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Ticked off outdoors: preventing tick borne illness

Prevention is Key: the common small brown tick is the source of many diseases.
Prevention is Key: the common small brown tick is the source of many diseases that can be prevented.

Nothing says summer to those in health care like poison ivy, lice, chiggers, and ticks; amazing what kids (and many adults) can get into on a simple summer outing! Ticks have a special attachment as the calcium claw at the end of each leg helps them firmly grip the skin as they search for that perfect feeding spot. Ever wonder why a tick can’t be flicked off with the same ease of say, an ant? That’s why. Then, once the tick finds a nice place where the skin is fairly easy to burrow through, they stick their head in and commence with blood sucking.

Tennessee itself is a feasting ground for tick related diseases. According to the CDC Tennessee, ranks high in incidence of several tick borne diseases. Though the Rocky Mountains are far off and those states are among the lowest incidence of the disease, Rocky Mountain Spotted Fever occurs in Tennessee at the rate of between 10 and 14.9 cases per million people, among eight highest states in the nation. Arkansas and the Carolinas, which all border Tennessee, have the highest occurrence at 15 or more cases per million people. This disease is clearly misnamed, perhaps because people found Appalachian Mountain Spotted Fever too difficult to spell without using spell check, but they still wanted to name it after an easy to spell American mountain range (sorry Adirondacks!). Your Intrepid Pharmacist says to write your Congressman and the CDC and demand a name/location change! (That forwarded email I received claiming "we need a universal sarcasm font” was right. We need one).

Tennessee ranks among the top three in the nation for the icky sounding illness erlichiosis. Happily, Tennessee is among the bottom states for Lyme Disease incidence, with only 24 occurrences in 2008, compared to a whopping 2,738 cases in the comparatively small confines of Connecticut, where Lyme disease and its name originate.

Now there are a lot of factors to tick induced illnesses: geography, type of tick (yes, there are several), treatments for the tick bite (usually doxycycline), and you can read on these via the hyperlinks located throughout this column and at the CDC tick website. The focus here is the more important prevention and, failing that, successful tick removal, the latter of which is rife with Old Wives Tales that can be harmful.

Your Intrepid Pharmacist will be the first to tell you that prevention is not new news, but somehow these details escape people’s thinking when they are planning outdoor activities. First and foremost, wear light colored clothing! Yes, jeans are always the durable outdoor attire of choice (short leg “jorts” or long leg versions). They are durable, comfortable, hide dirt stains well, and, in the hands of the Abercrombie & Fitch people, sexy. And we all know nothing makes one feel and look sexier than wearing a pair of A&F jeans while sweating buckets on hike through the forest in summer or autumn heat.  Tick season does not end just because spring and summer do.

Ticks are a nice dark brown and blend into the dark blue of denim quite easily. Understand, too, that deer ticks are very tiny, almost pinhead tiny, unlike the more commonly thought of kind in the picture above, making them difficult to spot on light clothing and impossible to see on dark colors. Consider light blue colored jeans or a lighter color of denim all together. White jeans are good. No, they don’t hide dirt well. Nor are not as sexy as the dark A&F ones, but they will make anything dark crawling on you very easy to spot, and they can be bleached in the wash. Those not wearing denim should also consider light blues, white or a very light khaki. Ditto on the shirts: avoid black, brown, red, navy blue, dark green, etc. White and yellow are excellent color choices here as the brown ticks (and any other spider or random insect) will instantly stand out.

Insect repellants are another good prevention. Aside from keeping away pesky mosquitoes and their West Nile Virus, these also discourage tick attachment. Again, what is it with the geographic disconnect? We are nowhere near the Nile river! Is West Mississippi Virus really that hard to spell (or pronounce)? Disease naming digressions aside, be sure to read the insect repellent can and see how often reapplication needs to occur. Yes, read the instructions! Nothing annoys your Intrepid Pharmacist more than when people call him asking him doses and usage rules that are printed on the can they are holding in their other hand, usually after they have already used it. Why would you spray chemicals on yourself or your child without reading what it was and how it is used? And people think the super glue sequence in American Pie 2 was implausible! Ha! Anyways, even if you are wearing long pants still apply the insect repellant, since a tick can crawl up the inside of a pant leg just as easy as it can the outside, though the latter is the more likely place they’ll first land.

And lastly, after coming in from the outdoors or once returning to your campsite conduct a thorough inspection of your body, or someone else’s (hey, it works for the monkeys!) . This is providing you trust the other person not to go “OMG! There’s one in the middle of your back, fat as blueberry!” just so they can see you freak out and dance around screaming “get it off!” because there’s something you can’t see or reach sucking your blood that isn’t Robert Pattinson. Only to be followed by the long pause follow-up of “wait, no, sorry, it’s just a piece of dirt, mole, etc.” During the post-outdoors check look especially at the back of the knees, groin area, underarms, under breasts (more on that next column), butt crack, behind ears, in the hair and beards, and yes, even the back (more on that next column, too).

So, the three rules for tick bite prevention: wear light colored clothing, use properly selected pest repellent, and perform a post outdoors body check.

Important stand-alone note: “Coming in from the outdoors” covers anytime you or your children are outdoors. Ticks can be picked up while you are sitting on your front lawn (or kneeling in the flower bed) just as easily as they can when you are hiking a nature trail at the local park. Check for them, always. And should you find one, the next column will tell you what to do about it. In the meantime, don’t panic! And don’t get the kerosene, either.


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