Where and when are ticks found in nature?
Ticks are more active outdoors in warm weather, but can attack a host at any time. Changes in temperature and day length are some of the factors signaling a tick to seek a host. The activity of ticks depends on several factors - mainly on the temperature and humidity therefore they are the most numerous from spring to autumn. They are found hidden in the leaves and branches of shrubs, low plants (up to 1 m) shrubs; in the ground layer of forest edge, along with walking, gardens, picnic etc. Ticks can also be found in most wooded or forested regions throughout the world and are especially abundant near water, where warm-blooded animals come to drink, in meadows wherever shrubs and brush provide woody surfaces and cover.
In Croatia, the most common are forest ticks (Ixodes ricinus). They are the most active in spring and early summer (May), and in early fall (in much smaller numbers). In winter (December - March) ticks are encountered in cases of mild winter without the cold and snow.
How Ticks come to us?
Hidden on a blade of grass, branches and leaves of shrubs and trees, waiting for the passage of its’ suitable accommodation: warm-blooded animals or humans. Structure of their feet is adapted to the acceptance on the fur or hair of animals or on clothing of people. Tick bites are generally painless. Many people may not even notice the bite and may never find the tick if it falls off.
Which are the diseases transmitted by ticks?
Ticks are important as transmitters of infectious diseases. In Croatia, the bite of ticks can transmit Lyme disease and Tick-borne Encephalitis (TBE), and in some cases Q fever, Ehrlichiosis, Babesiosis and some Rickettsial diseases.
How can we prevent tick bite?
When going for walks in nature, recreation, or staying in the open we should always think of the possibility of tick bites. Therefore it is necessary to:
- Avoid areas heavily populated by ticks, in such areas walk on marked trails (avoid crawling through the bushes, leaving your clothes on the bushes/grass and lying on the ground).
- Use appropriate footwear and clothing during stay in the countryside-wear long trousers and shirts/blouses with long sleeves, closed shoes.
- Wear light-colored clothing so ticks can be easily seen, and brush them off.
- Tuck pants into boots or socks.
- Apply insect repellant, specifically the brands designed to repel ticks. Follow label instructions. They last up to several hours, depending on the sweating. Avoid use of DEET-containing repellents on children. Carefully follow instructions and apply some repellents directly to skin and others to clothing.
- Promptly check yourself, others, and pets if exposed to tick areas. Check yourself during the stay in the countryside every 2-3 hours, and after returning home, especially after staying in the area of infected ticks. During checkup especially search the marginal areas of the scalp (behind ears, back of the head, neck), groins, armpits and the area behind the knees, navel etc.
- Make sure to treat pets with flea and tick repellents. If ticks are removed from pets, manage them the same way you would remove a tick on a person. Protect yourself from the potential exposures with gloves.
Procedure in case of the tick bite - the moment when you noticed a tick:
- Immediately remove it with tweezers. It is necessary to take the tick with tweezers right next to the skin and gently draw it by pulling, taking care not to damage the body of the tick when pulling out. If it is necessary to accurately capture it a magnifying glass can be used, because tearing the tick remains part of it under the skin and that can lead to infection. In this case, one should seek medical help.
- Never put alcohol, oil or grease on the tick.
- Do not touch ticks with bare hands.
- After the tick is removed, clean the area with some antiseptic.
Tick bites symptoms:
There are some symptoms that may occur and that can be directly related to the tick itself; they are due to the tick bite. The actual bite may cause symptoms only after the tick drops off. However, some people may notice local redness, itching, burning, and rarely, localized intense pain (soft ticks) before or after the tick drops off. The majority of tick bites result in few, if any, immediate symptoms.
The results of the illnesses transmitted by ticks often begin days to weeks after the tick is gone. The most important clue about any tick-related illness is to tell the physician about a tick bite. Also, tell your physician about outdoor activity (camping, hiking, etc.) in tick-infested areas even if the you do not remember a tick bite.
After a tick bite, individuals may develop any of these symptoms that may be due to the pathogen(s) that the tick transmits during its bite:
- flu-like symptoms,
- pain and swelling in joints,
- shortness of breath, and
- nausea and vomiting.
Tick-borne encephalitis (TBE):
Central European tick-borne encephalitis type appears in Croatia. Incubation of the disease, on average, takes 7-14 days (2-28 days). The course of disease is biphasic. The first phase of the disease occurs in two thirds of infected persons and lasts from 1-8 days to manifest symptoms like: fatigue, fever, headache, general lassitude, nausea, vomiting, muscle aches. The first phase of the disease is usually accompanied by asymptomatic phase that has lasted for 1-20 days. In a small number of patients it progresses to the secondary phase, which occurs suddenly with a very high temperature and signs of involvement of the central nervous system and meningitis: severe headache, nausea, vomiting, neck braking, photophobia. Less frequently, the disease progresses encephalitis which is manifested by drowsiness, dizziness, tremor, disturbance of consciousness involuntary twitching of the eyeballs, speech disorder, brain damage etc.).
Treatment is symptomatic and is carried out in hospital. There is no specific antiviral medications treatment for the tick-borne encephalitis. The disease can be effectively prevented by vaccination. It is best to start vaccination during the winter months to ensure protection before the ticks "season" in the spring. Vaccination is carried out in three doses.
To who is vaccination recommended?
Only a small number of ticks is really infected. Therefore, the statistical chance of infection is very small. The danger is substantially increased during multiple and frequent exposure to tick bites. Therefore, vaccination against TBE is recommended to people who work and stay in the wild and in areas which are natural focus of ticks (foresters, forest workers, soldiers) and people who occasionally stay in the above mentioned areas (hikers, campers, hikers, hunters, tourists).
Lyme disease or Lyme borreliosis:
Lyme disease (Lyme borreliosis) is the most commonly reported tick-borne disease. Microbial or serological confirmation of borrelial infection is needed for all manifestations of the disease except for typical early skin lesions. Prevention relies mainly on avoiding exposure to tick bites. Borrelia is transmitted to humans by the bite of infected ticks. Early symptoms may include fever, headache, fatigue, depression, and a characteristic circular skin rash called erythema migrans. Left untreated, later symptoms may involve the joints, heart, and central nervous system. In most cases, the infection and its symptoms are eliminated by antibiotics, especially if the illness is treated early. Delayed or inadequate treatment can lead to the more serious symptoms, which can be disabling and difficult to treat.
Not all patients with Lyme disease will have all symptoms, and many of the symptoms are not specific to Lyme disease but can occur with other diseases as well. The incubation period from infection to the onset of symptoms is usually one to two weeks, but can be much shorter (days) or much longer (months to years). Attached ticks should be removed promptly, as removal within 36 hours can reduce transmission rates.