Summer is tick season. Are you prepared to prevent tick-borne disease?

We talk a lot about the importance of identifying changing moles and having them checked, since a mole that changes size is one of the warning signs for skin cancer.  That’s why, at least once each summer, someone will come into the clinic with a “changing mole” or a “blood blister" only to learn it’s actually an engorged tick. Learn how to avoid ticks and tick-borne disease this summer.

The Prevalence of Ticks in Ohio

Though it’s not the most charming thing to discuss (or remove!) ticks are a reality here in Ohio, and 2024's tick season began early, thanks to a warming climate. According to Diane Caporale, Professor Emeritus at the University of Wisconsin-Stevens Point (UWSP), the survival of ticks through milder winters is a key factor contributing to their early emergence.

Ticks are "very common" in central Ohio, Ohio State University assistant professor Tim McDermott said. The tick that causes Lyme disease, the blacklegged tick, prefers to live in the woods. Other tickborne diseases that are common in Ohio include Rocky Mountain spotted fever (RMSF), anaplasmosis, babesiosis, and ehrlichiosis. Less common diseases that may be carried by Ohio ticks include tularemia, southern tick-associated rash illness (STARI), and Powassan virus. 

Prior to 2010, there were no known established populations of the blacklegged tick, the vector that transmits lyme disease, in Ohio.  Since then, the tick has spread into Ohio and can now be found in at least 60 counties mostly in the eastern, southern, and central parts of the state. Ixodes scapularis, also known as the blacklegged tick or the deer tick, is a small, black bodied tick that primarily lives off of the white tailed deer. It lives on the forest floor and can hang from vegetation to attach itself to prey. Most humans are infected through the bites of immature ticks called nymphs. Nymphs are tiny (less than 2 mm) and difficult to see; they feed during the spring and summer months.

Tick-borne Lyme Disease

Lyme disease rates have risen proportionally with the growth of the tick population.  In 2010, there were 37 cases of Lyme disease in Ohio. By 2023, there were 1,298, a 35-fold increase, according to the Ohio Department of Health (ODH). 

Lyme disease is caused by the transmission of the bacteria borrelia burgdorferi from the tick to humans.  The primary initial presentation of the disease is a red, expanding, ring-like rash occurring 7-15 days after tick detachment that has a “bulls eye” appearance.  It is important that this stage of disease be recognized and treated appropriately because if left untreated, the infection can spread internally causing organ system and nervous system damage.

Other Common Tick-borne Diseases

Rocky Mountain Spotted Fever

In Ohio, the American Dog Tick is the insect most likely to carry RMSF. Early signs and symptoms of the infection mimic common flu, and a rash is also common. The rash typically develops 2 to 4 days after the fever begins, and the look varies from red splotches to pinpoint dots. Since the rash appears late in the illness, it’s important to seek care early. If you develop flu-like symptoms after a tick bite or after being in a wooded area or locations with high brush, seek medical care immediately. RMSF can be deadly, but is much less severe if treated early with antibiotics. Long term effects of severe illness can include blood vessel damage in extremities, requiring amputation, hearing loss, and mental disability.   

Anaplasmosis

Anaplasmosis is caused by the bite of the blacklegged tick. Like other tick-borne diseases, it usually presents with flu-like symptoms, which usually begin 1-2 weeks after a tick bite. As with other tick-borne diseases, early treatment is critical to prevent more serious outcomes such as respiratory failure, bleeding issues, organ failure, and death. 

Babesiosis and ehrlichiosis

Babesiosis and ehrlichiosis are other less-common tick-borne diseases that occur here in the midwest and begin with similar flu-like symptoms. 

The most important way to avoid tick-borne disease is to avoid getting bitten by ticks in the first place. Apply an insect repellent with DEET before any exposure to normal tick habitats. If you do identify a tick attached to your skin, then the proper way to remove it is with tweezers. Grasp the tick as close to the base of the skin as possible and pull upward with steady, even pressure.  Do not twist or jerk the tick. Avoid “fokelore” remedies such as nail polish, petroleum jelly, or burning the tick off.  

Call your dermatologist if you develop a rash at the site of the tick bite and seek medical care if you develop flu-like symptoms after a tick bite.