ALABAMA A&M AND AUBURN UNIVERSITIES

ANR-2315 Ticks & Tick-borne Illnesses in Alabama

What is a tick, why do ticks bite, and why does it matter? Ticks are very small external parasites that feed by sucking blood from animals (hosts), including mammals, birds, reptiles, and amphibians. Most ticks go through four life stages: egg, six-legged larva, eight-legged nymph, and adult. After hatching from eggs, ticks must consume blood at every stage to survive, and most ticks prefer a different Centers for Disease Control and Prevention, James Gathany host at each life stage. Figure 1. Lone star tick (top left), black-legged tick (top right), American dog tick (bottom right) In Alabama, there are several tick species, some of which carry What species of ticks are found illness-causing bacteria that can in Alabama, and what hosts be transferred to the hosts on do they bite? which they feed. While we do not The lone star tick, Amblyomma know the percentage of infected americanum, is the most abundant ticks in Alabama, we do know tick species in Alabama. Adult that many people become ill females are easily identified by a from them every year. single white dot in the center of All people who spend time their brown bodies, the feature that outdoors, either in their backyard lends to their name. Lone star ticks or the wilderness, are at risk of aggressively seek human and pet exposure to ticks and contracting a hosts and may transmit disease. The American dog tick, tick-borne illness. Hikers, hunters, Dermacentor variabilis, is an outdoor workers, and other groups The black-legged tick, Ixodes scapularis, is an abundant tick abundant tick species in Alabama. are more likely to be bitten by ticks Adults of this species commonly because their activities usually take species in Alabama. This species is also known as the deer tick. This attach to human and pet hosts and place in prime tick habitat. Horses, may transmit disease. dogs, cats, and other pets that name should not be interpreted as spend time outdoors can be bitten meaning that it only feeds on deer The brown dog tick, Rhipicephalus by ticks and infected with a tick- or is the only tick species found sanguineus, is found throughout borne illness. If those pets come on deer. A reddish-brown body Alabama and commonly infests inside, they can bring ticks into distinguishes adult females of this homes, animal pens, and dog your home and put you at greater species. Black-legged ticks will kennels. They can spend their risk of being bitten. readily attach to humans and pets entire life cycle indoors. Controlling and may transmit disease. infestation in a home can be

www.aces.edu difficult once this species “questing,” on the tips of grasses treated quickly. Dogs may also get is established. Brown dog ticks and shrubs along a well-used path. spotted fever infections if bitten prefer dogs, but will feed on Ticks cannot fly or jump; but when by an infected tick. humans and other mammals. hosts brush past, ticks can quickly Lyme disease. This is the most They may transmit disease. climb onto their clothing or fur. commonly reported vector-borne The Gulf Coast tick, Amblyomma When a tick finds a prime location illness for humans in the United maculatum, is found in Alabama on a host, it cuts into the skin, States, with approximately 300,000 and looks similar to the American inserts its feeding tube (hypostome), cases reported per year. Over the dog tick. The species prefers to feed and begins feeding. past 10 years, the Southeast has on large hosts such as livestock, experienced a tremendous increase deer, and coyotes. Gulf Cost ticks What happens when ticks in the number of reported cases. may attach to humans and pets are attached? Typical symptoms appear within if given the opportunity and days or weeks after being bitten may transmit disease. During feeding, a tick will slowly suck its host’s blood for several by an infected tick and may days. If the tick contains an include fever, headache, chills, stiff How do ticks find and stay infectious organism (pathogen), neck, fatigue, mental fogginess, attached to hosts? it could be transmitted to the host depression, swollen lymph nodes, Ticks find their hosts by sensing during this time. At its next feeding, muscle aches, and joint pain. A animals’ breath, odor, heat, an infected tick can transmit telltale sign of Lyme disease is an vibrations, or shadows. They pathogens to a new host, expanding red skin rash (figure 4), also can find hosts by waiting, or potentially causing illness. called erythema migrans, located anywhere on the body. This rash may have a central area of clearing, What illnesses can ticks cause? giving it a “bull’s-eye” appearance Spotted fever. This illness caused (figure 5). Most, but not all, of those by the spotted fever group of infected present a rash, but the Rickettsia bacteria is the most rash may not be at the location commonly reported tick-borne of the bite. illness in Alabama. The best known Lyme disease is treated with and most severe form of the illness antibiotics. If caught early enough, is Rocky Mountain spotted fever. recovery is usually quick. If Symptoms begin to present in a few treatment is not immediately days to 2 weeks after infection and include fever, headache, muscle pain, lack of appetite, nausea, vomiting, and abdominal pain. Most people develop a spotted red rash, typically around the wrists and ankles at first. This rash can spread to the entire body (figure 3). Spotted fever infections are treated with antibiotics. These illnesses, like Lyme disease, are difficult to diagnose because of their nonspecific symptoms. This is particularly true when the rash is absent, which happens in approximately 10 percent of cases. These infections can cause lifelong Figure 2. Brown dog tick (top), Gulf Coast tick (bottom) Figure 3. Spotted fever rash. Photo courtesy of the Centers for Photos courtesy of the Centers for Disease Control and Prevention, health problems or be fatal if not Disease Control and Prevention James Gathany

