Health Advisory
TICK-BORNE DISEASES - PREVENTION IS KEY

The Delaware Division of Public Health (DPH) reminds Delawareans that simple precautions reduce a person’s chances of getting tick-borne infections this summer.

Lyme disease is the most common disease spread by ticks in Delaware. Other tick-borne diseases such as Rocky Mountain spotted fever and Ehrlichiosis are diagnosed much less frequently in Delaware but can cause severe illness and often require hospitalization.

It usually takes 24-36 hours of attachment before a disease is transmitted from a tick to a person. Individuals who get tick-borne diseases may be treated with antibiotics. Early diagnosis and intervention are key to appropriate treatment and improved health outcomes. People who have been bitten by a tick and do not have symptoms do not require treatment, but they should monitor their health closely and contact a physician if they feel unwell or have any of the symptoms detailed below. Diagnosis of tick-borne disease is based on an individual’s symptoms and the results of blood testing.

PREVENTION

DPH reminds residents to take the following protective measures to avoid tick bites when gardening, camping, hiking, and playing outdoors:

• Wear light colored clothing to allow you to see ticks crawling on your clothing.
• When possible, wear long sleeves and long pants. Tuck your shirt into your pants and your pant legs into your socks.
• Apply tick repellants. Repellents containing permethrin can be sprayed on boots and clothing and will last for several days and through several washings. Repellents containing DEET (N, N-diethyl-m-toluamide) should be applied to exposed skin. Protection lasts several hours after which reapplication is necessary. Always follow product information regarding reapplication times.
• Use insect repellent containing 20-50% DEET for adults. Use repellent containing 20-30% DEET on children older than 2 months.**
• Upon return from outdoor activities, search your entire body for ticks.
• Check children’s entire body for ticks, especially in the hair and behind the ears.
• Note that ticks may be carried into the household on clothing and pets.

Tick Removal

• Using fine-tipped tweezers grasp the tick close to the skin surface and pull upward with steady, even pressure.
• If part of the tick remains attached to the skin and you are unable to remove it easily with clean tweezers, leave it alone. Attempts to remove the tick forcibly may cause tissue damage. The portion of the tick that is still attached will fall off as the skin heals and the risk of Lyme disease is not increased as the full tick must be attached for 24 – 36 hours for disease transmission.
• After removing the tick, cleanse the site with rubbing alcohol, an iodine scrub, or soap and water, and wash your hands.
• Delaware’s DPH does not recommend the use of home remedies such as petroleum jelly or hot matches for tick removal.
• Further information regarding tick prevention can be found at:   http://www.cdc.gov/Features/StopTicks/

Lyme disease is transmitted to humans by the bite of infected ticks (in Delaware, usually the deer tick). Ticks are active all year, but most cases of Lyme disease occur during the spring and summer months when humans enjoy outdoor activities. In 2011, Delaware had 873 confirmed cases compared to 656 cases in 2010. Common symptoms include a "bull’s-eye" rash (seen in approximately half of Lyme disease cases), fever, fatigue, headache, muscle and joint aches. Late manifestations such as chronic joint, heart and neurological problems may occur.

Rocky Mountain spotted fever (RMSF) and Ehrlichiosis are diagnosed less frequently in Delaware. In 2011, Delaware had 20 cases of RMSF compared to 22 in 2010. Ehrlichiosis cases totaled 35 in 2010 compared to 17 in 2011. Common symptoms of these diseases include fever, fatigue, headache, rash, muscle aches, abdominal pain, and vomiting.

**The American Academy of Pediatrics (AAP) recommends that repellents with DEET should not be used on infants less than 2 months old.

Delaware Division of Public Health, Bureau of Epidemiology: 888-295-5156

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