April 29, 1997

SPRINGFIELD, IL -- As Illinoisans head outdoors after a long winter, their plans to enjoy the better weather should include taking precautions against tickborne diseases, warns Dr. John R. Lumpkin, state public health director.

Infected ticks that live in and near wooded areas, tall grass and brush spread various diseases, including Lyme disease, Rocky Mountain spotted fever, ehrlichiosis and tularemia. The ticks, often no bigger than a pin head, become active and can spread disease any time of the year when the temperature is 40 degrees or more at ground level. Peak months for tick-borne diseases are June and July.

Dr. Lumpkin said the best way to protect yourself against tickborne illnesses is to avoid tick bites. He suggested the following precautions:

• Check your clothing often for ticks climbing toward open skin. Wear white or light- colored long-sleeved shirts and long pants so the tiny ticks are easier to see. Tuck long pants into your socks. Wear boots or sturdy shoes and a head covering.

• For those who do not want to wear all those clothes in hot, muggy weather, apply insect repellent containing DEET (30 percent or less) to exposed skin (except the face). Be sure to wash treated skin after coming indoors. If you do cover up, use repellents containing permethrin to treat clothes (especially pants, socks and shoes). Follow label directions; do not misuse or overuse repellents. Always supervise children in the use of repellents.

• Walk in the center of trails so weeds do not brush against you.

• Check yourself, children and other family members every two to three hours for ticks. Most ticks seldom attach quickly and rarely transmit tickborne disease until they have been attached for four or more hours.

• If you let your pets outdoors, check them often for ticks, which also can transmit disease to them. (Check with your veterinarian about treatments for ticks.) You are at risk from ticks that hitch a ride on your pets but fall off in your home before they feed.

• Remove any tick promptly. Do not try to burn the tick with a match, or cover it with petroleum jelly or nail polish. Do not use bare hands. The best way to remove a tick is to grasp it with fine-point tweezers as close to the skin as possible and gently, but firmly, pull it straight out. Do not twist or jerk the tick. If tweezers are not available, grasp the tick with a piece of tissue or cloth or whatever can be used as a barrier between your fingers and the tick. You may want to put the tick in a jar of rubbing alcohol labeled with the date and location of the bite in case you seek medical attention and your physician needs to identify the tick. The mouthparts of a tick are shaped like tiny barbs and may remain embedded and lead to infection at the bite site if not removed properly. If the mouthparts break off, consult your physician about removing them.

• Wash the bite area and your hands thoroughly with soap and water, and apply an antiseptic to the bite site. Make sure the property around your home is unattractive to ticks. Keep your grass mowed and keep weeds cut.

The following are brief descriptions of diseases carried by ticks in Illinois. For additional information about tickborne diseases, check the Department's web site (www.idph.state.il.us) under "Hot Off the Presses."

EHRLICHIOSIS -- Erlichiosis is a disease caused by bacteria, Ehrlichia, that infect white blood cells and are transmitted by the bite of an infected tick. The lone star tick, the American dog tick (or wood tick) and the deer tick have been associated with this disease. The bacteria can cause two illnesses -- human monocytic ehrlichiosis (HME) or human granulocytic ehrlichiosis (HGE). The two illnesses are similar and can be so mild that no medical care is sought or so severe they can result in death. Symptoms are generally non-specific and other diagnoses may be considered. The most common complaints are fever, headache and muscle aches. Persons with ehrlichiosis also may experience loss of appetite, nausea and vomiting. A rash may occur but is not usually present. In Illinois, there was one case of HME in 1994, four in 1995 and, provisionally, four in 1996. No cases of HGE have been reported in Illinois.

LYME DISEASE -- Although not many cases have been reported in Illinois, nationally this is one of the fastest growing infectious diseases. (Gov. Jim Edgar has proclaimed May 1 Lyme Disease Awareness Day in Illinois, and the Department has issued three public service announcements about this disease.) According to provisional numbers for 1996, there were nine cases of Lyme compared with 18 in 1995 and 24 in 1994. Lyme disease is transmitted by the bite of an infected deer tick. Lyme is not a fatal disease, but it can be debilitating. Among its symptoms may be a rash that starts as a red patch and forms an expanding ring or bull's-eye pattern. The rash may be accompanied by other symptoms such as fatigue, chills and fever, headache, swollen lymph nodes, and joint and muscle pain. Lyme is effectively treated with antibiotics. Even if not treated, symptoms may disappear but can recur intermittently for several weeks, months or even years after acquiring the infection. Other complications -- such as meningitis, certain heart irregularities, blindness, memory loss, temporary paralysis of certain facial muscles, pain with numbness or weakness of an arm or leg, and, most commonly, arthritis -- also may occur after several weeks or months.

ROCKY MOUNTAIN SPOTTED FEVER -- This is a potentially fatal disease but, if diagnosed early, can be successfully treated with antibiotics. The most common carrier is the American dog tick. Symptoms -- sudden onset of fever, muscle aches, severe headache and eye irritation -- usually develop within three to 14 days of the bite of an infected tick. About three days after these symptoms appear, a red, spotting rash may develop, usually on the arms and legs and often on the palms of the hands and soles of the feet. There were 11 cases of Rocky Mountain spotted fever reported in Illinois in 1994, 10 in 1995 and, provisionally, three in 1996.

TULAREMIA (rabbit fever) -- Most commonly transmitted by the blood or tissue of an infected animal (primarily rabbits), tularemia also can be spread by the bite of ticks and deerflies and by drinking contaminated water. While the disease occurs throughout the United States in all months of the year, the incidence is higher for adults in early winter during rabbit hunting season and for children during the summer when ticks and deerflies are abundant. A deerfly is a large fly, up to ½-inch long, that has a very painful bite and often leaves a drop of blood at the site of the bite. The American dog tick and the lone star tick are the ticks most commonly involved in the transmission of tularemia. The first sign of the bacterial infection is a pimple- like bump, or papule, that appears at the site where the bacterium entered the skin. This papule, which may appear about three to five days after the bite of an infected tick or deerfly, usually develops into an open sore and painful lymph nodes may produce pus. Other symptoms may include abrupt onset of fever , chills, malaise and fatigue, headache, loss of appetite and swelling of lymph nodes. Tularemia occurs infrequently in Illinois: three cases in 1994, four in 1995 and, provisionally, four in 1996.

Illinois Department of Public Health 535 West Jefferson Street Springfield, Illinois 62761 Phone 217-782-4977 Fax 217-782-3987 TTY 800-547-0466 Questions or Comments