You're camping in the bush. You find a tick lodged between your big and second toe. What do you do now?
"Don't freak out and yank it off," warns Dr Marcus Brauer from Medi-Travel International in Cape Town. The tick's head, which it cements right into the skin to feed on blood, might get left behind and cause an infection – or even worse, lead to tick bite fever.
Still, it's important to remove the tick as soon as possible. Ideally use tweezers to grasp the tick as close to the skin as possible. If you don't have tweezers, wear a glove or use something like a tissue so your fingers don't come into contact with the tick, as fluids infected with the rickettsia bacteria (that's what causes tick bite fever) might be released.
Once you have a firm grip on the tick, gently pull it away from the skin. This should dislodge it. But watch out that the tick's head doesn't break off and stay behind in the skin. If that happens, use the tweezers, or whatever else you have handy to remove it as you would a splinter.
Disinfect the wound once the tick has been removed, and the person who did the removing should wash their hands. Don't squash the tick or handle it with your bare hands. Preferably flush it down the toilet to dispose of it.
Not out of danger
The organisms that cause tick bite fever are transmitted in the saliva of an infected tick once it bites. Not all ticks are infected, though, so it's not advisable to go onto any medication pre-emptively. Keep an eye out for possible symptoms which will start to show within five to 10 days of being bitten. They include the following:
- A black mark where the bite occurred (called an eschar) is a typical feature of a tick bite;
- Severe headache;
- Malaise (a general feeling of ill health);
- Lymph nodes near the eschar may be enlarged;
- A rash may occur (but not always);
- You may also have severe nightmares.
Brauer advises that people with compromised immune systems, for instance the elderly or people with HIV/Aids, should contact their health care provider immediately if they think they may be infected, as they are more prone to develop complications from infection.
How is tick bite fever treated?
Some forms of tick bite fever are fairly mild and self-limiting – people may get better on their own without specific treatment. This can take up to two weeks, however, and treatment with an antibiotic can shorten the duration of symptoms and reduce the chance of a serious side-effect.
In severe cases antibiotic therapy is more important, and can be life-saving. The antibiotic doxycycline is the preferred agent for treating tick bite fever. Some people are not able to take doxycycline, in which case chloramphenicol, or sometimes ciprofloxacin, may be used instead.
Prevention better than cure
Obviously it's best to take preventative steps to avoid being bitten in the first place.
Tick bites usually occur in the outdoors in rural or wilderness areas; in fact, most people are infected while hiking or camping. "They really are all over," says Brauer.
He also warns that dogs or other pets could bring them into the house where they can be transferred to humans.
Here are a few things to keep in mind when going outdoors:
- Wear long trousers and long-sleeved shirts to minimise skin exposure. And if you wear light coloured clothing it will be easier to spot a tick.
- When hiking, wear gaiters to cover the exposed skin between your shoe and trouser leg.
- Applying insect repellent, such as Tabard or Peaceful Sleep, on your clothes and exposed body parts will make you less appealing to ticks.
- Inspect your whole body for ticks after spending time in the outdoors – pay particular attention to your groin area and armpits, as ticks are particularly fond of warm, dark hiding places.
- Parents should inspect their children for ticks after they spent time in the outdoors. "Bath time is the perfect opportunity for parents to check their children's bodies for ticks," says Brauer. He emphasises the importance of this as children are more prone to develop complications from tick bite fever.
(Wilma Stassen, Health24, November 2008)