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Ticks and ChiggersTicks and Chiggers-Information, Safety, and -Information, Safety, and

PreventionPrevention

By Rob Edmunds

Background??

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What are Ticks?What are Ticks? Ticks belong to the class Ticks belong to the class

Arachnida, which includes Arachnida, which includes spiders, scorpions, and mites. spiders, scorpions, and mites. There are two well established There are two well established types of ticks: the hard ticks, and types of ticks: the hard ticks, and the soft ticks.the soft ticks.

Ticks are very small insects that Ticks are very small insects that attach to a host using their front attach to a host using their front legs and mouth. Ticks feed off the legs and mouth. Ticks feed off the blood of the host, living on the blood of the host, living on the surface of the skin during the surface of the skin during the nymphal stage of development.nymphal stage of development.

In all, there are approximately In all, there are approximately 850 species of ticks, and roughly 850 species of ticks, and roughly 100 of them are capable of 100 of them are capable of transmitting diseases. transmitting diseases.

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Tick-Transmitted DiseasesTick-Transmitted Diseases

One tick bite has the possibility of transmitting One tick bite has the possibility of transmitting multiple diseases, the most common of which multiple diseases, the most common of which are: Lyme Disease, Human Ehrlichiosis, are: Lyme Disease, Human Ehrlichiosis, Rocky Mountain Spotted Fever, and an Rocky Mountain Spotted Fever, and an Encephalitis-like Virus that causes swelling of Encephalitis-like Virus that causes swelling of the brain the brain

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What Is Lyme Disease?What Is Lyme Disease?

Lyme Disease is the most common Lyme Disease is the most common type of tick-transmitted disease. type of tick-transmitted disease.

It is a Bacterial InfectionIt is a Bacterial Infection Primarily transmitted by ‘Black-legged’ Primarily transmitted by ‘Black-legged’

(Deer Tick)(Deer Tick) Affects both animals and humansAffects both animals and humans

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SymptomsSymptoms Early Lyme Disease (Days to month after Early Lyme Disease (Days to month after

bite)bite)– Large ring shaped rash at the location of Large ring shaped rash at the location of

bite bite– Syptoms are similar to the Flu, including stiff neck, Syptoms are similar to the Flu, including stiff neck,

chills and fever, headache, and fatiguechills and fever, headache, and fatigue Late Lyme DiseaseLate Lyme Disease

– Syptoms of Late Lyme disease include meningitis, Syptoms of Late Lyme disease include meningitis, arthritis, facial palsy, and heart abnormalities. arthritis, facial palsy, and heart abnormalities.

– Information from Brookhaven National Laboratories Information from Brookhaven National Laboratories http://www.bnl.gov/esh/shsd/PDF/SHSDhttp://www.bnl.gov/esh/shsd/PDF/SHSD%20Disease%20Sympton%20Handout.pdf%20Disease%20Sympton%20Handout.pdf

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Images from Hunterdon Health Department: www.co.hunterdon.nj.us/health/lymeinfo.htm

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TREATMENTTREATMENT

Doxycycline, amoxicillin, and ceftinDoxycycline, amoxicillin, and ceftin Usually treated for 4-6 weeks. Usually treated for 4-6 weeks.

A recent study reported in the A recent study reported in the New England Journal of New England Journal of MedicineMedicine states that a four-week course of oral states that a four-week course of oral doxycycline is equally as effective in treating Lyme doxycycline is equally as effective in treating Lyme Disease in late stages, and much less costly, than a Disease in late stages, and much less costly, than a similar treatment of intravenous Ceftriaxone (Rocephin) similar treatment of intravenous Ceftriaxone (Rocephin) unlessunless neurological or severe cardiac abnormalities are neurological or severe cardiac abnormalities are present. present.

Information from Hunterdon Health Department: www.co.hunterdon.nj.us/health/lymeinfo.htm

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TypicalTypical SeasonalSeasonal DistributionDistribution of of Reported Lyme Disease CasesReported Lyme Disease Cases


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LYME Cases by AgeLYME Cases by Age

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1 1

16

23

30

13

10

5

13

17

39

35

50

40

34

60

0

10

20

30

40

50

60

Num

ber

of

Cas

es

UnknownAge

2 - 9 20 - 29 40 - 49 60 +

Male

Female


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EhrlichiosisEhrlichiosisA disease caused by bacteria in the A disease caused by bacteria in the Lone-Star tick and Deer tick. Lone-Star tick and Deer tick. It is considered an acute infection It is considered an acute infection without chronic long-term consequences. without chronic long-term consequences. The severity of the disease varies from The severity of the disease varies from person to person. May be life-threatening person to person. May be life-threatening or fatal for elderly and others with or fatal for elderly and others with compromised immune systems.compromised immune systems.

Information from Brookhaven National Laboratories: http://www.bnl.gov/esh/shsd/PDF/ESH%20COORDINATORS%20061108%20TICKS.pdf

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SymptomsSymptoms

The infected person may be asymptomatic or The infected person may be asymptomatic or may have mild to severe symptoms.may have mild to severe symptoms.

