Prothonotary Warbler

Prothonotary Warbler

Monday, 4 May 2015

Tick Talk....it's Lyme Tyme!

If you spend any time in the out-of-doors in southern Ontario this season, this blog post may be one of the most important things you read if you value your health! And not just if you spend time in southern Ontario, but many other parts of Ontario, Canada and the US.

Spring is here, finally, and the weather is much more enjoyable to be outside. But some of the critters that inhabit natural areas have been awaiting spring as well, and they may be hazardous to your health. Ticks need a blood meal to assist in their development, and before they produce young.

Ticks can occur in long grassy and shrubby areas:

They can also occur in more heavily wooded areas:

There are actually at least 17 kinds of ticks found in southern Ontario, but the two that are most likely to be found on humans are: the Wood Tick (a.k.a. American Dog Tick) and the Black-legged Tick (a.k.a. Deer Tick). Technically they are not insects, which have six legs. They are Invertebrates, as are insects, but part of the Arachnid group which includes spiders; members of this group have eight legs.

This first photo is a close-up of a Black-legged Tick (Deer Tick).


If you want to get a better idea of its size, note the next photo.
This full sized adult's body is only about two millimetres in length. And the young, called nymphs and which also feed on blood, are a fraction of this size!

An adult Wood Tick, on the other hand, is several times the size of the Deer Tick. Note this next photo of a Wood Tick, and compare the colouration and pattern with the Deer Tick.
Note also the way that the tick clings to a blade of grass, with its front legs stretched out. They have little hooks on the end of the front legs to be able to grab onto something as it passes by. That something could be a mouse, a deer or a bird......or you. Once it grabs onto a passing creature, it starts to search for some way to get to the skin, so it can attach itself by its mouth-parts and begin to bite into the skin looking for a blood vessel. Common locations are at a spot where there is a restriction of clothing, such as at the waist or behind the knee, but it may latch onto the skin at any point, even at the hairline on the back of the neck. Wherever the attachment happens to be, it will feed for as long as it can, usually for several hours. By engorging on the victim's blood, the tick will swell to several times its previously flattened size. Fully engorged, it can look like a small grape! At that point, it will detach itself from the victim, and drop to the ground and use the protein in its blood meal to grow or produce young.

In many cases of a tick bite, nothing will happen. In fact Wood Ticks are not known to be vectors of Lyme Disease (LD) at all, only the Deer Tick. (Having said that, there is concern by some that other biting invertebrates including Wood Ticks which bite a host critter carrying LD may spread the disease, but nothing is conclusive yet.) Not even all Deer Tick bites will do damage. However some ticks do carry the spirochete that when transmitted via its bite, will result in the victim getting LD.

If you happen to get bitten by a Deer Tick carrying the LD spirochete, things may then become quite interesting, but not in a good way.

First stage symptoms typically result in the victim feeling like they are coming down with the flu.....e.g. tired, fatigue, sore and aching muscles. These are telltale symptoms, especially if it isn't a normal season for getting the flu. A more conclusive indication of dealing with LD is noticing a rash. It isn't normally itchy, but it may feel warm. It may take on different appearances, but usually will spread to become several centimetres in diameter and then start to clear in the middle, resulting in some form of a 'bull's-eye' rash. If it occurs in an area of the body that isn't visible to the person, one could easily miss it. It is believed that only 30-40% of LD tick bites result in a bull's-eye rash, but that low % may be because by the time a person gets properly assessed, the rash may have disappeared on its own, or it may occur in an area that is not visible. Regardless, don't rely on the presence of or lack of a bull's-eye rash to determine whether you have LD.....the flu-like symptoms are more reliable.

I have had the misfortune to have been bitten over the years by a LD carrying Deer Tick on at least 6 occasions. The first time was in 1976, when LD was not on anyone's radar for the Rondeau area. In fact at that time it was believed that LD only occurred in the greater Long Point area. I know of several field biologist colleagues or acquaintances who contracted LD from field work at Long Point in the 1960s and early 1970s.

