crawl upon a human and bite them."

We also received a question regarding pets and whether they can spread a tick-borne illness to humans. Currently, except for tularemia, most illnesses cannot be spread to humans, however, ticks can certainly ride a pet into the home and crawl upon a human and bite them. There has also been some talk that cats are not infected by tick diseases, but research has shown that cats can have tick-related diseases in their blood, they do not exhibit the same symptoms as dogs do.


Preventing Tick Bites

There are many things you can do to try and avoid tick bites, unfortunately, none of these things is foolproof, so it's important to take many safety measures to keep yourself healthy. Here are some tips:

  • As much as you can, avoid areas where ticks are present. This includes moist and humid locations, grassy and wooded areas, and trails. Ticks are found in shrubs and leaf litter too.

  • If you must go hiking, avoid brushing against bushes or thick plants. Walk where it is clear, along the center of trails.

  • Treat hiking boots and clothing with permethrin-based anti-tick products.

  • Protect skin from bites for hours by applying tick repellents containing DEET. Be sure to use it according to instructions; on children, use it with caution or check with your doctor.

  • Even when advised to avoid tick-prone areas so you can prevent tick bites, there is really no guarantee that you can one hundred percent do so. When you know you have exposed yourself to ticks, make sure to check after coming indoors.

  • Ticks may have attached to your clothes and if so, wash them immediately and place them in high heat. Exposing ticks to a specified temperature kills them.

  • It could also make a significant difference if you immediately shower to wash off ticks. If a tick has already found its way to your body crevices and has attached itself, this could be the best time to inspect areas such as the armpits, the ear area, around the waist, behind the knees and the belly button, and through the hair.

Removing a Tick

Doubtlessly, measures to prevent tick bites from happening will always be the best defense against tick bite illnesses. Still, there could be instances when a tick would still find a way to grab a bite or two in its quest for blood. What do you do?

  • Should you find a tick attached to your skin, remove it immediately. Observe tick removal directions.

  • If a fever or rash develops after a bite, see your doctor.

  • It would be helpful if you could bag the tick that bit for clinical inspection, easier diagnosis, and medication.

Create a Tick Safe Environment

Reducing the chances of ticks infesting your home or surroundings is your first step to preventing tick bites. While you can’t completely control the presence of ticks outside your home, there are steps you can take to lessen the chances of an infestation at home and in its immediate surroundings.

  • Regularly clean your yard and free it of tall grasses and bushes. Don’t let leaf litter stand for days. Place gravel or sand on areas by the swing or the children’s play area to create an obstruction for ticks.

  • Avoid storing unused equipment in shaded areas for longer periods that could create a haven for ticks.

  • Control tick presence with the use of home-grade anti-tick chemicals. You can also consult professional pest control specialists who can apply tick treatments thereby helping you and your loved ones prevent tick bites. But remember that many seniors have respiratory issues that could be affected by chemical sprays.

  • Use tick-control soaps or shampoos on your pets. Your dog or other pets that you have at home could be the most convenient vehicle for ticks to invade your domain and cause tick problems.

As things stand today, there is no way to totally eradicate these pests from our environment but there are certainly ways to combat them. Educate yourself in these ways so you and the rest of the family members can continue enjoying the outdoors. And, if you think you were bitten, seek medical advice. Better safe than sorry.


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