What are ticks?

Ticks are small parasites that feed on the blood of animals, birds, or humans. There are hundreds of different types of ticks which vary in colour and size depending on the type and age of the tick and whether it has fed. Ticks are found in soil, woodland and areas with long grass. They then can transfer to fur of animals and birds but they can attach themselves to human skin.

Which diseases can they carry?

Ticks can carry diseases which they pass on when they bite. The type of diseases caused by ticks varies depending on the type of tick and the region of the world.

• Conditions ticks can cause include:
• Lyme disease also known as Lyme borreliosis – this is one of the most common conditions caused by tick bites
• Rickettsioses – these are a group of tickborne diseases that include:
  • Rocky Mountain Spotted Fever is caused by the bacteria Rickettsia rickettsiia found in the US
  • Mediterranean Spotted Fever is caused by the bacteria Rickettsia conorii found in the Mediterranean
  • African Tick Bite Fever is caused by the bacteria Rickettsia africae found in sub-Saharan Africa and the Caribbean)
• Crimean-Congo Haemorrhagic Fever (CCHF) is caused by a tick-borne virus (Nairovirus). CCHF is found in Eastern Europe, particularly in the former Soviet Union, central Asia, parts of southern Europe, Africa, the Middle East, and the Indian subcontinent
• Tickborne encephalitis (inflammation of the brain) is viral disease caused by a virus from the Flaviviridae virus family and causes 12,000 cases every year according to the World Health Organization

The symptoms of tick bites can vary depending on the pathogen that the tick carries. If you have been bitten by a tick, you may experience one or more of the following symptoms:

• A rash at the site of the bite
• Muscle aches
• Headaches
• Fatigue
• Fever
• Nausea
• Vomiting

Where do ticks live?

Ticks live can be found in several places including:

• The fur and feathers of many birds and animals such as:
  • Deer
  • Cattle
  • Sheep
  • Goats
• Woodland
• Grassy areas
• Trees
• Bushes

How to prevent tick bites

There are areas in the world which are infested by ticks and by educating yourself about ticks, their appearance and when and where you are most likely to be bitten will help reduce the risk of tick borne diseases. The following will also help:

• When out walking, avoid long grass and stay on footpaths
• If you are in a tick-infested area, wear suitable clothing for example, a long-sleeved shirt and trousers, making sure all clothing is tucked in
• Spray clothing with an insecticide called Permethrin or buy clothing that’s been impregnated already
• Use insect repellent on exposed skin, such as PMD or DEET
• Wearing light coloured clothing may help you spot a tick on your clothes
• When you return home, make sure that you check the head, scalp and whole body for ticks including the creases and folds in the skin

What to do if you notice a tick

If you notice a tick on your clothing or body you should:

• Wash them off and as soon as you can and remove all your clothes
• If you have been bitten by a tick and it has attached itself to your skin, it is important to remove it. There are many tools that you can use to remove ticks including tweezers and tick-removal cards, which have been designed to slide easily between the tick and the skin with squeezing the tick. You should use tweezers where the tips bend inwards as flat tipped tweezers will squeeze the tick, and bacteria could be squeezed onto the skin

Removing ticks:

• Using the tweezers, hold the tick as close to the skin as possible
• Carefully pull the tick upwards but don’t twist or use too much pressure as it may break and some parts might remain in the skin. If you can’t remove some or all of the tick with tweezers, then leave it alone and let the skin heal.
• Once you have removed the tick, clean the area and your hands with soap and water
• If the tick is still alive when you remove it, you can flush it down the sink or toilet, but you should never crush a tick with your fingers
• If you are bitten by a tick in the UK, try to keep the tick and give it to your doctor as Public Health England conducts surveillance of ticks

You should also:

• Carry out a full body check including under the arms, behind the knees, around the waist and the hair. Parents should also check their children for ticks
• Check your pets and outerwear clothing carefully as ticks can also be transmitted via clothing and pets
• Wash your clothes using hot water as cold and medium temperatures will not kill ticks. If your clothes can’t be washed, then tumble dry them on a high heat for at least an hour

When to see a doctor

Tick borne diseases usually result in mild symptoms which can be treated at home, however, the sooner you recognise and get treatment for any infection or symptoms the less likely you are to experience serious complications. You should visit your doctor immediately if you have been bitten by a tick or if you are concerned that you might have been bitten and experience any of the following:

• A target lesion which is often seen with Lyme disease which is red in the centre surrounded by a circle or other symptoms of Lyme disease following a bite such as unexplained headaches, a flu-like illness, neck stiffness, joint pains, dizziness or facial weakness
• Symptoms of a severe allergic reaction which is a medical emergency can include:
  • Raised, red areas (hives) all over your body
  • Swelling of the throat, mouth, lips, or tongue
  • Problems with breathing
  • Feel very lightheaded or suddenly feel weak, confused
• Signs of infection including:
  • Increased pain
  • Fever
  • Aching muscles or joints
  • Headaches
  • Tiredness
  • Swelling
  • Warmth, or redness around the bite
• Red streaks or puss at the site of the bite
• Symptoms that last longer than a week or you are concerned are related to a tick-borne disease

Tick bites myths / QA

Myth:   All ticks carry diseases
Fact:    Not all ticks carry diseases

Myth:   If you are bitten by a tick you will get sick
Fact:   Some tick-borne diseases need the tick to be attached for longer than 24 hours to transmit disease and therefore if you check yourself and your clothing as soon as you are inside, you can minimise the risk of getting sick.

Myth:   You will know if you have been bitten by a tick.
Fact:    Tick bites do not cause any pain, so you won’t know when or if you have been bitten. Also not everyone that has been bitten by a tick and infected with a disease will have the rash.

Myth    Ticks can be removed with perfume or alcohol
Fact:    Once attached, ticks can be removed by using tweezers and grabbing the tick as close to the skin as possible and pulling it out.

Myth:   You can’t get tick bites in winter
Fact:    Some deer ticks are active during cold weather and temperatures have to drop to about minus 12oC for a significant period of time to kill the ticks.