All of my occurrences were from my extensive field time at Rondeau. As the former Park Naturalist who spent as much time as possible roaming around the park looking to document and photograph plants, birds, herps and almost anything else of natural history interest, I was often well off the trail, and if anyone was likely to get LD, it was me. Rondeau has been a favourite place of mine to explore going back to the late 1960s and continues to this day. Every year I spend hundreds of hours in the field in my quest to discover, document and photograph Rondeau's biodiversity. In one sense, considering how much time I have spent roaming the wilds of Rondeau over the decades, it is surprising I have only contracted LD a few times. But that is okay......6 times is enough!

On four of these occasions, I noticed a rash. The photographer in me decided to take some photos to document my experience so here is what the rash can look like. The first image shows the bull's-eye rash on my forearm that I received in 2006. The very circular rash was quite pinkish, and as it expanded, eventually showed the clearing in the middle.

The next image shows the bull's-eye rash I received from a tick bite in 2013, on my side a bit above my belt line. The bull's-eye is still evident here, but isn't quite as classic as the previous one.


This third image brings us to 2015. Some readers will be aware of my ongoing interest to document some of Rondeau's largest trees which feature old growth characteristics. I've collected data to include the diameter, species and GPS location. And most of the almost 275 trees I've documented in the last couple of months have been well off the trail, not surprisingly. A little over two weeks ago I woke up one morning and found a Deer Tick which had attached itself to my lower leg. I consider myself reasonably vigilant when it comes to ticks, yet this one escaped my initial checks. However by the time I noticed it, it had been squashed, and all the blood that it had engorged on had been forced back under my skin. At first there was just the very dark centre which featured the regurgitated blood. But after a few days, the rash appeared. After a couple more days, the centre started to clear. If it hadn't been for the regurgitated blood at the centre of the tick bite, I am sure the entire centre would be clear.

I experienced the first stage symptoms of LD once again....extreme tiredness, aching muscles, feeling like I was getting the flu. A visit to the doctor was necessary, and now I am on antibiotics for three weeks. Taking antibiotics means, among other things, that I should avoid spending much time in the sun. So I must limit my time on bright sunny days and plan my outings, if I feel up to it, during the cooler morning or evening hours when the sun is not as intense. Also I try and cover up as much as possible. Hopefully by the time I am finished my current round of antibiotics, that will conclude this episode of LD.

It wasn't that long ago that LD was not recognized by the traditional medical establishment as occurring in Chatham-Kent. The standard response from many was that while it may occur in the US, it only occurred in Canada in very restricted areas (e.g. Long Point), and in very low numbers. In fact when I was diagnosed with it in 2004, it was a reportable disease, so shortly after I visited the doctor and got antibiotics, I got a follow-up telephone call from someone in the local health unit who told me "You know, Mr. Woodliffe, Lyme Disease doesn't occur in Chatham-Kent." Unbeknownst to this person, confirmation of LD carrying ticks in C-K had been published in a medical journal two years before! But at the time, the front line medical personnel here and in most other places in Canada, as directed by Health Canada, refused to believe that LD was as widespread as it really was.

Fortunately the level of knowledge and understanding of LD since then has increased dramatically across Canada. As unfortunate as it is in contracting LD, when celebrities get it (note the recent publicity concerning Avril Lavigne), the general public as well as the politicians and medical professionals will hopefully gain a better awareness and understanding of this serious disease. Awareness is far from ideal, but much improved from only a short time ago.

One of many complicating factors in assessing and treating LD is that if you catch it in its earliest stages, it is easily treatable with antibiotics, usually for a 3-4 week period. But if it is missed, even though the first stage symptoms can disappear and one feels like it is behind you, the spirochete remains, and can attack different systems in your body. Each person reacts differently, presumably depending on the initial health of the person. The condition of the immune system is undoubtedly a factor, as is where the spirochete ends up. In extreme cases, some people have become quite crippled in just a few weeks. In other cases, LD has been mis-diagnosed as Multiple Sclerosis, Chronic Fatigue Syndrome, Fibromyalgia, and other serious conditions. Treatment for such conditions is very expensive, unlike the inexpensive antibiotic treatment for LD.
Deer Tick territory
 As mentioned earlier, I first contracted LD back in 1976. It went untreated, and almost immediately, even though the first stage symptoms had subsided, I noticed changes that should not have been happening to me. As a long distance runner and quite healthy individual at that time, I should not have been experiencing the many annoying things that were happening to me. Fortunately I did not deteriorate to the very serious level that some LD sufferers experience. I am not going to describe all of the frustrations I have had over the years in dealing with medical professionals and others with respect to dealing with LD. Suffice to say, it has not been a fun time! But at least treatment for first stage symptoms of LD has become much more available.

