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Chigger Treatment

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					     Ticks and Chiggers
   -Information, Safety, and
          Prevention
Background??




               By Rob Edmunds

                                1
                    What are Ticks?
   Ticks belong to the class
    Arachnida, which includes
    spiders, scorpions, and mites.
    There are two well established
    types of ticks: the hard ticks, and
    the soft ticks.
   Ticks are very small insects that
    attach to a host using their front
    legs and mouth. Ticks feed off the
    blood of the host, living on the
    surface of the skin during the
    nymphal stage of development.
   In all, there are approximately 850
    species of ticks, and roughly 100
    of them are capable of
    transmitting diseases.


                                          2
       Tick-Transmitted Diseases
   One tick bite has the possibility of transmitting
    multiple diseases, the most common of which
    are: Lyme Disease, Human Ehrlichiosis,
    Rocky Mountain Spotted Fever, and an
    Encephalitis-like Virus that causes swelling of
    the brain



                                                    3
        What Is Lyme Disease?


   Lyme Disease is the most common type
    of tick-transmitted disease.
   It is a Bacterial Infection
   Primarily transmitted by „Black-legged‟
    (Deer Tick)
   Affects both animals and humans

                                              4
                               Symptoms
   Early Lyme Disease (Days to month after
    bite)
    –   Large ring shaped rash at the location of
        bite
    –   Syptoms are similar to the Flu, including stiff neck,
        chills and fever, headache, and fatigue
   Late Lyme Disease
    –   Syptoms of Late Lyme disease include meningitis,
        arthritis, facial palsy, and heart abnormalities.

            –   Information from Brookhaven National Laboratories
                http://www.bnl.gov/esh/shsd/PDF/SHSD%20Disease%20Sympton%20Handout.pdf




                                                                                         5
Images from Hunterdon
Health Department:
www.co.hunterdon.nj.us/healt   6
h/lymeinfo.htm
                              TREATMENT
   Doxycycline, amoxicillin, and ceftin
   Usually treated for 4-6 weeks.

   A recent study reported in the New England Journal of
    Medicine states that a four-week course of oral
    doxycycline is equally as effective in treating Lyme
    Disease in late stages, and much less costly, than a
    similar treatment of intravenous Ceftriaxone (Rocephin)
    unless neurological or severe cardiac abnormalities are
    present.


      Information from Hunterdon Health
      Department:                                             7
      www.co.hunterdon.nj.us/health/lymeinfo.
      htm
     Typical Seasonal Distribution of
      Reported Lyme Disease Cases
140

120

100

  80
  60

  40

  20

    0
         Jan     Feb      Mar      Apr     May   Jun   Jul   Aug   Sept   Oct   Nov   Dec

Information from Hunterdon Health Department:                                               8
www.co.hunterdon.nj.us/health/lymeinfo.htm
                                         LYME Cases by Age
                       60                                                                                             60

                                         Male
                       50                                                                              50




                       40                Female
Num b e r of C ase s




                                                                                                            40
                                                                                             39

                                                                                                  35
                                                                                                                 34
                       30                                   30



                                                       23
                       20
                               19
                                    18
                                                  16                                  17

                                                                 13              13
                       10                                               10

                                          1   1                              5

                        0
                            Unk nown              2 - 9               20 - 29              40 - 49               60 +
                              Age

                            Information from Hunterdon Health
                            Department:                                                                                    9
                            www.co.hunterdon.nj.us/health/lym
                            einfo.htm
                  Ehrlichiosis
A disease caused by bacteria in the
Lone-Star tick and Deer tick.
It is considered an acute infection
without chronic long-term consequences.
The severity of the disease varies from
person to person. May be life-threatening
or fatal for elderly and others with
compromised immune systems.
    Information from Brookhaven National Laboratories:
    http://www.bnl.gov/esh/shsd/PDF/ESH%20COORDINATOR
    S%20061108%20TICKS.pdf                               10
                           Symptoms
   The infected person may be asymptomatic or
    may have mild to severe symptoms.
   Initial symptoms can include fever, headache,
    and muscle aches. Other symptoms include
    nausea, vomiting, diarrhea, cough, and joint
    pains. May also have a rash. Severe
    complications include prolonged fever, renal
    failure, seizures, or coma.
   As many as half of all patients require
    hospitalization. 2-3% of patients die from the
    infection.
         Information from Brookhaven National Laboratories:
         http://www.bnl.gov/esh/shsd/PDF/ESH%20COORDINATO
                                                              11
         RS%20061108%20TICKS.pdf
                           Treatment
   Treatment should be initiated immediately
    when there is suspicion of Ehrlichiosis.
    Treatment should not be delayed until lab
    confirmation is obtained.
   100 mg. Doxycycline twice daily for a
    minimum of 7 days. Severe cases may
    require longer treatment.

         Information from Brookhaven National Laboratories:
         http://www.bnl.gov/esh/shsd/PDF/ESH%20COORDINATO
         RS%20061108%20TICKS.pdf                              12
                                Babesiosis
    Babesiosis is a malaria-like illness caused
    by a protozoan parasite that is primarily
    transmitted by the black-legged deer tick.




