Written by Sara Peach for UNC Health Care
CHAPEL HILL, NC — Lurking on a leaf or at the tip of a blade of grass, blood-thirsty ticks wait for their next meal to approach.
Clinging to vegetation with their front legs outstretched, they wait for a sign – a whiff of carbon dioxide, a vibration, a shadow – that means an animal or person is near. Once attached to a host, ticks spend several days or weeks feeding and then drop off. But before they go, they can infect the host with serious illnesses.
That concerns Marcia Herman-Giddens, DrPH, who has watched North Carolina's tick disease rates rising in recent decades. Herman-Giddens is the president of the Tick-Borne Infections Council of North Carolina, which advocates for better education, research and control of the diseases. She is also an adjunct professor of maternal and child health at the Gillings School of Global Public Health at the University of North Carolina at Chapel Hill.
Herman-Giddens points to data on diseases such as Rocky Mountain spotted fever, which grew from 78 to 515 cases statewide between 2000 and 2008, according to the state Department of Health and Human Services. Rocky Mountain spotted fever is a potentially fatal illness that can cause fever, chills, aches, nausea and a rash.
Reported cases of Lyme disease have remained relatively steady since 1990. But in March, state officials declared for the first time that the disease was a known threat in Wake County. Similar declarations have been made in Wilkes, Wilson, Pitt and Carteret counties.
Herman-Giddens blames the rise in tick diseases on growth in the state's population of white-tailed deer, a favorite tick host. Suburban development in central North Carolina has broken forest land into patches of borders and wooded areas where the deer thrive.
Herman-Giddens said white-tailed deer were so rare when her children were young that her family was thrilled when they saw one in the early 1970s.
“It was very exciting,” she said. “It was an exotic animal.”
Since then, the deer population has grown to more than one million statewide, according to the North Carolina Department of Transportation.
At the same time, the state has been invaded by the aggressive lone star tick. That tick's favorite host is the white-tailed deer.
“When my children were growing up, ticks weren't a big deal,” Herman-Giddens said.
But after she stepped in a nest of tiny larval lone star ticks and got an estimated 200 bites during a hike near her Chatham County home, she gave up walking outdoors in the woods during tick season.
“That tick is getting worse and worse,” she said.
- When you go out, wear long, light-colored pants. Tuck your pants into your socks and stay out of long grasses and deep forest, said David Weber, MD, MPH, professor of infectious diseases and pediatrics in the UNC School of Medicine and professor of epidemiology in the UNC Gillings School of Global Public Health. He is also medical director of hospital epidemiology (infection control) and the Occupational Health Clinic at UNC Hospitals.
- Use an anti-tick liquid or collar to protect your dog. Check both the dog and yourself for ticks, paying special attention to your groin, ear lobes and underarms, which some tick species prefer.
- To remove a tick, pull it off gently with a fine-tipped tweezers or notched tick extractor. “One of the most important things is to not squeeze the body of the tick,” Herman-Giddens said. “It should not be touched by bare fingers.”
- Place ticks you find in a plastic bag and label it with the date you discovered it. If you become ill later, the tick may help doctors make a diagnosis.
- If you work or play outdoors, check yourself for ticks twice a day, Weber said.
- If you have flu-like symptoms, especially if you know you have been bitten by a tick, talk to your doctor about the possibility of a tick disease. You may be infected even if you don't have a rash, a hallmark of several tick diseases. Half of people with Rocky Mountain spotted fever don't have a rash when they see a doctor, Weber said.