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Take precautions against ticks to prevent disease : review

By Shereen Jegtvig

NEW YORK (Reuters Health) - People spending time outdoors in tick-infested areas should wear appropriate clothing and check themselves regularly for ticks, according to a new review.

Ticks can spread serious illnessesex like Lyme disease and tickborne encephalitis. Preventing bites is the first line of defense. But when ticks get through, it's important to remove them safely to avoid infection or allergic reactions, researchers say.

"Ticks can carry pathogens that cause disease that can make you very ill if untreated," James Logan told Reuters Health in an email.

Logan, from the London School of Hygiene and Tropical Medicine in the UK, is the review's senior author.

He said a lot of people aren't aware of the dangers of ticks and Lyme disease, and that in many cases, people have been misdiagnosed by their family doctor or given the wrong information on how to remove ticks safely.

Logan and his colleagues say the first step is to know where ticks may be located.

"Not all ticks will be infected but if you spend time in the outdoors it is worth checking whether ticks in your area might be infected," Logan said.

Wearing protective clothing and keeping everything tucked in can help keep ticks at bay, the researchers write in the British medical journal BMJ.

"Prevent them biting in the first place by using repellents and long trousers tucked into socks, permethrin impregnated clothing and closed footwear," Logan advised.

Permethrin is an insect repellant that's sometimes used in clothing. It should only be used on jackets and other types of outerwear, not on underwear, according to the U.S. Environmental Protection Agency.

Even when preventive measures are taken, ticks can sometimes find a way to latch on.

"Regularly check yourself for ticks whilst walking outdoors and have a 'tick buddy' to check the areas of your body you can't reach when you get home," Logan said. "They can stay attached for days."

If a tick does bite, it needs to be removed quickly and safely. Ticks anchor themselves onto their victims with a cement-like substance. Improper removal can leave mouthparts lodged in the skin.

Logan suggests carrying a tick removal kit that contains fine-tipped forceps or tweezers.

"Remove the tick by pulling steadily and firmly upwards with no twisting. It's a myth that ticks have spiral mouthparts," he said. "The quicker you remove them the less chance of you picking up a pathogen that may cause a disease."

Some tick removal tools, such as the O'Tom Tick Twister, have been developed for use in animals and are available online. But the authors don't recommend them because they haven't been tested in humans.

People who have been bitten by ticks should look out for symptoms of Lyme disease, they say.

According to the Centers for Disease Control and Prevention, there were more than 22,000 confirmed cases of Lyme disease in the U.S. in 2012.

About 60 percent of people with Lyme disease get a "bull's eye" rash on the bite site. Other symptoms include unexplained headaches, neck stiffness, flu-like symptoms, joint pain, a racing heartbeat or dizziness.

Symptoms usually start three to 30 days after a bite, according to Logan.

"This could indicate Lyme disease," he said. "If you have been bitten by a tick in an area where Lyme is present, it is important to speak to your doctor as soon as possible so you can be treated with antibiotics. The sooner the better."

Logan believes outdoor activities are important for well-being.

"We all love the outdoors and we should continue to pursue the activities we love, but just be tick aware," he said.

SOURCE: http://bit.ly/1glF9xU BMJ, online December 9, 2013.

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