Initial symptoms can include fever, headache, Initial symptoms can include fever, headache, and muscle aches. Other symptoms include and muscle aches. Other symptoms include nausea, vomiting, diarrhea, cough, and joint nausea, vomiting, diarrhea, cough, and joint pains. May also have a rash. Severe pains. May also have a rash. Severe complications include prolonged fever, renal complications include prolonged fever, renal failure, seizures, or coma.failure, seizures, or coma.

As many as half of all patients require As many as half of all patients require hospitalization. 2-3% of patients die from the hospitalization. 2-3% of patients die from the infection.infection.


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TreatmentTreatment

Treatment should be initiated immediately Treatment should be initiated immediately when there is suspicion of Ehrlichiosis. when there is suspicion of Ehrlichiosis. Treatment should not be delayed until lab Treatment should not be delayed until lab confirmation is obtained.confirmation is obtained.

100 mg. Doxycycline twice daily for a 100 mg. Doxycycline twice daily for a minimum of 7 days. Severe cases may minimum of 7 days. Severe cases may require longer treatment.require longer treatment.


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BabesiosisBabesiosis

Babesiosis is a malaria-like illness caused Babesiosis is a malaria-like illness caused by a protozoan parasite that is primarily by a protozoan parasite that is primarily transmitted by the black-legged deer tick. transmitted by the black-legged deer tick.


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SymptomsSymptoms May be asymptomatic; May be asymptomatic;

symptoms include fever, symptoms include fever, chills, sweating, muscle chills, sweating, muscle aches, fatigue, and aches, fatigue, and hemolytic anemia. hemolytic anemia. Symptoms typically Symptoms typically occur after an incubation occur after an incubation period of 1-4 weeks, and period of 1-4 weeks, and can last several weeks. can last several weeks. Disease is more severe Disease is more severe in the elderly and in the elderly and immunosuppressed immunosuppressed individuals.individuals.

TreatmentTreatment

Clindamycin + Clindamycin + quinine or atovaquone quinine or atovaquone plus azithromycin for 7 plus azithromycin for 7 days.days.


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Engorged Nymphal Tick

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Know Your Facts...Know Your Facts... Ticks must be attached 36 Ticks must be attached 36

- 48 hours to transmit - 48 hours to transmit bacteriabacteria

Approximately 20% of Approximately 20% of nymphal ticks carry nymphal ticks carry bacteriabacteria

Nymphal ticks cause Nymphal ticks cause majority of Lyme cases majority of Lyme cases

Nymphal ticks most active Nymphal ticks most active late May thru Julylate May thru July

Adult ticks most active late Adult ticks most active late Oct. and early November.Oct. and early November.

If an attached tick is found If an attached tick is found and removed, your and removed, your chances of developing chances of developing Lyme disease is just 1-3%Lyme disease is just 1-3% Information from Hunterdon

Health Department: www.co.hunterdon.nj.us/health/lymeinfo.htm

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Common Tick HabitatsCommon Tick Habitats

Tall grassy Tall grassy areas areas

Leaf litterLeaf litter Ground coverGround cover Low bushes / Low bushes /

shrubsshrubs Need moisture Need moisture

to surviveto survive

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Wood TickWood Tick

Larger than Larger than Deer TickDeer Tick

Does NOT Does NOT transmit Lymetransmit Lyme

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Three Three Active Active StagesStages

Need ‘host’ Need ‘host’ at each at each stage stage

(Such as (Such as mouse, other mouse, other animal or animal or person)person)

Attach as Attach as host host passes bypasses by

White-footed mice serve as the principal reservoirs of infection on which many larval and nymphal ticks feed and become infected with the LD spirochete. Information from Hunterdon Health

Department: www.co.hunterdon.nj.us/health/lymeinfo.htm

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ChiggersChiggers

Chiggers are small insects no bigger than Chiggers are small insects no bigger than 1/20th of an inch and are bright red. Though 1/20th of an inch and are bright red. Though extremely annoying, chiggers are not known extremely annoying, chiggers are not known for transmitting any diseases. Both Ticks and for transmitting any diseases. Both Ticks and Chiggers live in low lying foliage and brush Chiggers live in low lying foliage and brush and are encountered when a person comes in and are encountered when a person comes in contact or brushes against the foliage. contact or brushes against the foliage.

1/20 inch is very large, actually they are only visible in the best of lighting conditions

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Chigger InformationChigger Information

Chiggers are a part of Chiggers are a part of the mite family. the mite family.

There are four stages in There are four stages in the life span of a the life span of a chigger; egg, larva, chigger; egg, larva, nymph, and adult. nymph, and adult.

The larval chigger is The larval chigger is responsible for the responsible for the irritating bites and irritating bites and ensuing rashes.ensuing rashes.

