The coming of the summer months and increased outdoor activity for the whole family will bring all of us into closer proximity to bugs—lots of them. While many are harmless, there are a few that may sting or bite, making for a not-so-pleasant addition to a family outing. One such creepy-crawly, the tick, is common across the United States and, although it is small, it has the potential to cause some pretty serious illness to your and/or the members of your family.

As housing developments encroach into areas that were formerly uninhabited wilderness areas, more and more people are coming into contact with ticks and the animals that carry them. The American Academy of Family Physicians states that those who are most likely to experience tick bites and have a higher risk of getting a tick-borne illnesses are those who work or spend recreation time in the tick's favorite areas—wooded areas and high grass. Ticks typically wait near the top of low bushes and grassy plants waiting for animals and/or people to brush against them while passing by. At that point, the tick climbs aboard and spends several hours crawling upward on clothing or bodies before attaching to the skin. Ticks may also be brought indoors aboard the family pet who just spent time running through the tick's home ground. Once inside your home, they can come in contact with your family members. The National Institute of Allergy and Infectious Diseases (NIAID) notes that the spring and summer months are the most likely seasons for people to experience an infection as the result of a tick bite.

There are a number of tick-borne diseases that are found throughout the United States. The NIAID notes the following diseases as the most prevalent:

• Babesiosis
• Ehrlichiosis and Anaplasmosis
• Lyme disease
• Rocky Mountain Spotted Fever
• Tularemia

Of these diseases, Lyme disease is probably the most commonly known. First discovered in Connecticut in the early 1970s, Lyme disease has since spread to every state, with the exception of Hawaii. According to NIAID, the first symptom of Lyme disease is a red rash referred to as erythema migrans (EM). The rash starts as a small red spot at the site of the tick bite and expands over a period of days or weeks to form a circular or oval-shaped rash. The rash sometimes resembles a bull's eye—a red ring surrounding a clear area with a red center. Other symptoms, which accompany the rash, include body aches, fatigue, fever, headache, and a stiff neck. The symptoms are flu-like and resemble those of many common viral infections. Symptoms may persist or come and go. Untreated, the infection often leads to recurrent attacks of painful and swollen joints, which last a few days to a few months. Lyme disease can also affect the nervous system and can lead to symptoms such as:

• Stiff neck and severe headache
• Numbness, pain, or weakness in the limbs
• Poor muscle movement
• Temporary paralysis of the facial muscles (Bell's palsy)

Memory loss, difficulty concentrating, change in mood, or changes in sleep habits are additional symptoms that have been associated with Lyme disease. The good news is that most tick-borne diseases, including Lyme disease, can be treated with antibiotics. The key to successful treatment is prompt medical attention following a tick bite.

The Centers for Disease Control and Prevention (CDC) notes that certain species of ticks are so small that they can be difficult to see. The best way to prevent your family from coming into contact with tick-borne diseases is to avoid being bitten by ticks. When you or your family members are outdoors, the American Academy of Family Physicians CDC recommends following these guidelines:

• Use a repellent with DEET (on skin or clothing) or permethrin (on clothing) and wear long sleeves, long pants, and socks. Products containing permethrin can be used to treat boots, clothing, and camping gear and stays protective through several washings. Repellents containing 20% or more DEET (N, N-diethyl-m-toluamide) can be applied to the skin and can protect for several hours. Always follow product instructions for use and application and consult with your health care provider before using DEET on children. Parents should apply such products to their children, avoiding hands, eyes, and mouth.
• Tuck your pant legs into your socks to prevent ticks from crawling up the inside of your pant legs. Some ticks are small enough to crawl down into shoes and through socks.
• Avoid tick-infested areas. If you must walk in an area that is possibly infested with ticks, walk in the center of trails to avoid contact with vegetation.
• Wear light-colored clothing. The light color makes it easier to see ticks crawling on your clothing.

As an extra measure of safety, the CDC also recommends performing daily tick checks after being outdoors (even in your own yard). Use a full-length or hand-held mirror to view all parts of your body or your child's body. Pay particular attention to the following locations when checking for ticks:

• Around the waist
• Back of the knees
• Between the legs
• In and around the ears
• In and around the hair
• Inside the belly button
• Under the arms
• On the feet and between the toes

Ticks may also be carried into your home on clothing and pets. Examine both carefully and if any ticks are found, remove them. Clothing may be placed in a dryer on high heat to kill ticks. Pets may be treated with tick collars and medication treatments available through your veterinarian.

If a tick is found, the American Academy of Family Physicians provides the following instructions for tick removal:

Remove any attached ticks as soon as possible. To remove an attached tick, use fine tweezers to grab the tick firmly by the head or as close to the head as possible and pull. Do not use heat (such as a lit match), petroleum jelly, or other methods to try to make the tick "back out" on its own. These are not effective ways to remove a tick. Wash the area where the tick was attached thoroughly with soap and water. The NIAID adds that you should take care not to squeeze the tick's body while pulling it out with tweezers and to apply antiseptic to the bite area. Keep an eye on the area for a few weeks and note any changes. Call your doctor if a rash develops around the area where the tick was attached or if a fever is present. According to The National Institutes of Health research indicates that a tick must be attached for at least 48 hours to transmit the Lyme disease bacteria so, prompt removal of a tick is key to preventing infection.

Now that you know the tick's favorite hiding places and how to reduce the chances of getting bitten, you can rest a bit easier while enjoying the summer months outdoors. So take precautions, perform thorough body inspections, and promptly remove any ticks you might find. Don't give ticks a chance to ruin your family's time outdoors!

As with any health-related issues, consult with your family physician or health care provider regarding specific questions or concerns.

Sources:
Centers for Disease Control and Prevention—www.cdc.gov
National Institutes of Health National Institute of Allergy and Infectious Diseases—www.niaid.nih.gov
American Academy of Pediatricians—www.familydoctor.org
U. S. National Library of Medicine—www.nlm.nih.gov

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