Dr. Swiner’s Medical Note of the Month-June 2010-Dog ticks, and deer ticks, and mites..oh my! by Nicole Price Swiner on Friday,

Tick season seemed to start earlier this year than usual. One of my partners in our practice in March said she awoke one morning with a deer tick, and we knew the season was here.

the interesting things I’ve learned about since practicing in N.C., as these illnesses are more common in the Southeast. But apparently they are an issue all over the U.S. during this time.

The illnesses include the above-mentioned RMSF, Ehrlichiosis, Tularemia and Lyme disease. Lyme disease is actually very rare in N.C., because the tick that carries the disease is rarely found here.

The usual season for ticks is during the spring and summer months. The different types of ticks vary from dog ticks to deer ticks to Lone Star ticks. The American dog tick is generally a reddish-brown color and becomes large and red after it’s attached itself and fed. Deer ticks are usually smaller and darker than dog ticks. The Lone Star tick is also small and reddish-brown in color but usually has a white spot on the back. Clear as mud? If confused like I was, you can go to the Center for Disease Control and Prevention website to see pictures.

I also have a hard time identifying which is which, so I’ve posted a picture of types in my examination rooms for patients to point them out. Lone Star ticks are probably the most common type in this area, and they cause symptoms like fever, headaches, body aches and possibly a round “bulls-eye” rash where they have bitten. This is the classic rash called erythema migrans, and it’s very helpful to see when trying to diagnose the illness. Not all tick bites will cause the symptoms if caught early enough.

The best way to remove them is with tweezers and picking the whole body off, but most importantly the head. If you don’t know whether you’ve removed the entire body, don’t play around with it, have you doctor look at it and remove the rest as quickly as you see it. Don’t use matches or ointments, because they don’t work well all the time.

Once symptoms have been identified, your doctor may go ahead and start treatment or do blood work. Labs that are affected by tick-borne illnesses include white blood cell count, platelet count, liver labs and sodium. There are also antibody tests for RMSF, Erhlichiosis and Lyme disease. Once I generally have a good idea that a person has been affected, I usually will start treatment with Doxycycline, which is the most common antibiotic that treats all the common types of tick-borne illnesses. The medicine is prescribed either for one or two weeks depending on the severity of symptoms.

Now, to say a word about Lyme disease in N.C. – it is present but not very common. In 2008, the CDC reported 16 cases in the state versus 2,000 to 3,000 cases in the upper north states of Connecticut and Minnesota. Because of its long-term effects and consequences – arthritis and neurologic effects – Lyme disease is taken seriously. But the other types of tick-borne illnesses are far more common here in N.C. Be careful this summer!

* Reference: www.aafp.org (American Family Physician), www.cdc.gov (Center for Disease Control and Prevention)

  1. Nicole Price Swiner, MD, works for the Durham Family Practice in Durham. Contact her at 220-9800.
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