2 Alabama Cooperative Extension System cells, much like the parasite that causes malaria. Symptoms may never develop in some people. Others may develop fever, chills, sweats, headache, body aches, loss of appetite, nausea, fatigue, and anemia. If not treated early, problems can become severe and cause fatality. Dogs may become infected with babesiosis as well. Tularemia. This is caused by a bacterium transmitted by ticks and deer flies, or by handling an infected animal’s carcass such as when skinning a rabbit without gloves. (Rabbits are common carriers of this disease.) Symptoms appear within 3 to 5 days after being bitten and include Figure 4. Rashes caused by Lyme disease. Photo courtesy of the Bay Area Lyme Disease Foundation. chills, headache, muscle aches, vomiting, diarrhea, fever, and swollen lymph nodes. Skin ulcers received, infection can spread to Ehrlichiosis. This is another also may develop; they occur in other parts of the body, and cause emerging tick-borne illness that about 80 percent of cases. It is serious chronic medical issues. is more common in the South, not uncommon for symptoms to particularly in dogs. Symptoms Because Lyme disease can be disappear for 1 to 3 days and return commonly occur within 5 to 10 days mistaken for other illnesses, such for 2 to 3 weeks. This disease can be of infection and may include fever, as arthritis, Alzheimer’s disease, fatal but is successfully treated with headache, muscle ache, lethargy, ALS, fibromyalgia, mental illnesses, antibiotics if diagnosed early. confusion, nausea, and vomiting. and more, it is important to watch Less than 30 percent of infected Tick paralysis. This is one of a few for other symptoms and educate adults develop a body rash. Serious, tick-borne conditions not caused yourself. Remember, too, that lifelong illness and possible fatality by a pathogen. The illness is caused horses and dogs can acquire this can occur if antibiotic treatment is disease from tick bites. not administered quickly. Southern tick-associated rash Anaplasmosis. Symptoms typically illness (STARI). STARI, also known occur within 1 to 2 weeks after as Masters disease, is an emerging a bite from an infected tick and tick-borne illness found particularly include fever, headache, lethargy, in the South. While symptoms chills, cough, nausea, abdominal are similar to Lyme disease, not pain, muscle pain, and confusion. much is known about its cause or A rash is rare with anaplasmosis long-term effects. Symptoms occur infection. Early antibiotic treatment within approximately 7 days of can be successful, but long-term infection and include fatigue, fever, complications and death are possible. headache, and muscle and joint pain. A red bull’s-eye rash may form Babesiosis. Unlike other tick-borne on the skin at the location of the illnesses in Alabama, babesiosis bite. Antibiotics are used is not bacterial, so it does not in treatment. respond to antibiotics. It is caused

by a parasite that infects red blood Figure 5. Bulls-eye rash caused by Lyme disease and STARI Photo courtesy of the Centers for Disease Control and Prevention

