1 Photo
2007
James Gathany
This 2007 photograph depicts the pathognomonic erythematous rash in the pattern of a “bull’s-eye”, which manifested at the site of a tick bite on this Maryland woman’s posterior right upper arm, who’d subsequently contracted Lyme disease. Lyme disease patients who are diagnosed early, and receive proper antibiotic treatment, usually recover rapidly and completely. A key component of early diagnosis is recognition of the characteristic Lyme disease rash called erythema migrans. This rash often manifests itself in a “bull's-eye” appearance, and is observed in about 80% of Lyme disease patients.
Lyme disease is caused by the bacterium Borrelia burgdorferi, and is transmitted to humans by the bite of infected blacklegged ticks. Typical symptoms include fever, headache, fatigue, and as illustrated here, the characteristic skin rash called erythema migrans. If left untreated, infection can spread to joints, the heart, and the nervous system. Note that there are a number of PHIL images related to this disease and its vectors.
Spring is in full swing—and, unfortunately, tick season is well on its way, too.
Experts are expecting this year to be particularly rough, mainly because the South Fork had so much snow this winter: Snow keeps ticks moist and safe instead of killing them off. That means an earlier start for the bites of adult lone star and dog ticks that people normally wouldn’t experience until fall.
“With the high amount of snow … it actually acted like insulation. So the ticks have been living under that insulation all winter,” said Dr. Jerry Simons, a physician assistant at East Hampton Family Medicine who also serves on the advisory panel for Southampton Hospital’s Tick-Borne Disease Resource Center.
Dr. Simons noted that he already had patients coming to him with tick bites in March. “As the ticks are waking up, they’re, of course, very angry—and very hungry.”
With that in mind, and with May being Lyme Disease Awareness Month, experts are encouraging South Fork residents to be extra vigilant outdoors. They recommend wearing long pants and shirts with long sleeves, as well as hats and socks, if venturing out into wooded or grassy areas. They also suggest that it’s best for people stay out of those kinds of areas as much as possible to prevent exposure.
Many also advise frequent applications of insect repellent such as DEET, or even permethrin, a synthetic chemical commonly found in repellents.
Dr. George Dempsey, a physician at East Hampton Family Medicine and also a member of the Tick-Borne Disease Resource Center’s advisory panel, said that spraying permethrin on shoes at least would be effective in repelling ticks for several weeks, and that clothes can be purchased that are laden with enough permethrin to last through as many as 60 wash cycles. “It’s very hard to be diligent,” he said. “I think if you do that, you will be able to decrease your risk.”
If a person does get bitten by a tick, experts agree that it is not necessary to get tested immediately for Lyme disease or other tick-borne illnesses, especially if the tick is removed within a few hours.
They recommend keeping the tick once it’s removed, though, so that it can be shown to a doctor if the person who has been bitten starts feeling under the weather shortly afterward. Also, when a tick is found on the body or on clothing, the clothing should be run through the clothes dryer rather than washed, as heat will kill ticks.
When symptoms of a tick-borne illness do arise—they range from skin rashes and itching to fevers and aches and pains, according to the Centers for Disease Control and Prevention—it is important to see a doctor right away.
Brian Kelly, a tick and mosquito control specialist and owner of East End Tick and Mosquito Control, even suggests that local residents or frequent visitors get tested at least once a year, regardless if there are any known bites or not. “I’d rather be safe than sorry,” Mr. Kelly said. “Just because you aren’t in a trail in the middle of the woods on Shelter Island doesn’t mean you won’t get a tick.”
A common tick-borne illness is Lyme disease, usually carried by the backlegged, or deer, tick, which is also one of the most prevalent ticks on the South Fork. The alpha-gal allergy, transmitted by the lone star tick as well, causes a mammalian meat allergy in humans, with symptoms occurring just four hours after consuming meat. Powassan virus is another illness unique to the Northeast that, according to the CDC, has been known to affect only about 60 individuals over the last decade, but it induces symptoms that are more severe than those associated with Lyme.
Over the last year, the Tick-Borne Disease Resource Center at Southampton Hospital has worked to educate the South Fork community and beyond about ticks. Since its inception last spring, the center has held many panels and discussions featuring leaders in the medical field talking about prevention, education, diagnosis and treatment. It has also launched a hotline that people from all over the country can call with questions about ticks and tick bites.
“I think it’s been an outstanding resource for the community as a whole. It’s really been a resource for anyone, even people outside our local communities,” said Dr. Erin McGintee, a member of the center’s advisory panel and an allergist at ENT and Allergy Associates in Southampton. Dr. McGintee sees and treats many individuals who have contracted the alpha-gal allergy. “It’s really a huge issue. Tick-borne diseases are really complicated, so there’s a lot of questions and misinformation out there. The goal of the resource center is to correct information out there to the public and help point people in the right direction.”
Mr. Kelly also recently donated $25,000 to the center to put toward pediatric education on the subject of ticks. This spring, the Tick-Borne Disease Resource Center will partner with the Children’s Museum of the East End in Bridgehampton to create educational programs for children about ticks and bites.
Dr. Joseph Quinn, a pediatrician at Southampton Pediatric Associates and a member of the center’s advisory panel, said it is important for kids to learn about ticks because they play outside. “I think a lot of the education actually occurs inside a lot of doctors’ offices,” said Dr. Quinn, who said he sees about 200 children a year for tick bites. “As far as the tick center, it is an additional resource for people. I think it’s been helpful as far as being able to reach more people.”
Other organizations have also jumped in to educate people about ticks. In late March, the Cornell Cooperative Extension of Suffolk County launched a free tick identification phone application called TickClick. It provides photographs of ticks and information about safe removal and destruction, health concerns, and information and precautions for pets. According to a press release from the organization, the application was funded with an $8,000 grant to Cornell’s Agricultural Program from the New York State Integrated Pest Management Program.
Experts in the medical field are continuing to research different strands of tick-borne illnesses in order to better understand how diseases work and how aggressive they can actually be.
“There’s a lot to talk about in that area—the whole ecology and the prevention, and all the techniques that can be done. It’s a whole area of knowledge that needs to be acquired,” Dr. Dempsey said. “It’s more than just mowing your lawn.”
Alyssa Melillo on May 4, 2015