Information from Brookhaven
National Laboratories:
http://www.bnl.gov/esh/shsd/P
DF/ESH%20COORDINATO
RS%20061108%20TICKS.pd
f
                                               13
Symptoms                             Treatment
   May be asymptomatic;         Clindamycin +
    symptoms include fever,     quinine or atovaquone
    chills, sweating, muscle    plus azithromycin for 7
    aches, fatigue, and         days.
    hemolytic anemia.
    Symptoms typically
    occur after an incubation
    period of 1-4 weeks, and
    can last several weeks.
    Disease is more severe
    in the elderly and
    immunosuppressed
    individuals.                    Information from Brookhaven National
                                    Laboratories:
                                    http://www.bnl.gov/esh/shsd/PDF/ESH%20
                                    COORDINATORS%20061108%20TICKS.
                                                                             14
                                    pdf
Engorged
Nymphal
Tick




       15
                 Know Your Facts...
   Ticks must be attached 36
    - 48 hours to transmit
    bacteria
   Approximately 20% of
    nymphal ticks carry
    bacteria
   Nymphal ticks cause
    majority of Lyme cases
   Nymphal ticks most active
    late May thru July
   Adult ticks most active late
    Oct. and early November.
   If an attached tick is found
    and removed, your
    chances of developing
    Lyme disease is just 1-3%      Information from Hunterdon
                                   Health Department:
                                   www.co.hunterdon.nj.us/health/ly   16
                                   meinfo.htm
        Common Tick Habitats

   Tall grassy
    areas
   Leaf litter
   Ground cover
   Low bushes /
    shrubs
   Need moisture
    to survive

                               17
               Wood Tick


   Larger than
    Deer Tick
   Does NOT
    transmit Lyme



                           18
   Three
    Active
    Stages
   Need ‘host’
    at each
    stage
    (Such as
    mouse, other
    animal or
    person)
   Attach as
    host
                   White-footed mice
    passes by      serve as the principal
                   reservoirs of infection
                   on which many larval
                   and nymphal ticks
                   feed and become
                   infected with the LD
                   spirochete.               Information from Hunterdon Health
                                             Department:                         19
                                             www.co.hunterdon.nj.us/health/lym
                                             einfo.htm
                            Chiggers
   Chiggers are small insects no bigger than
    1/20th of an inch and are bright red. Though
    extremely annoying, chiggers are not known
    for transmitting any diseases. Both Ticks and
    Chiggers live in low lying foliage and brush
    and are encountered when a person comes in
    contact or brushes against the foliage.
         1/20 inch is very large, actually they are only visible in
         the best of lighting conditions

                                                                      20
           Chigger Information
   Chiggers are a part of
    the mite family.
   There are four stages in
    the life span of a
    chigger; egg, larva,
    nymph, and adult.
   The larval chigger is
    responsible for the
    irritating bites and
    ensuing rashes.

                                 21
   Chigger’s secrete a digestive fluid onto the
    host’s skin cells causing them to breakdown.
    Then a feeding tube descends from the chigger
    allowing them to feed on the liquified cells
    until they become engorged. Once the larva
    has finished nourishing itself they will leave
    the host and find a place to develop
    The nymph and adult stages do not affect
    humans or animals

                                                 22
      Symptoms of a Chigger Bite
   Chigger bites effect
    people differently,
    however, a red puffy
    rash is typical, and is
    caused by the digestive
    enzymes secreted by the
    chigger
   Rash can last from 2-3
    days, up to 3 weeks

                                   23
                  Treatment
   Once chigger bites have been noticed, the best
    course of action is to take a hot bath, which
    will kill the remaining larvae and remove them
    from the skin
   Ointment can be used to control the itch
    related to the chigger’s digestive secretion



                                                 24
                                     OSHA
   There were no OSHA recorded fatalities
    cuased by Ticks or Chiggers during the time
    period of 1990- 2007
   However, according to the American Lyme
    Disease Foundation, there have been more
    than 150,000 cases of Lyme disease identified
    since 1982
       –   Information from The American Lyme Disease Foundation. http://www.aldf.com/lyme.shtml



                    Consider two slides for this. Be sure to
                    add a reference for the OSHA data.                                             25
 Personal Protection
 Measures to Reduce
Your Risks From Ticks
    and Chiggers


                        26
Before entering areas
  with Ticks or
  Chiggers:
 Wear light-colored
  clothing
 Wear loose-fitting
  clothing
 Tuck shirt into pants
  and pants into socks
 Wear closed-toe shoes




                          27
   Perform
Frequent Tick
  Checks….

 …while in tick
  habitats AND
 when returning
     home

                  28
    Avoid areas where
    it is likely to
    encounter ticks
    and chiggers, when
    possible
    Keep to center of
    pathways



                     29
 Tick Repellents
for Personal Use
        30% - 40% DEET content
         most effective for ticks and
         chiggers
        Use on skin OR clothing
        Apply to the shoes and
         pant legs




                                   30
 Tick Repellents
for Personal Use
           Permethrin-containing
            products
           Use on clothing only,
            as it is an insecticide
            and can cause
            serious reactions is
            applied to skin




                                 31
 What Can You Do to
  Reduce the Risk of
Encountering Ticks and
     Chiggers?

                         32
                Keep grass and
                 foliage short
                Prune trees and
                 shrubbery
                Remove old leaf and
                 debris piles
                Allow sunlight!


Ticks need
  moisture
to survive
                                       33
    The Proper Use of
     Insecticides Can
   Greatly Reduce the
  Incidence of Tick and
       Chigger Bites
  Late May: Granular
Late September: Liquid




                          34
Proper Tick Removal

                Use fine-point
                 tweezers
                Grasp the tick CLOSE
                 TO SKIN
                Pull gently
                Wash area with soap,
                 water and antiseptic
                Burning, suffocating,
                 and poisoning of ticks
                 does not work in
                 removing them from
                 host


                                      35
      Jobsite Awareness Activities
   Tick ID cards and Lyme Disease Alert notices
    should be presented and available to all
    employees
   “Toolbox Talks” every week to remind workers
    about the dangers of ticks
   Mandate long pants and sleeves for workers
    working in tick and chigger habitats
   Set time aside at the end of the day for tick
    checks


                                                    36
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