Heading north soon? Just hang on a tick …
Our strong dollar means more Australians are travelling to North America and Europe this year to escape the southern winter.
One of the joys of visiting northern hemisphere countries during summer is enjoying the great outdoors. Taking long walks or hiking in parks is not only an inexpensive form of exercise, it also offers the chance to see new animals, birds, plants and trees at every turn of the trail.
The other bonus in visiting developed countries is fewer travel-related health risks.
One exception is ticks. In the northern spring and summer, ticks are the equivalent of mozzies in tropical countries – small, annoying, and potentially VERY dangerous.
In North America the main concern is Lyme Disease, named after the Connecticut town where it was first detected in 1975. In Europe it’s tick-borne encephalitis (TBE), a viral infection of the central nervous system transmitted by tick bites.
About Lyme Disease
WHERE IN THE USA: The main risk period for Lyme disease is May to September and there has been a dramatic upswing in Lyme diseases on America’s east coast this year. New York State, one of the most popular US destinations with Australian travellers, has had more than 357 cases and now ranks third to New Jersey (1677) and Pennsylvania (969). Nine eastern states have had more than 100 cases.Read more
THE DISEASE: Lyme disease is caused by a bacterium (Borrelia burgdorferi). The blacklegged tick (or deer tickIxodes scapularis) spreads the disease in the northeastern, mid-Atlantic, and north-central areas of the United States, and the western blacklegged tick (Ixodes pacificus) is the vector on the Pacific Coast.
THE SYMPTOMS: Fever, headache, fatigue, and a characteristic skin rash called erythema migrans are the usual symptoms. But, if left untreated, Lyme infection can spread to joints, the heart, and the nervous system, resulting in debilitating, long-term symptoms.
TREATMENT: While there is no preventative vaccine, most cases can be treated successfully with a regime of antibiotics over several weeks. Read more about Lyme disease.
WHERE TBEV OCCURS: There are three distinct types of tick-borne encephalitis virus (TBEV) – European, Far Eastern and Siberian.
TBEV is most common in Austria, Estonia, Latvia, the Czech Republic, Slovakia, Germany, Hungary, Poland, Switzerland, Russia, Ukraine, Belarus and Slovenia between April and August. It occurs less frequently in Bulgaria, Romania, Denmark, France, the Aland archipelago and the neighbouring Finnish coastline, and the coastline of southern Sweden (from Uppsala to Karlshamn), while occasional cases are reported in Serbia, Croatia, Bosnia and Herzegonia, Albania, Greece, Italy, Norway, and Turkey. Map:
THE SYMPTOMS: The symptoms of TBE include fever, malaise, anorexia, muscle aches, headache, nausea, and/or vomiting. After about 8 days of remission, the second phase of the disease occurs in 20% to 30% of patients and involves the central nervous system with symptoms of meningitis (e.g., fever, headache, and a stiff neck) or encephalitis (e.g., drowsiness, confusion, sensory disturbances, and/or motor abnormalities such as paralysis) or meningoencephalitis. TBE is more severe in adults than in children.
TREATMENT: There is no specific drug therapy for TBE. Depending on the severity of symptoms, meningitis, encephalitis, or meningoencephalitis may require hospital treatment.
TBEV Vaccine for travellers
The vaccine is available in most parts of Europe and in Canada, but can only be obtained in Australia by applying to Australia’s Therapeutic Goods Administration under the Special Access Scheme. Call Travelvax on 1300 360 164 for information on the vaccine, or read more on the risk of TBEV for your trip.
WHO SHOULD HAVE IT: There is a very effective vaccine against TBEV called FSME-IMMUN which provides 100% protection. However, immunisation is usually only recommended for those travellers who anticipate spending a month or more working outdoors, or on hiking, cycling, or camping holidays.
HIGHLY EFFECTIVE: The conventional immunisation schedule using FSME-IMMUN consists of 3 doses – the first two a month apart prior to travel (providing 97% protection), and the final dose 9-12 months later. However, the regime can be accelerated: the first two shots two weeks apart (92% protection), and the third 9-12 months later. With either regime, the third dose increases the level of protection to 100%. Read more
To avoid ticks:
- Walk in the centre of trails, avoiding wooded and bushy areas with high grass and leaf litter.
- Wear long trousers and shirts with long sleeves.
- Tuck trousers into socks.
- Use insect repellents that contain 20% or more of DEET (N, N-diethyl-m-toluamide) or oil of eucalyptus on exposed skin for protection that lasts several hours.
- Treat clothing and gear, including boots, socks, pants and your tent with permethrin. (It’s easy to use and continues to be effective after several washings.)
The longer ticks are attached, the greater the risk of infection. That said, young ticks can be as small as a poppy seed, making them very difficult to spot.
So, it’s very important to check yourself, your partner, and children for ticks EVERY day.
After visiting a tick-infested area, conduct a full-body tick check using a hand-held or full-length mirror to view all parts of your body.
Parents should check their children for ticks under the arms, in and around the ears, inside the belly button, behind the knees, in the groin area, around the waist, and especially in their hairline.
Ticks live close to the ground and usually hitch a ride on your lower legs, but also on hands or arms if they are in contact with grass or low shrubs.
Ticks usually don’t transmit disease until they have been attached for more than 24 hours, so showering after coming indoors (preferably within two hours) may help to wash off ticks that have not latched onto your body.
If you find a tick attached to your skin, the best way to remove it is to:
- Using fine-tipped tweezers or tick remover, grasp the tick from the side rather than from above, and as close to the surface of your skin as possible. (If you grip the tick along its length you are more likely to squeeze the contents of its stomach into the bite or onto your skin, which only defeats the purpose.)
- Pull upward using steady, even pressure. (Twisting or jerking the tick can cause its mouth to break off and remain in your skin, which is also not desirable. If part of a tick breaks off and is left in your skin, seek medical attention.)
- After completely removing all traces of the tick, thoroughly clean the bite area and your hands with rubbing alcohol, or soap and water.
Read more about removing ticks.
If you develop a rash or fever within 28 days of removing a tick, see your doctor.
Be sure to advise where and when you were bitten.
There are numerous other tick-borne diseases in the Americas, Europe and Asia.
Get more information on tick-borne diseases and other travel health risks for your journey by calling Travelvax Australia’s free travel health advisory service on 1300 360 164.