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  • 1. Ticks and Chiggers -Information, Safety, and Prevention By Rob Edmunds Background??
  • 2. What are Ticks?
    • Ticks belong to the class Arachnida, which includes spiders, scorpions, and mites. There are two well established types of ticks: the hard ticks, and the soft ticks.
    • Ticks are very small insects that attach to a host using their front legs and mouth. Ticks feed off the blood of the host, living on the surface of the skin during the nymphal stage of development.
    • In all, there are approximately 850 species of ticks, and roughly 100 of them are capable of transmitting diseases.
  • 3. Tick-Transmitted Diseases
    • One tick bite has the possibility of transmitting multiple diseases, the most common of which are: Lyme Disease, Human Ehrlichiosis, Rocky Mountain Spotted Fever, and an Encephalitis-like Virus that causes swelling of the brain
  • 4. What Is Lyme Disease?
    • Lyme Disease is the most common type of tick-transmitted disease.
    • It is a Bacterial Infection
    • Primarily transmitted by ‘Black-legged’ (Deer Tick)
    • Affects both animals and humans
  • 5. Symptoms
    • Early Lyme Disease (Days to month after bite)
      • Large ring shaped rash at the location of bite
      • Syptoms are similar to the Flu, including stiff neck, chills and fever, headache, and fatigue
    • Late Lyme Disease
      • Syptoms of Late Lyme disease include meningitis, arthritis, facial palsy, and heart abnormalities.
          • Information from Brookhaven National Laboratories http://www.bnl.gov/esh/shsd/PDF/SHSD%20Disease%20Sympton%20Handout.pdf
  • 6. Images from Hunterdon Health Department: www.co.hunterdon.nj.us/health/lymeinfo.htm
  • 7. TREATMENT
    • Doxycycline, amoxicillin, and ceftin
    • Usually treated for 4-6 weeks.
    • A recent study reported in the New England Journal of Medicine states that a four-week course of oral doxycycline is equally as effective in treating Lyme Disease in late stages, and much less costly, than a similar treatment of intravenous Ceftriaxone (Rocephin) unless neurological or severe cardiac abnormalities are present.
    Information from Hunterdon Health Department: www.co.hunterdon.nj.us/health/lymeinfo.htm
  • 8. Typical Seasonal Distribution of Reported Lyme Disease Cases Information from Hunterdon Health Department: www.co.hunterdon.nj.us/health/lymeinfo.htm
  • 9. LYME Cases by Age Information from Hunterdon Health Department: www.co.hunterdon.nj.us/health/lymeinfo.htm
  • 10. Ehrlichiosis
    • A disease caused by bacteria in the Lone-Star tick and Deer tick.
    • It is considered an acute infection without chronic long-term consequences. The severity of the disease varies from person to person. May be life-threatening or fatal for elderly and others with compromised immune systems.
    Information from Brookhaven National Laboratories: http://www.bnl.gov/esh/shsd/PDF/ESH%20COORDINATORS%20061108%20TICKS.pdf
  • 11. Symptoms
    • The infected person may be asymptomatic or may have mild to severe symptoms.
    • Initial symptoms can include fever, headache, and muscle aches. Other symptoms include nausea, vomiting, diarrhea, cough, and joint pains. May also have a rash. Severe complications include prolonged fever, renal failure, seizures, or coma.
    • As many as half of all patients require hospitalization. 2-3% of patients die from the infection.
    Information from Brookhaven National Laboratories: http://www.bnl.gov/esh/shsd/PDF/ESH%20COORDINATORS%20061108%20TICKS.pdf
  • 12. Treatment
    • Treatment should be initiated immediately when there is suspicion of Ehrlichiosis. Treatment should not be delayed until lab confirmation is obtained.
    • 100 mg. Doxycycline twice daily for a minimum of 7 days. Severe cases may require longer treatment.
    Information from Brookhaven National Laboratories: http://www.bnl.gov/esh/shsd/PDF/ESH%20COORDINATORS%20061108%20TICKS.pdf
  • 13. Babesiosis
    • Babesiosis is a malaria-like illness caused by a protozoan parasite that is primarily transmitted by the black-legged deer tick.
    Information from Brookhaven National Laboratories: http://www.bnl.gov/esh/shsd/PDF/ESH%20COORDINATORS%20061108%20TICKS.pdf
  • 14. Symptoms
    • May be asymptomatic; symptoms include fever, chills, sweating, muscle aches, fatigue, and hemolytic anemia. Symptoms typically occur after an incubation period of 1-4 weeks, and can last several weeks. Disease is more severe in the elderly and immunosuppressed individuals.
    Treatment
    • Clindamycin + quinine or atovaquone plus azithromycin for 7 days.
