Tick Bite Prevention
Avoid walking in long grass and thick low lying bush with overhanging shrubs and small trees, especially after a rainy or humid day.
Ticks wait on the leaves of shrubs and small trees with legs extended, questing for hosts. They can detect heat emission and carbon dioxide from their host and latch on to them. They prefer warm, moist environments on the body (eg behind the ears, armpit or head).
Ticks secrete an anaesthetic in their saliva so you will not feel their bite or their attachment.
Some important tips for preventing tick bites include:
1. Wear a wide brimmed hat to protect your head and neck.
4. Tuck your pants into your socks so ticks can’t get onto your legs.
|5. Spray insecticide containing permethrin on boots and clothing (see 6). The effects will last several days.
6. Apply insect repellent to your skin containing 20% DEET (not on children) (Rid®, Tropical strength Aerogard® 17%, Bushman’s® 40%) or picaridin (Off® Skintastic family care-9.5%, Off® Tropical Strength-16% Aerogard Low irritant® 9.5%). Because DEET lasts only a few hours, you may need to reapply it. Lotions and gels last longer than sprays. Mighty Tick Off, an electronic tick-repelling device, is currently being trialled.
7. Always walk on the track to decrease the chance of brushing past a tick bearing plant.
8. Tick checks are vital. Check your body, children and pets for ticks when you return from hiking or walking. Conduct a thorough search especially behind the ears, in the hair and on the back of the head.
9. Cut grass and trim the shrubs and small trees (to allow sunlight to saturate the lawn) around your house.
10. Regularly remove plant debris and undergrowth to remove moist vegetation where ticks thrive
11. Store firewood in a sunny dry place away from vegetation to discourage ticks from living there.
12. Grow insect repelling plants such as chrysanthemums, citronella, lavender, sage or garlic.
13. Discourage bandicoots, wallabies, possums, lizards and other small animals around your house.
14. Brush skin and clothing before entering the house or vehicle. All clothing should be changed. Put in a plastic bag and then into a dryer on high heat for 30 minutes to kill ticks.
For people suffering from tick allergies the above method is not advised by the Australasian Society of Clinical Immunology and Allergy (ASCIA) as there is still a risk of allergen containing saliva being transmitted. ASCIA recommends that the tick is first killed by freezing in situ and in cases of severe allergy, this should be conducted under medical supervision. For more information please go to ASCIA website.
Tick Removal Devices
There are many devices that can be purchased to remove a tick. Tick Twister removes the tick with a twisting motion and without compressing it. It can remove nymphs and adults. View video for a demonstration.
The research on the use of these devices is on animals only. It was noted that less force was required and less damage to the mouth parts. More studies are needed assessing the use of these tools in humans before any recommendation can be made.
Severe Larval Infestation
Infants and ticks
The use of some pesticides is contraindicated with infants. In severe infestation of microscopic larval ticks, a 30 minute bath with 1 cup of bicarbonate of soda can help to dislodge ticks. Larval ticks may contain microorganisms for transmission.
Creams or Lotions
To remove ticks use a paralyzing topical cream or lotion such as:
i) Permethrin 5%, cream or lotion (usually for scabies ) (Lyclear 30g or Quellada Scabies Treatment 100ml) and is suitable for use for children. Apply from the chin down and wash off with warm, soapy water 8–14 hours later. Rinse thoroughly. Can also apply to the scalp, neck, face and ears in children <2 years, elderly or immunocompromised people. Permethrin acts on nerve cell membranes of the tick and subsequent paralysis (Australian Medicines Handbook, 2014).
For a single attached tick, dab Lyclear to the tick and leave alone for 1/2 hr. If the tick is still attached after 1/2 hr apply more Lyclear. After another 1/2 hr the tick should be dead and safe to remove with tweezers if it hasn't already fallen off.
