Summer brings warmth and vitality, creating many opportunities for for fun outdoor recreation and leisure. However, ticks are more active during the summer and can make enjoying the outdoors challenging.
David Pigott, M.D., professor in the University of Alabama at Birmingham Department of Emergency Medicine, and Brandon Buchel, M.D., director of Emergency Medicine and Hospital Medicine at UAB St. Vincent’s Chilton, provide insight on ticks, bite symptoms and prevention while being safe and aware outdoors.
Symptoms of a tick bite
Ticks are commonly found in high brush and wooded areas. When one is exposed to a tick, its bites are painless and often go unnoticed until discovered. Most people find the tick before experiencing symptoms.
Immediate symptoms of a bite are mild redness, itching or irritation around the bite site. Symptoms of a tick-borne illness typically do not appear until days or weeks after the initial bite, making it difficult for people to connect their ailments to outdoor exposure.
Common symptoms of tick-borne diseases include:
- Fever
- Chills
- Fatigue
- Nausea
- Muscle aches
- Joint pain
- Rash (occasionally)
“If a tick is found attached to the skin, it should be removed promptly using fine-tipped tweezers by grasping the tick close to the skin and pulling upward with steady pressure,” Buchel said.
Following removal, the area should be cleaned with soap and water or rubbing alcohol. Buchel advises it is best to avoid home remedies such as burning the tick or covering it with petroleum jelly, as these methods are ineffective and may cause irritation. Individuals should monitor the area at home for mild redness or itching.
“The more concerning symptoms occur when a tick transmits an infection,” Buchel said.
If individuals develop worsening symptoms after being bitten, seeking immediate medical attention is critical. Early evaluation is particularly important in the South, where several tick-borne illnesses can progress quickly if left untreated.
Tick-borne illnesses
“While most tick bites are harmless, some can transmit potentially serious diseases, and the risk often depends on the species of the tick involved,” Buchel said. “The level of danger depends on the type of tick, how long it remains attached and whether it carries an infectious organism.”
The most notable illnesses related to tick bites are Lyme disease and Rocky Mountain spotted fever.
“As ticks are sucking your blood, their saliva is injected into the wound, and through that saliva, it can contain microorganisms and bacteria that can go into your bloodstream and make you sick,” Pigott said.
The American dog tick is known to transmit RMSF, which causes a spotted rash and severe systemic symptoms that can be life-threatening if not treated early. According to Pigott, RMSF is uncommon in Alabama and more common in Tennessee and the Carolinas.
The blacklegged tick, also known as the deer tick, can transmit Lyme disease. Lyme disease causes a rash that looks like a “bullseye” with a pink center.
“Physicians in the Southeast often maintain a high index of suspicion for tick-borne illness during the warmer months because early treatment with antibiotics significantly improves outcomes,” Buchel said.
Another illness associated with tick bites is alpha-gal syndrome, the delayed allergic reaction to red meat. This illness is carried by the Lone Star tick, involving the transfer of the alpha-gal molecule commonly found in mammals into the human bloodstream. Although there is no cure for AGS, it is highly manageable. Patients who suspect or have AGS symptoms should consult an allergist for symptom management and care.
Preventing tick bites
“Prevention remains the best defense against tick-borne illness, especially for people spending time outdoors during Alabama’s warmer seasons,” Bucher said.
Bucher and Pigott recommend individuals wear long sleeves and pants, if possible, when outside in wooded and heavy brush areas. Wearing long sleeves and pants create a barrier, preventing ticks from latching onto the skin.
Insect repellents that contain DEET, a common chemical ingredient found in insect repellents, should be used. Treating clothing with permethrin, an insecticide that mimics natural repellents of chrysanthemum flowers, can also be effective.
After camping, hiking or spending extended time outdoors, individuals should perform full body tick checks. Parents should check their children for ticks after being outside.
Areas to search include:
- Scalp
- Behind the ears and knees
- Waistline
- Under the arms
“Showering soon after coming indoors and placing clothing in a hot dryer can help remove ticks before they attach,” Bucher said.
Pet owners should check their pets regularly, as pets can carry ticks into the home.
“You are more likely to have problems related to heat illness or dehydration than you are to be bitten by a tick,” Pigott said. “Individuals should stay hydrated and, if working outdoors, try to do most of the work early in the morning to help mitigate risk of exposure or take frequent breaks.”