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Chigger’s secrete a digestive fluid onto the Chigger’s secrete a digestive fluid onto the host’s skin cells causing them to breakdown. host’s skin cells causing them to breakdown. Then a feeding tube descends from the chigger Then a feeding tube descends from the chigger allowing them to feed on the liquified cells allowing them to feed on the liquified cells until they become engorged. Once the larva until they become engorged. Once the larva has finished nourishing itself they will leave has finished nourishing itself they will leave the host and find a place to developthe host and find a place to develop

The nymph and adult stages do not affect The nymph and adult stages do not affect humans or animals humans or animals

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Symptoms of a Chigger BiteSymptoms of a Chigger Bite

Chigger bites effect Chigger bites effect people differently, people differently, however, a red puffy however, a red puffy rash is typical, and is rash is typical, and is caused by the digestive caused by the digestive enzymes secreted by the enzymes secreted by the chiggerchigger

Rash can last from 2-3 Rash can last from 2-3 days, up to 3 weeksdays, up to 3 weeks

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TreatmentTreatment

Once chigger bites have been noticed, the best Once chigger bites have been noticed, the best course of action is to take a hot bath, which course of action is to take a hot bath, which will kill the remaining larvae and remove them will kill the remaining larvae and remove them from the skin from the skin

Ointment can be used to control the itch Ointment can be used to control the itch related to the chigger’s digestive secretionrelated to the chigger’s digestive secretion

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OSHAOSHA

There were no OSHA recorded fatalities There were no OSHA recorded fatalities cuased cuased by Ticks or Chiggers during the time by Ticks or Chiggers during the time period of 1990- 2007period of 1990- 2007

However, according to the American Lyme However, according to the American Lyme Disease Foundation, there have been more Disease Foundation, there have been more than 150,000 cases of Lyme disease identified than 150,000 cases of Lyme disease identified since 1982 since 1982

– Information from The American Lyme Disease Foundation. http://www.aldf.com/lyme.shtmlInformation from The American Lyme Disease Foundation. http://www.aldf.com/lyme.shtml

Consider two slides for this. Be sure to add a reference for the OSHA data.

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Personal Protection Personal Protection Measures to Reduce Measures to Reduce

Your Risks From Ticks Your Risks From Ticks and Chiggersand Chiggers

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Before entering areas Before entering areas with Ticks or with Ticks or Chiggers:Chiggers:

Wear light-colored Wear light-colored clothing clothing

Wear loose-fitting Wear loose-fitting clothingclothing

Tuck shirt into pants Tuck shirt into pants and pants into socksand pants into socks

Wear closed-toe shoesWear closed-toe shoes

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Perform Perform Frequent Tick Frequent Tick

Checks….Checks….

…while in tick habitats AND

when returning home

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Avoid areas where Avoid areas where it is likely to it is likely to encounter ticks encounter ticks and chiggers, when and chiggers, when possiblepossible

Keep to center of Keep to center of pathways pathways

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Tick Repellents Tick Repellents for Personal Usefor Personal Use

30% - 40% DEET content 30% - 40% DEET content most effective for ticks and most effective for ticks and chiggerschiggers

Use on skin OR clothingUse on skin OR clothing Apply to the shoes and Apply to the shoes and

pant legspant legs

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Tick Repellents Tick Repellents for Personal Usefor Personal Use

Permethrin-containing Permethrin-containing productsproducts

Use on clothing only, as it is an insecticide and can cause serious reactions is applied to skin

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What Can You Do to What Can You Do to Reduce the Risk of Reduce the Risk of

Encountering Ticks and Encountering Ticks and Chiggers?Chiggers?

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Keep grass and foliage Keep grass and foliage shortshort

Prune trees and Prune trees and shrubbery shrubbery

Remove old leaf and Remove old leaf and debris pilesdebris piles

Allow sunlight!Allow sunlight!

Ticks need Ticks need moisture moisture

to surviveto survive

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The Proper Use of The Proper Use of Insecticides Can Insecticides Can

Greatly Reduce the Greatly Reduce the Incidence of Tick and Incidence of Tick and

Chigger Bites Chigger Bites

Late MayLate May: Granular: Granular

Late SeptemberLate September: Liquid: Liquid

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Proper Tick RemovalProper Tick Removal

Use fine-point Use fine-point tweezerstweezers

Grasp the tick CLOSE Grasp the tick CLOSE TO SKINTO SKIN

Pull gentlyPull gently Wash area with soap, Wash area with soap,

water and antisepticwater and antiseptic Burning, suffocating, Burning, suffocating,

and poisoning of ticks and poisoning of ticks does not work in does not work in removing them from removing them from hosthost

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Jobsite Awareness ActivitiesJobsite Awareness Activities

Tick ID cards and Lyme Disease Alert notices Tick ID cards and Lyme Disease Alert notices should be presented and available to all should be presented and available to all employees employees

““Toolbox Talks” every week to remind workers Toolbox Talks” every week to remind workers about the dangers of ticksabout the dangers of ticks

Mandate long pants and sleeves for workers Mandate long pants and sleeves for workers working in tick and chigger habitatsworking in tick and chigger habitats

Set time aside at the end of the day for tick Set time aside at the end of the day for tick checkschecks

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Documents

hard ticks

adult ticks

soft ticks

species of ticks

tick bite

attached tick

treatment treatment

severe symptoms