Note: The likelihood of transmitting micro-organisms into the skin with these methods has not been studied and is unknown.
ii) Benzyl benzoate 25%, lotion (Ascabiol 200ml or Benzemul 200ml) is an alternative to permethrin though it is usually more irritant and use is unsuitable in children. Apply from the chin down and wash off with warm, soapy water 24 hours later. Traditionally applied after a hot bath, but this is unnecessary (Hadani et al, 1977, Gouck, 1966).
Removing multiple nymph infestation of the head can be addressed with, anti-lice shampoo containing 1% permethrin e.g., Quellada Head Lice Treatment, 100ml, or dab permethrin 5% cream or lotion as in i) above.
Insect Repellent Sprays
Insect repellents containing natural ingredients may not provide complete protection e.g tea tree oil, rosemary and eucalyptus oil (contraindicated in infants less than 3 years old). However, multiple repetitive tick encounters can be reduced with natural oils, especially if allergic to pesticides. Repellent sprays that are not permethrin or picaridin based may not provide complete protection also. One exception is BioUD a product from tomato plants that has been shown to be as effective or more effective than DEET (depending on tick species) and more effective than permethrin at repelling ticks (Bissinger et al., 2009).
- 20% DEET (not on children) (Rid®, Tropical strength Aerogard® 17%, Bushman’s® 40%)
- 16% picaridin (Off Tropical Strength®)
- BioUD – a new product thought to be less toxic than DEET.
- Mighty Tick Off, an electronic tick-repelling device, is currently being trialled.
Lotions and gels last longer than sprays.
Tick Removal Using Pesticides
i) pyrethroids -these include permethrin (Biomist®), resmethrin (Scourge®) and sumithrin (Anvil®).
ii) picaridin: ( Off®)
For a single attached tick, apply permethrin spray (to a small exposed patch of skin created by a hole in a band aid) and leave alone for 1/2 hr. If the tick is still there after 1/2 hr apply more spray. After another 1/2 hr the tick should be safe to remove with tweezers if it hasn't already fallen off. Note. The likelihood of transmitting micro-organisms into the skin with this method has not been studied and is unknown.
Clothes - Insecticide Application
Pyrethroids or picardin sprays can be applied directly to clothes and shoes. Deet can also be used but may deteriorate plastics and other surfaces.
Ether containing aerosol sprays – Aerostart and Wart-Off Freeze (see the Australasian Society of Clinical Immunology and Allergy)
Ether containing aerosol sprays kill the tick by rapid freezing. It appears that further injection of allergen containing saliva is minimized but human studies need to be conducted to clarify.
1) This is an anti-knock and anti-corrosive starting fluid for engines (which contains benzene) and is not registered for use in humans but there is anecdotal evidence in those with serious tick allergies (possibly applied to tick on a small patch of skin created by a hole in a band aid to minimize skin contact).
2) Wart-Off Freeze and Elastoplast Cold Spray
These products have been used in a limited manner and anecdotally reported to be effective. As more experience is documented advice will be updated. Both products are registered for use in humans.
IF SYMPTOMS OCCUR
It is normal for a tick bite to remain slightly itchy for several weeks. A short course of the less sedating oral antihistamines (1-5 days) such as, desloratadine, fexofenadine, loratadine, cetirizine and levocetirizine (e.g. Aerius, Telfast , Claratyne, Zyrtec and Xyzal respectively), can be taken to relieve symptoms of swelling and itchiness.
If you are highly allergic to tick bites, it is recommended you carry emergency medication such as EpiPen (an adrenaline autoinjector). Please consult with your doctor.
If other symptoms develop 3-7 days post tick bite e.g. headache, fever, malaise, muscle and joint tenderness or a bull’s eye rash, then a doctor should be consulted immediately. Sometimes symptoms develop long after the tick bite (weeks), if this occurs it would be worthwhile mentioning the tick bite to your doctor. See treatment after a tick bite.
Growing evidence of an emerging tick-borne disease that causes a Lyme like illness for many Australian patients
On 12 November 2015, the Senate referred the following matter to the Senate Community Affairs References Committee for inquiry and report:
The growing evidence of an emerging tick-borne disease that causes a Lyme‑like illness for many Australian patients.