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Letter from the Chief-Tick Bites: Prevention and Treatment

Wednesday, August 21, 2013

There are many different types of ticks on Long Island, some of which are capable of transmitting infections. The risk of developing these infections depends upon the season, type of tick, and, for Lyme disease, how long the tick was attached to the skin.

While many people are concerned after being bitten by a tick, the risk of acquiring a tick-borne infection is quite low, even if the tick has been attached, fed, and is actually carrying an infectious agent. According to the Center for Disease Control, ticks transmit infection only after they have attached and then taken a blood meal from their new host. A tick that has not attached (and therefore has not yet become engorged from its blood meal) has not passed any infection. Since the deer tick that transmits Lyme disease must feed for at least 36 hours before transmission of the spirochete, the risk of acquiring Lyme disease from an observed tick bite, is only 1.2 -1.4%, even in an area where the disease is common.

The organism that causes Lyme disease, Borrelia burgdorferi, lies dormant in deer ticks. The organism only becomes active after exposure to warm blood entering the tick's stomach. Once active, the organism enters the tick's salivary glands. As the tick feeds, it salivate organisms into the wound, thereby passing the infection to the host.

How to lower your risk of coming in contact with ticks:
-When walking outdoors, avoid contact with wooded and bushy areas with high grass and leaf litter. Try to walk in the center of trails.
-Use repellents that contain 20 - 30% DEET on exposed skin for protection that lasts up to several hours.
-Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on you.
-Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and day packs. Tumble clothes in a dryer on high heat for an hour to kill remaining ticks.
-Speaking of pets, dogs are very susceptible to tick bites and tick-borne diseases. Vaccines are not available for all the tick-borne diseases that dogs can get, and they don't keep the dogs from bringing ticks into your home. For these reasons, it's important to use a tick preventive product on your dog. Tick bites on dogs may be hard to detect. Signs of tick-borne disease may not appear for 7-21 days or longer after a tick bite, so watch your dog closely for changes in behavior or appetite if you suspect that your pet has been bitten by a tick.
-Clearing leaves, brush, tall grasses, woodpiles, and stone fences from around your house and the edges of your yard or garden may help reduce the tick population and the rodent population that the ticks depend on.

How to remove a tick:
The proper way to remove a tick is to use a set of fine tweezers and grip the tick as close to the skin as is possible. Do not use a smoldering match or cigarette, nail polish, petroleum jelly, liquid soap, or kerosene because they may irritate the tick and cause it to inject its bodily fluids into the wound.
-Use fine tweezers to grasp the tick as close to the skin surface as possible.
-Pull backwards gently but firmly, using an even, steady pressure. Do not jerk or twist.
-Do not squeeze, crush, or puncture the body of the tick, since its bodily fluids may contain infection-causing organisms.
-After removing the tick, wash the skin and hands thoroughly with soap and water.
-If any mouth parts of the tick remain in the skin, these should be left alone; they will be expelled on their own. Attempts to remove these parts may result in significant skin trauma.

Tick characteristics:
It is helpful if you can tell your doctor about the size of the tick, whether it was actually attached to the skin, if it was engorged, and how long it was attached.
-Ticks that are brown and approximately the size of a poppy seed or pencil point are deer ticks. These ticks are indigenous to Long Island and the northeast.
-Ticks that are brown with a white collar and about the size of a pencil eraser are more likely to be dog ticks. These ticks do not carry Lyme disease, but can rarely carry another tick-borne infection called Rocky Mountain spotted fever that can be serious or even fatal.

The key thing to remember if you are bitten by a tick and observe any sort of rash is to see your doctor right away.




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