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Sussex Travel Clinic News

Latest news for vaccinations and healthy travel.

Feeling ticked off?

Feeling ticked off?

Ticks are tiny little blood suckers. Sometimes they can be difficult to spot, they can be as small as a poppy seed! After having a feed, adult ticks can swell up to the size of a small pea and become much lighter in colour.

tick

 

They can infect you with Lyme disease, Tick Bourne Encephalitis, Rocky Mountain Spotted fever and Crimean-Congo Haemorrhagic Fever.

Who’s most at risk?

Rural travellers in tick risk areas, countryside workers, children, hikers, gardeners, campers and outdoor athletes.

So how do I protect myself from ticks? – Top Tick Tips

Tip 1 – Where are ticks found?

The castor bean tick (Ixodes ricinus)

The castor bean tick (Ixodes ricinus)

They live in the soil and emerge to climb tall grass shrubs, bushes and low level tree branches, where they wait for their next victim. This means they can be found in gardens, woodland and meadows and dunes.

Ticks can’t jump or fly they normally hitch a lift and become attached to skin or clothing after brushing against the bracken or long grass, they then wander off to warm moist areas of the body such as groins, armpits or backs of knees to have a meal. You won’t feel the bite because the tick injects a toxin that anesthetises the area.

Tick season in the UK is normally March to October during the warmer months

Tip 2 – Use an insect repellent

Lifesystems Deet 50+

Lifesystems Deet 50+

DEET has been proven to be the most effective preparation in preventing ticks.

DEET has been used as an insect repellent for around 50 years and it is available in different concentrations. 50% concentration is recommended.

DEET can be used for children over the age of 2 months. For children, use clothing as the main barrier and repellent on any remaining exposed areas of skin.

If you are taking a baby under two months travelling to countries with risks ticks get expert advice about suitable repellents.

It can be used in pregnancy and breast feeding women.

If you are using sunscreen, it is advised that repellent must be applied after sunscreen. Choose a high factor sunscreen as DEET can reduce the effectiveness of the SPF. Always wait for half an hour after applying sunscreen before applying DEET.

Remember to remove repellent with soap and water when it is no longer needed.

Do not spray directly onto faces, spray on hands first and then apply to face. Wash hands after applying to prevent contact with lips and eyes.

Never use on cuts, abrasions or irritated skin.

Tick sprayYou could use a natural insect repellent as an alternative to DEET.

Sussex Travel Clinic now stocks the new Care Plus Anti-Tick repellent which contains a powerful Citriodiol®-based formula, this natural Anti-Tick repellent offers up to 6 hours protection per application, and can be used on anyone over 3 months of age, this makes it an excellent product for children and families.

 Tip 3 – dress (not) to impress a tick!

Protecting Against Ticks by Tucking Pants into Socks

Protecting Against Ticks by Tucking Pants into Socks

Clothes are your best protection. Try to wear long trousers and tuck them into your socks, not an attractive look I know, but vital.

You could consider wearing bug socks that are manufactured with impregnated insect repellent.

It’s a good idea to treat your clothing using an insecticide spray that contains permethrin (an insecticide that kills insects on contact) this should only be used on clothing NOT your skin.

Tip 4 – Do the tick check! No, it’s not a dance move!

After you have been outdoors, check your body regularly for ticks. It’s a good idea to have a ‘tick buddy’ who can help you check difficult to reach areas!

Tip 5 – Carry a tick remover

Carry a tick remover or fine tipped tweezers so that ticks can be safely and easily removed. You should always try to remove ticks as soon as possible, preferably within eight hours.

How a tick is removed is really important. Incorrect tick removal can result in:

  • The tick’s mouth parts being left behind in your skin.
  • Squeezing of the tick’s body.
  • Puncture of the tick’s body.
  • Injury and irritation to the tick.

    Care Plus Tick Remover

    Care Plus Tick Remover

 Why does this cause a problem?

  • If the tick’s mouth parts are left behind they can lead to a localised infection, which in severe cases can result in abscesses and possibly even septicaemia.
  • Squeezing the tick’s body could cause fluids (its saliva and gut contents) to be squeezed back into your bloodstream. These fluids may contain disease-causing organisms.
  • If the tick’s body is punctured during removal it can spill infective fluids on to you, or on to the person removing the tick.
  • Causing injury or irritation to the tick may result in it regurgitating (vomiting) infective fluids you, which could potentially cause a serious infection.

Remember DON’T – crush or squeeze the tick’s body or hit with books or try to burn or freeze it, or use petroleum jelly or liquid solutions to suffocate the tick as this may shock the tick and prompt it to regurgitate saliva into the bite wound and spread infection.

Tweezer tick-removal technique

1) Grasp the tick as close to the skin as possible and pull upwards with steady, even pressure.

Do not twist or jerk the tick as this may leave its mouth parts embedded in the skin, or cause it to regurgitate disease causing fluids. If any mouth parts do break off, you can remove them with a sterilised needle or tweezer points.

Tick Removal: Tick-removal tool

 

There are quite a few tick-removal tools on the market.

