House Calls / There’s a new tick in town
Over the past few months, Southern Connecticut residents have been greeted by a new and unwelcomed guest; the Amblyomma americanum or “Lone Star” tick. Originally found living in warmer climates along the southeast coastal states, this tick has recently migrated northwards as temperatures have warmed over the past few years. Until now, most of the ticks found in Connecticut were either deer ticks or dog ticks. That has all changed with the discovery of a Lone Star tick breeding ground in the Norwalk area of the state.
Unlike dog or deer ticks, Lone Star ticks are easily identifiable by their distinctive white mark on their back (female ticks). Although this tick does not transmit Lyme disease, it can transmit other diseases including Ehrlichiosis.
A unique and disturbing reaction caused by a Lone Star tick bite is the development of an allergy to eating red meat and pork. While rare, this allergic reaction can result in severe and life threatening symptoms, including a rash followed by shortness of breath, anaphylaxis and death. Although the exact mechanism of action is still unknown, the allergy may be initiated by activating a patient’s immune system which reacts to ingesting red meat. Dr. Michael Rajkumar, an infectious disease specialist in Norwich, Connecticut says, “In the past, no one believed that humans could develop an allergy to mammalian meat, however, that all changed when cases were noted in the southeastern states where the Lone Star ticks are prevalent.” Dr. Rajkumar believes a protein found in the saliva of the tick is responsible. “We now know that Alpha-gal (a sugar found in red meat) can cause us to produce IgE antibodies to meat. The Lone Star tick bite exposes humans to Alpha-gal and increases the production of IgE antibodies and primes our immune system. Thus, any subsequent consumption of red meat can then leads to this allergic reaction.”
A second tick has also made its way into the Northeast and may ultimately arrive in Connecticut. Haemaphysalis longicornis also referred to as the “Asian Long horned” tick has been found as close as New York and New Jersey. Endemic to countries in the Far East, this tick can transmit a virus which may lead to low platelets and a severe fever has which been found to be fatal in as much as 30 percent of patients contracting this disease. Thus far, examination of these ticks by the Center for Disease Controls has not found any evidence that they are carrying any bacteria or deadly viruses.
If bitten by a tick, identification of the type is clearly important yet can be difficult. In general, deer ticks tend to be small and may have an orange/red appearance. Dog ticks tend to be larger and have may have a gray rounded tortoise-like shell appearance. Lone Star ticks generally have the recognizable white dot in the center of their back and may look slightly red or orange as well and the Asian Long Horned tick may appear dark brown in color and is also generally larger than the deer tick. In the event you are bitten by a tick and are unable to determine which type it is, you should save the tick and bring it to your local health department where they should able to identify the tick and examine it for diseases.
Once a tick is found, remove it immediately. Fortunately, if a tick is removed within 36-48 hours of a bite, the risk of transmission of any disease is remote. Therefore, make certain to look for ticks in all locations of the body including under the arms, under the breasts and behind the neck. Have someone look over areas which are difficult to explore including your back and gluteal regions. If you find a tick, there are ways to safely remove them. Apply fine tipped tweezers under the tick and as close to the skin as possible. One trick is to apply oil to the area as you apply upwards pressure. Corn or olive oil works best. The tick should come out intact. If you rip or tear off part of the tick, visit your health care provider to remove the remaining tick part.
Prevention is the first line of treatment for all types of tick bites. In addition, try to avoid wooded areas and locations with weeds or tall grass. Applying sprays containing DEET (or permethrin) to clothes, shoes, socks and exposed skin areas will help. One misconception is that wearing light colored clothing will reduce your risk. In actuality, dark clothing has been shown to prevent more tick bites. However, it is obviously easier to detect the presence of a tick while wearing lighter colored clothing.
If you have experienced a tick bite and are not sure of the duration, visit your physician to discuss. There are many medications available which can treat and/or prevent the risk of developing many diseases transmitted by these pests. Embedded ticks can cause other skin infections which can be dangerous. Finding a tick on you is not the end of the world. Use common sense and you can significantly reduce your risk of contracting a disease.
Dr. Michael Schwartz is Board Certified in Internal Medicine and is affiliated with Soundview Medical Associates with a private practice in Darien. For comments or questions, visit his web site at drmichaelbschwartz.com.