This post is not going to address the vast misunderstandings of assessing and treating LD. However improper treatment at the outset can result in Chronic Lyme Disease, which is extremely difficult to assess and treat.There have been many, many scientific and other articles written discussing the health science and politics around this challenging disease which can affect people in so many different ways. One of the most authoritative sources of information on the subject is the Canadian Lyme Disease Foundation. Check out its extensive web site here.

The best way to deal with the potential risks of LD is to avoid it if you can. Don't just stay at home and avoid natural areas, but play it smart. Some recommendations are:
  • wherever possible, avoid grassy, shrubby areas in areas where LD is known to occur;
  • wear light coloured and unpatterned clothing so if a tick grasps it as you pass by, it is more easily spotted;
  • stay on the trail to avoid brushing by shrubs or other vegetation where ticks may be;
  • if you are hiking with a friend or co-worker, keep an eye out for ticks on each other;
  • wear long pants, socks and shoes, not shorts and sandals;
  • tuck pant legs into your socks. It may not be the most fashionable, but it will help keep any ticks on the outside and more easily spotted for removal before they do their dastardly deed;
  • spray repellent with DEET around socks and shoes;
  • there are some products available at outdoor stores which can be sprayed on clothing (not skin!)....the applied chemical on the clothing must be completely dry before you wear them. This can repel and kill ticks and other biting insects (e.g. chiggers) for several weeks, and last for at least a couple of washings;
  • if you have a pet with you, they are just as vulnerable to ticks as you are, so should be checked as soon as possible when you leave a potentially infested area. Otherwise, they may share their ticks with you at a later date;
  • when you come in from an area where Deer Ticks are known, do a tick check as soon as possible;
  • put clothes you have been wearing in tick habitat, into a safe container, even directly into a washing machine. It is not advisable to leave them in the room that you will be sleeping in, as any ticks that may have been on your clothing might find you while you sleep!
If you find a tick attached to your skin, don't grab it by the abdomen, the largest body part, and pull it out. The head may break off, resulting in infection. If it has started to feed, grabbing the abdomen will squeeze the stomach contents into you. Instead use a pair of tweezers and grasp the tick as close to the skin as possible and gently but firmly pull the tick until it releases its grip. Do not use nail polish, a burned match or anything like that to press on the body, as the tick will likely regurgitate the contents of its stomach, which may include the LD causing spirochete it is carrying. Some local health units have a tick awareness package, complete with removal instructions and even a tool to facilitate removing a tick.

This blog post is not intended to diagnose or treat Lyme Disease. The intent is to share my experiences with LD carrying Deer Ticks, hopefully raising awareness of the dangers of enjoying infested areas, while doing so relatively safely.

Walk in the middle of the trail to avoid vegetation where ticks may be lurking.

May is Lyme Disease Awareness Month

Enjoy the out of doors, but be safe!!!!








17 comments:

  1. fascinating article Allen, I don't think I have heard of another person getting Lyme 6 times!

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    1. Hi Nate...thanks for the comment. And getting zapped by LD that many times isn't a claim to fame I would like :-)

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  2. Thank you Allen! I found a tick on me today - it was on the sleeve of my white shirt so the light clothing really helped me to see it. I stayed on the trail and didn't think I was anywhere near a tick type area and I had my pants tucked into my socks as well so it was a bit startling to find it. I soaked extra long in the hot-tub to be sure I drown any on me :)

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    1. Hi Mary....I'm glad you were prepared and found the little rascal sooner rather than later. A long soak in the hot tub is probably a good idea too.....I don't have any special insight into a tick's feelings, but I don't think they would like an extra long soak in it as much as you would.

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    2. I believe they are quite difficult to drown.

