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The Pajaroello Tick Bite the Frightening Folklore and the Mild Disease

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The Pajaroello Tick Bite the Frightening Folklore and the Mild Disease Refer to: Failing RM, Lyon CB, McKittrick JE; Pajaroello tick bite- The frightening folklore and the mild disease. Calif Med 116:16-19, May 1972 The Pajaroello Tick Bite The Frightening Folklore and the Mild Disease ROBERT M. FAIING, M.D., C. BENTLEY LYON, B.S., (Forestry), AND JAMES E. McKrrmIcK, M.D., Santa Barbara * The pajaroella tick (Ornithodoros coriaceus) has a fairly wide dis- tribution in the coastal and mountainous areas of California and Mex- ico. Persons engaged in outdoor activities there, are frequently bitten. Little is written in the medical literature concerning the tick and its bite. What has been written is liberally injected with frightening folk- lore that sometimes results in overzealous treatment. Conservative and supportive therapy is advisable and only rarely should one have to resort to such treatment as excision of an area of tissue necrosis to prevent ulceration and prolongation of healing. "ITS BITE MORE FEARED than that of the rattle- bulletins of the U.S. Forest Service, the Cali- snake"1,2 appears all too often in the meager fornia State Agricultural Department, and cer- literature generally available to the practicing tain entomological publications, all of which physician about the common California arthro- are generally beyond the immediate reach of pod Ornithodoros coriaceus, called pajaroello. physicians. In reviewing the medical literature two things The purpose of this paper, therefore, is one become immediately apparent. First, little has of been written and, second, that which has is of information on the pajaroello and its bite. questionable accuracy. Even as recent a publi- cation as that of the Communicable Disease History Center-"Ticks of Public Health Importance and Pajaroello (pronounced pa har wayo) comes Their Control"2 propagates the "more feared than from the Spanish "paja," meaning straw, and the rattlesnake" myth. "htiello," the undersurface of a hoof. It is also The most accurate data are found scattered called Pajahuello, leatherback or greyback tick, through various communiques, memoranda and and, in Mexico, "Talaja." From the Department of Pathology, Santa Barbara Cottage Hospital. This arthropod is found in California and Submitted July 12, 1971. Reprint requests to: R.M. Failing, M.D., Department of Pathology, Mexico in an area extending from Humboldt Santa Barbara Cottage Hospital, Post Office Box 689, Santa Bar- bara, Ca. 93102. County on the north to the Mexican isthmus of 16 MAY 1972 * 116 * 5 Figure 2.-Two pajaroellos on back of laboratory Figure 1.-Dorsal and ventral surfaces of unfed animal (rat). The larger has been taking a blood meal Ornithodoros coriaceus (pajaroello tick). for 30 minutes; the smaller (unfed) has been posi- tioned for comparison. Tehuantepec and the state of Chiapas on the south. With the exception of an obscure report another may be an important factor in extending from Paraguay in 1888, it has never been re- the geographic distribution of the tick. ported outside of this area. The pajaroello tick The pajaroello differs from other ticks in that was first described by Koch in 1844 from speci- it does not attach to moving hosts but lies in mens taken in Mexico. Nuttall and his cowork- wait for animal or man, crawling to its host, ers,3 the first to report its presence in California biting, feeding, and then dropping back to the (in 1904), described specimens collected near ground. It is up to one-half inch long and very Los Olivos in- Santa Barbara County. difficult to see even to the experienced observer because of its similarity in color and size to bits Its habitat extends from the coastal mountains of soil (Figure 1). The blood meal of an adult of California eastward to the Sierra foothills and lasts about 30 minutes and can increase its the Tehachapis, ranging from sea level to over weight sixfold (Figure 2). 7500 feet elevation.4 It is most prevalent in the dry, hot mountainous areas of Monterey, San Luis Obispo, Santa Barbara, Kern, Ventura and The Bite, Folklore and a Case Report Los Angeles Counties, and it has been found in The bite was first described as "intolerably more than half of California's 58 counties.5 sharp and painful . with intermittent irritation The tick abounds in deer beds among low that persisted after four months."3 Herms8 re- scrub oaks (Quercus dumosa). Its favorite hosts ported in some detail the "disagreeable feeling are the mule deer (Odocoileus species) and . irritability and numbness" of a lesion last- range cattle. ing for several weeks and still evident at three months. Local folklore in one area reports that "three bites will result in certain death."9 Life Cycle and Feeding Habits The lay press stimulates