Resources To Get Through Tick Season

Here are some resources that you may find useful during tick season.

On this page:

• Which ticks are prevalent in Maryland?

• How to avoid and remove ticks
  • Before you go out
  • When you return
  • How to remove a tick
• Illnesses caused by tick-borne bacteria, parasites and viruses

Which Ticks are Prevalent in Maryland?

• Not all ticks bite.  Those that do, and that are prevalent in Maryland, are the:
  • American dog tick
  • blacklegged tick (deer tick)
  • brown dog tick
  • Gulf Coast tick
  • lone star tick, and
  • Asian longhorned tick (new to the U.S.).

• Learn how to identify different kinds of ticks.

How to Avoid and Remove Ticks

Before You Go Out

• Treat your clothing: Boots, clothing and camping gear can be treated with insecticide products containing 0.5 percent permethrin. The protection will remain effective through several washings.  Clothing and gear pretreated with permethrin are also available.

• Treat your body:  Use Environmental Protection Agency (EPA)-registered insect repellents containing DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. The Environmental Protection Agency has a search tool to find the best tick and insect repellent for you and your family.  One important caution from the CDC: Don’t use oil of lemon eucalyptus (OLE) or para-menthane diol (PMD) on children under three.

• Treat your pets:  Treat dogs and cats for ticks as recommended by your veterinarian.

• Keep in mind that all repellents that are effective for ticks are effective against mosquitoes, but not all mosquito repellents work against ticks. For example, catnip oil is active against mosquitoes but not against ticks.

When You Return

• Check your clothing: When you’re ready to come inside, check your clothing for ticks and remove them — or put dry clothing in the dryer on high heat for 10 minutes, and that will kill them (additional time may be needed if the clothes are damp).  If clothing requires washing first, use hot water because cold and warm water won’t kill them.

• Check your pets.

• Check your body:
  • Take a hot shower within two hours — this has been shown to be effective in preventing Lyme disease and may reduce the risk of other tick-borne illnesses as well, according to the CDC.
  • Use a mirror and do a full body inspection, including:
    • your underarms,
    • in and around your ears,
    • inside your belly button,
    • on the backs of your knees,
    • in and around your hair,
    • in your groin and genital areas, and
    • around your waist.

How to Remove a Tick

Here’s the main CDC page on this topic (but also see the bottom of this other CDC page.)

Learn about Many Different Illnesses Caused by Tick-Borne Bacteria, Parasites and Viruses

There are at least 12 different kinds of tick-borne illnesses. The following is a list of the most common in Maryland (only eight! :-)); the links will take you to information about symptoms and treatment.  All can present with symptoms like fever and chills, but some also have symptoms (for example, particular kinds of rashes) that differentiate these illnesses from other tick-borne illnesses.  Note that while doxycycline is a popular treatment for Lyme, it’s not the best treatment for all of these illnesses.

• Alpha-gal allergy (AGS; also called alpha-gal syndrome, red meat allergy, or tick bite meat allergy). AGS is a serious, potentially life-threatening allergic reaction.
  • How does it happen?  The tick bite transmits an alpha galactose sugar molecule into a person’s body. In some people, the introduction of this molecule via the tick bite triggers an immune system reaction.  If a person has this reaction, then that person’s immune system may react again whenever the alpha-gal molecule is re-introduced to it.  Since red meat, such as beef, pork or lamb, and some other other mammal products, also contain the alpha-gal molecule, eating these foods triggers the immune system reaction.  More research is needed to understand the role ticks play in starting this reaction, and why certain people develop AGS.
  • How is it treated?  Allergic reactions to alpha-gal can be treated with an over-the-counter antihistamine such as diphenhydramine (Benadryl).  Stronger reactions provoked by alpha-gal might need to be addressed with epinephrine (Epi-pen) and/or a visit to an emergency room.
  • Which ticks cause it?  Growing evidence suggests that AGS may be triggered by the bite of a lone star tick in the United States, but other kinds of ticks have not been ruled out. Other tick species have been connected with the development of AGS in other countries.  View an article in the Washington Post about alpha-gal in the D.C. area.
• Babesiosis is caused by parasites that infect red blood cells. Most U.S. cases are caused by Babesia microti, which is transmitted by the blacklegged tick (deer tick).  Read more about babesiosis in this New York Times article.

• Ehrlichiosis is caused by the ehrlichia bacteria, and is carried primarily by the lone star tick and the blacklegged tick (deer tick).  There are three strains of this illness, one of them potentially deadly. Fatal cases of ehrlichiosis are highest among children around 10 and adults around 70, according to the CDC.

• Lyme disease is caused by the bacteria Borrelia burgdorferi and Borrelia mayonii, carried primarily by black-legged ticks (deer ticks). Young brown ticks often are no bigger than a poppy seed, which can make them nearly impossible to spot. Lyme is the only tick-borne illness that may cause the erythema migrans rash (PDF), which occurs in about 70-80% of people infected with Lyme. The rash can expand over several days to up to 12 inches; only about 20% resemble a bull’s eye.
  • See this page for images of the erythema migrans rash versus other, lookalike rashes.
  • See more information about treatment for Lyme.
• Powassan virus disease, carried primarily by the blacklegged tick (deer tick), can progress to meningoencephalitis, a very serious neurological condition resembling both meningitis and encephalitis with symptoms that include mental confusion, seizures, paralysis and palsies. If left untreated, it can lead to death.  Learn more from the Washington Post.

• Rocky Mountain Spotted Fever (RMSF) is generally transmitted by the American dog tick in the Eastern, Central and Western United States; by the Rocky Mountain wood tick in the Rocky Mountain states; and by the brown dog tick in the Southwestern United States.  Symptoms include fever, headache, rash, nausea, vomiting, stomach pain, muscle pain, and/or lack of appetite. If not treated with the right antibiotic early, RMSF can be fatal.  The rash usually develops 2-4 days after fever begins. The look of the rash can vary widely over the course of illness. Some rashes can look like red splotches and some look like pinpoint dots. While almost all patients with RMSF will develop a rash, it often does not appear early in illness, which can make RMSF difficult to diagnose. View more information about treatment for RMSF.

• Like Lyme, Southern Tick-Associated Rash Illness (STARI) can manifest via the erythema migrans rash (PDF), but unlike Lyme, STARI is caused by the Lone Star tick.

• Tularemia can be transmitted to humans via the dog tick, the wood tick, and the Lone Star tick.  Other transmission routes include deer fly bite, inhalation, ingestion, and through skin contact with infected animals.