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  3. Fantastic article Allen! I will definitely be sharing this to many of my nature friends (and I see it's already been making it's round on facebook!). Sorry to hear you are on yet another round of antibiotics for LD...and so early into the season too!

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    1. Hi Tianna....thanks for your comment. It has been getting lots of attention, and I am glad since it is something that so many people may be at risk for.

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  4. Allen, some people have all the (bad) luck, either that or the ticks (like the chiggers) find you particularly tasty. I had had someone (fairly knowledgable, or so I thought) indicate that Deer ticks tended to be more of a late summer species, vs. and early spring species. Apparently not!
    Also, I read somewhere recently that the Deer tick can also carry & transmit a version of Powassan disease, and that it has been confirmed in Ontario as well. I had never heard of it before. Have you come across any good resources on that particular disease while doing your research on Lyme Disease?
    Deb

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    1. Hi Deb.....certainly the ticks and chiggers make the field season a little challenging.

      I don't know much about Powassan disease....just what Google turns up. It is apparently similar to LD in that Deer Ticks are believed to be the main vector. So far it has been quite limited in its occurrence, at least that is the official stance.

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  5. This is a well-written post, Allen. Great to see those rash photos. This is information that we need our physicians better educated about. And everyone of us needs to know that there are many Lyme rash variations and that some people experience no rash. Apparently ticks are able to survive the washing cycles. So, it is now suggested that people toss their outdoor clothing in a hot drier for 10 to 20 minutes when they come indoors before washing them. The heat will dry the ticks out and kill them and then the clothes can be tossed into the washer. Thanks for promoting awareness about LD.

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    1. Thanks for your comments, Linda, and a good point about putting clothes in a hot dryer first to make sure any ticks are dead!

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  6. thank you for the very useful information. how can we get recognition and allow longer term antibiotics? There must be a way to control the tick population somehow so that this does not be come an epidemic as it is in some US states.

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    1. Hi Irene. Good question about recognition and treatment. Unfortunately all of that comes to some extent under the jurisdiction of Public Health Canada, and they seem reluctant to embrace an aggressive response to LD. I know that the Canadian Lyme Disease Foundation has put an enormous amount of effort into getting PHC and other officials they rely on to recognize the flaws in the current process. It is an uphill battle, and no doubt pharmaceutical companies are applying their own pressure on government to not do the right thing. After all, when these companies make huge profits providing pharmaceutical products for treating things like CFS, ALS, fibromyalgia and many other conditions that are sometimes misdiagnosed when it is really LD, there is no incentive to support using something as unprofitable as generic antibiotics!

      An MPP from the Renfrew area is a strong supporter of proper diagnosis and treatment for LD, and has tried to get the current Liberal gov't to act accordingly. Unfortunately he is in the opposition and hasn't had much success to date.

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  7. Hi Allen, a very well written blog on LD,I have brought unwanted visitors to my cabin after a photo hike. I now tuck everything in when I am out, and wear light color clothes. I leave all my clothing inside out on the deck and check several times to ensure no ticks are lurking in the corners...no dryer or washer at the lake. Sorry to hear that you have suffered with LD!
    Jade

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  8. Hi Jade. Thanks for the visit and comments. It sounds like you are taking the right approach. Hopefully your vigilance keeps you safe!

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  9. Great article. I live in a very different area (Nicaragua), but I receive about 1-5 tick bites a month due to the job. Recently, I've had some odd flu symptoms for more than 5 days and I've come to the conclusion that it may be some form of bacteria the ticks released into my blood stream. Unfortunately, Nicaragua does not have sufficient medical resources so I've started the rounds of doxycycline to see if it helps. Any experience with other tick borne illness outside of LD? Supposedly, LD does not exist down here. Thanks for sharing your experience.

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    1. Hi Amante. Thanks for your visit and comments. Doxycycline seems to be the preferred antibiotic, in my experience. There are other tick borne illnesses (e.g. Rocky Mountain Fever) but I am not sure what might be lurking in Nicaragua. I have been to Costa Rica four times in the past (1980s and 1990s) but don't recall hearing about any tick related problems, and I never encountered any ticks during those times. Sorry I cannot be of much help!

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