Dear Dr. Lanny:
What’s the right way to handle the discovery of a tick? Last summer my 5-year-old nephew got one while playing in his back yard in DeWitt. It was embedded in his skin and had to be removed surgically. Is Lyme disease a concern in this area, and if so, what do we need to watch out for?
A: Although I believe that all creatures large and small have a place in the grand scheme of nature, there are times that my “live and let live” philosophy is put to the test. While I have learned how to remove spiders, ladybugs, moths and other insects from my home (a postcard and an empty cat food can work great), mosquitoes still get mashed. I am not a perfect person. Ticks, if I happened upon them, would fall into the same category as mosquitoes.
Ticks, unfortunately, are an inevitable part of living where humans, greenery and deer come together. The hill behind our office, right in the middle of Syracuse, is a feeding ground to at least a half-dozen deer.
Far and away the Northeast is where the deer tick and the organism which causes Lyme disease are to be found. The upper central Midwest, particularly Wisconsin and Minnesota, are also hot beds of Lyme disease.
Every spring I call the Onondaga County Health Department and inquire as to whether our local ticks have been found to potentially carry Lyme disease. Even this year the local risk seems to be very slight. Almost all cases of Lyme disease diagnosed in Onondaga County are believed to have been the result of tick bites from other geographic areas. At this point in time I can tell you it is unlikely you or your child will catch Lyme disease in any part of Central New York.
However, although ticks are best known for carrying Lyme disease, it’s actually worse, as they can carry several other unpleasant diseases and a tick’s bite can even cause a form of paralysis. Suddenly living in the asphalt and concrete of New York City is starting to look better and better.
The risk is continually changing, and I would recommend several ounces of prevention. During the non-winter month (just a joke), playing in the woods or along the edge of the woods should ideally be done wearing a light-colored long-sleeve shirt and long pants.
Ticks do not jump. They must come into physical contact to be transmitted from blades of grass to humans. To complicate matters, your pet could have a tick in his fur and pass that onto you. Talk to your veterinarian about tick prevention. Consider insect repellent for yourself and your children as well. Any repellent containing no more than 10 percent DEET, the active ingredient, is safe and effective for children. Always follow the manufacturer’s instructions when using any insecticide.
Also make a daily tick search of your child. Although ticks are very small, they become larger and more obvious as they feed over a several-day period. The longer they remain attached to a host, the greater the chance of their transmitting infection. Ticks removed within 24 hours of attachment are very unlikely to transmit disease.
So, what do you do if you discover a tick on your child? Don’t freak. Don’t call 911. And don’t try anything that has to do with flame or flammable liquids. Ticks breathe very, very slowly, so suffocating one is unlikely to work either. What you don’t want to do is make the tick regurgitate any of its stomach contents back into the child.
Although there is an ever-growing list of ways to remove the tick, most home remedies are ineffective or even dangerous. The most effective and safest method is to pull them out using a small forceps or fine tweezers. Grasp the tick as close as possible to the skin, and slowly pull back perpendicular to the skin. In this manner it is unlikely that you can force any of the tick’s stomach contents back into the child. The tick not only attaches itself with many little fishhook-like barbs, but it also cements itself in place.
After removing the tick, carefully try to remove any remaining cement or mouth parts and then thoroughly clean the area with an antiseptic solution or antibiotic ointment. Your doctor can help remove any tick, but with a little care this is certainly a project a parent can perform at home.
I don’t know about you, but for the next several months I intend to tiptoe from my house to my garage wearing protective coveralls, helmet and goggles. The grass will have to take care of itself.
Dr. Alan Freshman, father of two grown boys, practices at Syracuse Pediatrics. Consult your own physician before making decisions about your family’s health care. Send e-mail to him at firstname.lastname@example.org.