    Information from Brookhaven National Laboratories: http://www.bnl.gov/esh/shsd/PDF/ESH%20COORDINATORS%20061108%20TICKS.pdf
  • 15. Engorged Nymphal Tick
  • 16. Know Your Facts...
    • Ticks must be attached 36 - 48 hours to transmit bacteria
    • Approximately 20% of nymphal ticks carry bacteria
    • Nymphal ticks cause majority of Lyme cases
    • Nymphal ticks most active late May thru July
    • Adult ticks most active late Oct. and early November.
    • If an attached tick is found and removed, your chances of developing Lyme disease is just 1-3%
    Information from Hunterdon Health Department: www.co.hunterdon.nj.us/health/lymeinfo.htm
  • 17. Common Tick Habitats
    • Tall grassy areas
    • Leaf litter
    • Ground cover
    • Low bushes / shrubs
    • Need moisture to survive
  • 18. Wood Tick
    • Larger than Deer Tick
    • Does NOT transmit Lyme
  • 19.
    • Three Active Stages
    • Need ‘host’ at each stage
    • (Such as mouse, other animal or person)
    • Attach as host passes 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                   
  • 20. Chiggers
    • Chiggers are small insects no bigger than 1/20th of an inch and are bright red. Though extremely annoying, chiggers are not known for transmitting any diseases. Both Ticks and Chiggers live in low lying foliage and brush and are encountered when a person comes in contact or brushes against the foliage.
    1/20 inch is very large, actually they are only visible in the best of lighting conditions
  • 21. Chigger Information
    • Chiggers are a part of the mite family.
    • There are four stages in the life span of a chigger; egg, larva, nymph, and adult.
    • The larval chigger is responsible for the irritating bites and ensuing rashes.
  • 22.
    • Chigger’s secrete a digestive fluid onto the host’s skin cells causing them to breakdown. Then a feeding tube descends from the chigger allowing them to feed on the liquified cells until they become engorged. Once the larva has finished nourishing itself they will leave the host and find a place to develop
    • The nymph and adult stages do not affect humans or animals
  • 23. Symptoms of a Chigger Bite
    • Chigger bites effect people differently, however, a red puffy rash is typical, and is caused by the digestive enzymes secreted by the chigger
    • Rash can last from 2-3 days, up to 3 weeks
  • 24. Treatment
    • Once chigger bites have been noticed, the best course of action is to take a hot bath, which will kill the remaining larvae and remove them from the skin
    • Ointment can be used to control the itch related to the chigger’s digestive secretion
  • 25. OSHA
    • There were no OSHA recorded fatalities cuased by Ticks or Chiggers during the time period of 1990- 2007
    • However, according to the American Lyme Disease Foundation, there have been more than 150,000 cases of Lyme disease identified since 1982
        • Information 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.
  • 26. Personal Protection Measures to Reduce Your Risks From Ticks and Chiggers
  • 27.
    • Before entering areas with Ticks or Chiggers:
    • Wear light-colored clothing
    • Wear loose-fitting clothing
    • Tuck shirt into pants and pants into socks
    • Wear closed-toe shoes
  • 28.
    • Perform
    • Frequent Tick
    • Checks….
    … while in tick habitats AND when returning home
  • 29.
    • Avoid areas where it is likely to encounter ticks and chiggers, when possible
    • Keep to center of pathways
  • 30. Tick Repellents for Personal Use
    • 30% - 40% DEET content most effective for ticks and chiggers
    • Use on skin OR clothing
    • Apply to the shoes and pant legs
  • 31. Tick Repellents for Personal Use
    • Permethrin-containing products
    • Use on clothing only, as it is an insecticide and can cause serious reactions is applied to skin
  • 32. What Can You Do to Reduce the Risk of Encountering Ticks and Chiggers?
  • 33.
    • Keep grass and foliage short
    • Prune trees and shrubbery
    • Remove old leaf and debris piles
    • Allow sunlight!
    Ticks need moisture to survive
  • 34.
    • The Proper Use of Insecticides Can Greatly Reduce the Incidence of Tick and Chigger Bites
    • Late May : Granular
    • Late September : Liquid
  • 35. Proper Tick Removal
    • Use fine-point tweezers
    • Grasp the tick CLOSE TO SKIN
    • Pull gently
    • Wash area with soap, water and antiseptic
    • Burning, suffocating, and poisoning of ticks does not work in removing them from host
  • 36. Jobsite Awareness Activities
    • Tick ID cards and Lyme Disease Alert notices should be presented and available to all employees
    • “ Toolbox Talks” every week to remind workers about the dangers of ticks
    • Mandate long pants and sleeves for workers working in tick and chigger habitats
    • Set time aside at the end of the day for tick checks