Cleaveland: New type of tick disease shows up

photo Dr. Clif Cleaveland
photo A lone star tick bite may cause red-meat allergy.

Ticks are nasty, numerous and carriers of a variety of complex illnesses worldwide. In the U.S., they may transmit Lyme Disease, Rocky Mountain spotted fever (despite its name, much more frequent in the Southeast and Atlantic Coastal states), and a number of less-common but potentially dangerous illnesses.

Recently, red-meat allergy has been linked to bites of the lone star tick, which is common in our area of the country. The biting female of the species is red-brown with a yellow-white spot on the back. The bite may show no symptoms or may cause localized itching. Once attached, the tick may hang on for days.

Red-meat allergy results not from transmission of a microbe but from injection into the skin of a chemical found in the gut or saliva of the tick. This chemical is also found in red meat -- beef, pork, lamb and venison. It does not occur in poultry or fish. The injected substance can sensitize the victim to future contact with red-meat. Sensitization may occur within two weeks of the tick bite.

Symptoms may begin with generalized itching that worsens over a span of several hours. This may respond to antihistamines, such as Benadryl, taken by mouth. Subsequent eating of red meat, however, can trigger anaphylaxis, a severe, generalized allergic response. Swelling of lips, tongue and upper airways create a medical emergency. The victim may collapse.

This cascade of symptoms may begin shortly after red meat is eaten and progress rapidly. Immediate injection of epinephrine will buy time by temporarily reversing the most severe symptoms. Prompt transfer to a medical facility is vital. Subsequent treatment may involve intravenous fluids, antihistamines and corticosteroids.

In addition to avoiding all red meat, the affected individual will need to have immediate access to an epinephrine self-injector and antihistamine tablets.

The exact incidence of red-meat allergy is unclear. Thousands of cases have been reported thus far across the U.S. and in the Southeast, in particular. Also unclear is whether all lone star ticks carry the sensitizing chemical.

Avoiding tick bites is an important tactic in the Southeast. Ticks live in grasslands, brush and leaves. They are attracted to heat and may drop from limbs onto hikers. Avoid walking in tall grass. Stick to the center of hiking trails, avoiding contact with brush and undergrowth at trail's edge. Ticks may lurk in clothing and outdoor gear, biting victims hours after an outdoor excursion.

Ticks are successfully repelled by application of DEET-containing repellants to exposed skin and clothing. Permethrin is an alternative, a tick-killing chemical that may be sprayed onto clothing and camping gear. It will be effective through several washings. Outdoor clothing may be purchased that is impregnated with permethrin that will persist even longer.

Careful inspection of the entire skin is important following hiking and camping. Ticks will be hard to spot in skin creases, between toes, and in scalp and bodily hair. A tick may remain in place for hours to days, ingesting blood and regurgitating its stomach contents and saliva into its host.

Safe tick removal requires needle-nose tweezers. The tick is grasped at its headpiece, immediately adjacent to the skin. The tick is lifted off with care to remove it in its entirety. A headpiece left behind may still transmit disease. Folk remedies such as touching the attached tick with a lighted cigarette until it withdraws, applying alcohol to it or covering it with Vaseline until it releases are not appropriate and may stimulate the tick to release its contents into the skin.

Since most tick-related illnesses have a two-week incubation, after a bite establish an internal timer in which you are vigilant for symptoms such as itching, rash, fever, muscle aches, headache and/or swelling of lips and tongue. If these occur, contact your health provider promptly.

Contact Clif Cleaveland at cleaveland1000@comcast.net.

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