No Walk in the Park

By Dr. Gerard Muraida

In addition to the heat, hydration issues, and uninvited ants that come with summer, we often don’t hear much about another pest that can have profound lingering health issues. I am referring to ticks.

Although New Mexico is not considered a hot spot for ticks, they are present here, especially between May and August. Ticks are out and about in forests, rivers, and other heavily wooded areas. You will typically find the Rocky Mountain wood tick in our higher elevation habitats, including meadows, shrubs, and lightly wooded areas. They sit in low-growing vegetation around trails and grasslands. Tall grass is especially conducive for ticks as they lie in wait for a human or animal to pass by.

Ticks are a concern because they carry a multitude of diseases. Two of the most worrisome are Lyme disease and Rocky Mountain spotted fever (RMSF). To protect yourself against infection, be aware of tick habitat, and consider using an Environmental Protection Agency-approved repellant, being sure to follow the manufacturer’s instructions. Most of the repellants approved for mosquitoes are also approved for ticks. Check yourself and your pet(s) before you get back into your car after conducting outdoor activities such as hiking, biking, or picnicking, and repeat the process in your shower or bath within two hours of returning home. Place your clothes in the dryer for 10 minutes to kill any loose ticks from later finding their way back to you. Pick your picnic areas and campsites carefully. Choosing an open space away from thick vegetation doesn’t guarantee that it’s tick-free, but it does greatly diminish your risk.

If you discover a tick embedded in the skin, grasp the tick as close to the skin’s surface as possible, using tweezers if available. Pull upward with a steady, continuous motion. To ensure the whole tick is removed, try not to twist it or jerk it. The tick must be attached for 36-48 hours to transmit infection.

The incidence of tick- borne diseases are on the rise. Patients presenting with flulike symptoms during the spring and summer months may be suspect. Prompt diagnosis and treatment can prevent complications and death. Location of exposure, identification of the specific tick vector, and evaluation of rash, if present, help identify the specific disease.

Lyme disease presents with an “erythema migrans” rash, or bull’s eye rash, in 70 percent to 80 percent of patients, and treatment may be initiated based upon this finding alone. RMSF presents with a “macular rash,” or flat skin discoloration, starting on the wrists, forearms, and ankles and turning purple in color. RMSF has a higher rate of mortality than other tickborne diseases, so treatment with doxycycline is recommended for all patients, including pregnant women and children, when there is high clinical suspicion.

Protective clothing and tick repellents are effective in reducing the risk of tickborne diseases. Long-sleeved shirts tucked into pants and pants tucked into socks limit exposed skin for ticks to bite. Repellents containing DEET (N,N-diethyl-m-toluamide), Picardin, and IR3535 provide effective protection against ticks. DEET is safe in the second and third trimester of pregnancy and for children older than 2 months. Permethrin can be sprayed on clothing to also repel ticks.

Now that you know some simple tick precautions, remember to pack the sunscreen, and stay hydrated.

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