Ticks & Tick-borne Illnesses 3 an allergic response within 4 to When the illness is not diagnosed 6 hours of ingestion. Symptoms early, treatment can be difficult, include upset stomach, diarrhea, and chronic symptoms may hives, itching, and anaphylaxis. A develop. Education is key to blood test confirms the condition, preventing lifelong illness. and avoiding red meat is the only Pets are at risk of becoming treatment. infected with some of these These are not exhaustive illnesses. If your pet spends time descriptions of each illness, and outdoors, check them regularly there are other tick-borne illnesses for ticks and be on the lookout you and your pets could be infected for signs of lethargy, arthritis, with. You should further educate lameness, fever, fatigue and change yourself on the characteristics and in appetite. Because illness is symptoms of them all. Be aware more difficult to detect in pets, of how you feel if you are at risk it is important to closely watch of coming into contact with ticks. their behavior. See a veterinarian Individuals that acquire these immediately if you have reason to diseases may not develop all the believe they are infected. Figure 6. Lone star tick (top) Photo courtesy of Gerald Homes, symptoms listed, and the number California Polytechnic State University at San Luis Obispo, Bugwood.org. Tick attached to skin (bottom) and combination of symptoms can When are ticks active and which vary greatly from person to person. illnesses do they transmit? by a neurotoxin produced in a Having more than one illness Because of the warm, southern female tick’s salivary glands and at a time, or co-infection, also is climate, ticks in all life stages may transmitted during attachment and possible. See a doctor immediately be active year-round in Alabama. feeding. Symptoms usually occur if you suspect infection. The “wait The table on page 5 shows when within 2 to 7 days and include and see” approach could be very each tick species is most active headache, vomiting, fatigue, and harmful to you. Many tick-borne throughout the year and what loss of muscle function. Treatment illnesses are successfully treated if illnesses they have the ability to requires removal of the tick, after symptoms are recognized during transmit. which symptoms go away within the early stages of infection. hours to days. If untreated, it can lead to respiratory failure and death. Children in rural areas during the spring, especially those not checked around the neck, scalp, and other areas upon coming indoors, are at greatest risk of getting tick paralysis. Alpha-gal allergy. Also known as the red meat allergy, this is an emerging illness in the Southeast, and like tick paralysis, is not caused by a pathogen. This allergy is induced in some people when the saliva of an attached lone star tick causes the immune system to produce antibodies specific to alpha-gal—a carbohydrate found in red mammalian meat. After this occurs, when a person eats red meat, the meat triggers Figure 7. Tick on a dog

4 Alabama Cooperative Extension System Where can you be exposed over the entire body. Especially illness. Proper removal is incredibly to ticks? focus on dark, moist places that important, because improper removal Ticks are commonly found in the bend and fold: can increase your risk of infection. following habitats: • hair/scalp To properly remove and dispose • tall grasses and prairies • in and around ears of a tick, grasp the tick as close to the skin as you can get with sterile • shrubs and brush • under the arms tweezers or a tick tool (figure 8) • low-lying branches • inside belly button and pull upward on the tick with a steady, even tug. After the tick is • leaf litter • around waist under waistband removed, wash and disinfect the • rotten logs or stumps • groin area area on the skin where the tick • wooded areas and their edges • where bras pull snug to skin was attached. Wash your hands. Dispose of the tick by submersing • moist/humid areas • inside of thighs it in rubbing alcohol for more than • beaches and dunes • around the knees and ankles 1 day, wrapping it tightly in tape and throwing it away, or flushing it • areas of lawn adjacent • in between fingers and toes to woods or fields down the toilet. For indoor/outdoor cats, check for • stone walls and woodpiles ticks all over, particularly around where small mammals live These are the don’ts the ears and eyes. For dogs, also of tick removal: Be on the lookout for brown dog check everywhere, especially • Don’t try to scrape off a tick. ticks on your pets and in your around the face, ears, neck, armpits, home, furniture, animal pens, thighs, belly, tail, and toes. • Don’t twist or squeeze the tick; and dog kennels. this can cause the mouthparts to break off in the skin. How is a tick properly removed Where are the most common from the body? • Don’t burn a tick with a hot places to find ticks attached match while it is still attached. on the body? If you find an attached tick on yourself or your pet, remove it as • Don’t apply a substance such as Immediately after coming in from soon as you can. The longer the tick nail polish remover, petroleum outside, you should check yourself, is attached, the greater the chance jelly, gasoline, or soap to the tick in an attempt to kill it while significant others, and pets for ticks it will transmit disease or cause it is still attached.