It is important to remember when choosing your tool that the most important points of tick removal are:

  • The tick’s body must not be squeezed, as this can force out saliva and gut contents which might contain disease-causing organisms.
  • The tick should not be irritated or injured, as this may result in it regurgitating (vomiting) saliva and gut contents along with any disease-causing organisms.
  • The mouth parts of the tick should be cleanly removed along with the rest of its body.
  • The tick should be removed without causing you discomfort.

Sussex Travel Clinic currently stocks the Care Plus Tick remover.

  • Hold the tick remover between your thumb and middle finger and press the back of the tool with your index finger: the gripping head will now open.
  • Place the gripping head carefully around the tick — as close as possible to the skin — and then close the gripping head.
  • Rotate the clamped tick slightly to the left and slightly to the right until it is partially released. With a few gentle tugs, pull the tick out in a motion perpendicular to the skin.

After removing the tick, it’s a very good idea to wash your hands and the affected area with soap and water, then treat the bite area with an antiseptic.

 

Tip 6 – what do I do with the tick once I’ve removed it?

The best way to dispose of a tick is by crushing it and flushing it down the toilet or wrap it in a tissue and throw it into a dustbin. Be aware that engorged ticks will contain potentially infected blood, which may splatter when crushed. Do not crush the tick with your fingers and do not allow the crushed tick or the blood it was carrying to come into contact your skin.

It is best not to let the tick go when you remove it as it can then go on to lay more eggs or bite someone else!

Lyme disease

What is it?

tick testDid you know that approximately 3,000 people in the UK contract Lyme disease (Borreliosis) from tick bites every year and that Lyme disease is more common than previously thought?

Fifteen percent of cases that are diagnosed in the UK are contracted abroad, generally from east coastal states in North America and in Europe, especially northern European countries and Scandinavia.

In the UK, known risk areas include Exmoor, the New Forest, the South Downs, the Lake District, the Yorkshire moors and many rural areas in Scotland, notably the Scottish Highlands. It may occur elsewhere in the UK.

You need to act quickly after suffering from a tick bite. If you wait for the first signs of illness, the disease can already have become chronic. Always seek advice from your doctor if an inflamed red ring appears around the bite which looks a little like a bull’s eye target; or if you have any symptoms such as joint and muscle pain, fever, headache and tiredness. All these symptoms could indicate that you have been infected with Lyme disease.

Early diagnosis and treatment reduces the risk of complications of the disease. Lyme disease is diagnosed with a blood test and is treated with antibiotics.

Sussex Travel Clinic stocks the Care Plus tick test – to test ticks for Lyme disease.

This tick test lets you find out immediately after the bite whether the tick carries the bacteria that causes Lyme disease. The tick test produces a result within 20 minutes. If the result is positive, your doctor can start treatment immediately. The earlier you start treatment, the more effective it will be.

 

Tick-Borne Encephalitis

What is it?

Tick-borne Encephalitis (TBE) is spread by tick bites. It is a serious infection of the brain and vaccination is advised for those in risk areas unable to avoid tick bites such as campers, forestry workers and ramblers.

Tick-borne Encephalitis is present in many countries worldwide. There are 3 main subtypes of Tick-borne Encephalitis that are found in the following locations:

European/Western – Europe to Russia

Siberian – Urals, Siberia, far Eastern Russia, Finland

Far Eastern – far Eastern Russia, China and Japan

Tick-borne Encephalitis Map

Initial symptoms of TBE are similar to flu and can include, a high temperature, a headache, tiredness and muscle pain

These symptoms typically last for up to eight days, after this most people get better.

However, some people go on to develop more serious symptoms, such as meningitis or encephalitis.

Second-stage symptoms:

  • confusion, drowsiness or disorientation
  • convulsions
  • sensitivity to bright light
  • paralysis

This is a medical emergency and would normally require admission to hospital. There is no treatment for TBE. Most people will slowly get better over a period of time, but it could take months even years to fully recover. Some people are left with long term complications from the disease. Approximately one in every 100 cases of TBE is fatal.

Travellers to TBE risk countries should consider having the vaccination before departure

Vaccine Schedule

3 doses – Day 0, 1-3 months later and 5- 12 after the second dose.

Or if short of time before departure the following schedule can be offered:

3 doses – 0, 14 days, 5-12 months after the 2nd dose

Booster – 3 years after a primary course as above, then every 3-5 years.

Children – can be given to children aged 1 year and over

We look forward to seeing you soon in clinic. Happy travelling!

Love the Sussex Travel Clinic Team x

Written by Nicki Harrison- RGN- Lead Nurse

Useful resources

Please see the following advice for more information on Tick Bourne Encephalitis:

http://www.tickalert.org/

References and Bibliography:

http://www.lymediseaseaction.org.uk/

http://www.tickalert.org/

http://www.bada-uk.org/tick-control/tick-control-domestic-environment

http://travelhealthpro.org.uk/tick-borne-encephalitis/

http://www.fitfortravel.nhs.uk/advice/disease-prevention-advice/tick-borne-encephalitis.aspx

http://www.masta.org/tickalert/

https://www.gov.uk/government/collections/immunisation-against-infectious-disease-the-green-book

http://www.who.int/

http://www.nhs.uk/Conditions/Tick-borne-encephalitis/Pages/Introduction.aspx

Posted July 21, 2016
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