the public's imagina- The life cycle involves four stages: egg, larva tion in reporting ". most dangerous to man is (6-legged), nymph and adult (both 8-legged). the dreaded pajaroello . It is one of two ven- The larvae, nymphs and adults can go without omous ticks in the West. The venom is similar a blood meal for as long as two years. Nymphs to that of a rattlesnake ...10 and adults feed rather rapidly, taking a blood Case Report. In May 1970 six healthy men meal in from a half hour to an hour and a half. from 40 to 57 years of age camped at 2,000 feet Larval forms, however, feed on their host for a elevation under a stand of scrub oak on the number of days.8'7 banks of the Sisquoc River in the San Rafael Wil- Loomis and Furman6 expressed belief that derness area of the Los Padres National Forest, rapid truck transportation of cattle (infested by Santa Barbara County. Four of the six, includ- long-feeding larvae) from one grazing area to ing two of the authors, (RMF and CBL) received CALIFORNIA MEDICINE 17 The Western Journal of Medicine The latter was composed of round cells with a few polymorphonuclear leukocytes. Fibrin thrombi and fibrinoid necrosis were not present. The lesions were most consistent with a nonspe- cific allergic vasculitis. Severe Reactions to Bite Severe systemic reactions have been reported but fortunately they are very rare. Probably they are related to previous bites with sensitization to some substance in saliva secretions. Such reac- tions are rather rapid in onset, with edema, Figure 3.-Pajaroello bite approximately 12 hours erythema and pain. Tissue necrosis, ulceration old on left lateral thigh of author(RMF). and a prolonged period of healing follow. No This painless lesion had reached maximum size (20 doubt the previously mentioned early reports3'8 mm in diameter), became mildly indurated, pruritic, did not ulcerate and gradually healed during the next concerned persons who had been sensitized by four weeks. previous bites. Most bites occur in persons engaged in out- painless bites numbering from two to seven on door, back country activities, such as Forest Serv- various parts of the body, including head, face, ice personnel, campers, hunters, fishermen, utility arms, back, legs, feet and toes. Several ticks iden- company workers, survey crews and ranchers. tified as Ornithodoros coriaceus were easily found Large numbers may be bitten at one time, as in within sleeping bags and about the camping the case of fire fighting crews seeking rest or area. The bites initially appeared as small mac- sleep in shaded areas frequented by deer and udes. Within 12 hours a central papule up to 2 cattle where the tick may abound. mm surrounded by a zone of erythema with an intense peripheral ring of hyperemia was noted Treatment (Figure 3). The lesions varied from 10 to 30 mm In general, treatment reported has been ag- in diameter. Some were associated with mild to gressive. Loomis and Furman6 pointed out that moderate edema. None were painful and only the treatment in some cases may be worse than minimal itching was noted. the bite. In many cases incision and suction, as During the next two weeks the lesions de- with snakebite, has been used. creased in size to macules 3 to 4 mm in diameter It would appear that conservative treatment with mild to moderate induration but no ulcera- is in order-cleansing of the wound, local com- tion. These, in turn, gradually subsided and by presses and administration of tetanus toxoid. four weeks there was little or no visible reaction. Only in the event of a rare systemic allergic reac- One of the four men bitten underwent extensive tion with severe pain and swelling should one laboratory investigation, including hematologic, resort to more vigorous therapy. Benadryl and SMA-12/60 chemistry studies and febrile agglu- ACIH may be of help.5 In cases where tissue tinins (including typhoid O,H,Para A, Para B, necrosis has occurred, consideration should be Brucella, OX-19, OX-K and tularemia). In addi- given to excision and primary closure, as has tion, acute and convalescent serum studies were been done in the treatment of brown (violin) done by the California Viral and Rickettsial Dis- spider bite,:" to prevent the ulceration and pro- ease Laboratory. No abnormal findings were re- longed healing that has been reported in some corded during six weeks of such studies. cases. The ulceration a,nd scarring associated The indurated areas about two of the bites with brown spider bite is directly related to in- were excised at 72 hours. Microscopic changes jection of a venom, but in the case of the pajaro- were nonspecific, showing a central focus of ello it is a local sensitization or Arthus phenome- acute necrosis, edema and congestion with a non with tissue necrosis and ulceration. The tick mild cellular infiltrate about dermal capillaries. contains no known toxin or venom.
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