Tick Species Months Active Illnesses Transmitted Lone star Nymphs and adults: March to October alpha-gal allergy ehrlichiosis southern tick-associated rash illness tick paralysis tularemia Black-legged Nymphs: March to June anaplasmosis Adults: September to March babesiosis Lyme disease American dog Nymphs and adults: April to September ehrlichiosis Rocky Mountain spotted fever tick paralysis tularemia Brown dog Nymphs and adults: all year canine babesiosis ehrlichiosis Rocky Mountain spotted fever Gulf Coast Nymphs: December to April spotted fever rickettsiosis Adults: May to August tick paralysis

Ticks & Tick-borne Illnesses 5 • Don’t touch the tick with Follow these guidelines Follow these guidelines for pets: your fingers. while outside: • Use a brush to facilitate full • Don’t wash the tick down a • Walk along the center of a body checks. drain; it can crawl back up the trail to avoid questing ticks • Consult with your veterinarian drain and into your home. at trail edges. for effective tick control • Do not sit on rotten logs products such as oral How can tick encounters and or stumps; that is where ticks medication, impregnated bites be prevented? seek refuge. collars, or topical treatments. There is currently no vaccination • Wear protective gloves when • Prevent tick-borne illnesses against Lyme disease or other tick- handling dead animals. in your pets—this may also borne illnesses for humans. prevent illness in you! It is incredibly important, therefore, Follow these guidelines to take preventative measures immediately after coming indoors: year-round when you are outside. • Carefully examine clothing, gear, and pets. Ticks can ride Follow these guidelines into your home on something before going outside: and attach later. • Wear light-colored long pants • Tumble clothes in a dryer on and long-sleeved shirts. Tuck high heat for a half an hour to the shirt tail into the pants, and kill undiscovered ticks. tuck the pants legs into socks. • Conduct a full body check Figure 8. Tick tool and tweezers to properly remove ticks • Put long hair in a bun or pull in the shower or by using it up into a hat. a partner or a mirror. You should do this for several days • Wear close-toed shoes. following potential exposure or make it part of your • Use repellents that contain daily routine. greater than 20 percent DEET on exposed skin and clothing. • Check skin for any bumps, scabs, or dirt specks that might • Treat clothing and gear with indicate a tick, especially on products containing 0.5 percent the scalp. If you feel something, permethrin. This is the most don’t squeeze or press it. effective preventative measure Check it. when used according to

the label.

6 Alabama Cooperative Extension System Tick Danger Zones

Ticks & Tickborne Illnesses 7 ANR-2315

Emily Merritt, Research Associate, School of Forestry & Wildlife Sciences, and Arnold Beau Brodbeck, Regional Extension Agent, Forestry, Wildlife and Natural Resource Management Adapted and used with permission from CIS 1013, University of Idaho Cooperative Extension System, Mary Ann Lawrowski, author. For more information, contact your county Extension office. Visit www.aces.edu/directory. Published by the Alabama Cooperative Extension System (Alabama A&M University and Auburn University), an equal opportunity educator and employer. Everyone is welcome! August 2016, ANR-2315 © 2016 by the Alabama Cooperative Extension System. All rights reserved. www.aces.edu