Summer is absolutely gorgeous in the Yampa Valley and Steamboat Area. People who visit and live in the Yampa Valley love the great outdoors. They love to hike, bike, picnic, barbeque, camp, fish and boat in the mountain, lakes, rivers and parks. It’s a fun way to gather with friends and family, and get plenty of exercise and vitamin D as well. There are a few little residents of our valley know as ticks and mosquitoes that could pose as threats to one’s health. But with taking a few precautions, the threats they present are minor.
TICKS
Tick season usually peaks from April till June, but ticks sometimes come out as early as March. There are over 30 kinds of ticks in Colorado. But the main disease characters are the Rocky Mountain Wood tick and the American dog tick. Remember biology class? Ticks go through life cycles as larvae, nymphs and adults. They feed on birds and small mammals, in addition to humans. If carrying the virus that causes tick borne illness, it can be transmitted to the next victim the tick chooses to feed on. The virus lives in red blood cells, and can remain in the body for up to 6 months. The main tick illnesses are Lymes disease, Rocky Mountain Spotted Fever, Tularemia, Relapsing Fever, Colorado Tick Fever and Erlichiosis. Fortunately, our dog and wood ticks do not carry most of these diseases. Ticks on the East and West Coasts and southern United states (deer ticks) carry most of these illnesses and have not yet been detected in Colorado. Colorado Tick Fever is the main illness from wood and dog tick. Here’s a great trivia question: what virus is responsible for Colorado Tick Fever? Celtivirus. The tick is Dermacenter andersoni. The vast majority of ticks do not carry the virus. If they do, fortunately most people do not become ill after coming into contact with the tick. About 200 cases were reported in Colorado last year (although it is likely many cases are not reported.) Like so many other infections, the “flu like symptoms” are very nonspecific: fever, headache, nausea, vomiting, muscle aches, fatigue and possibly a minimal rash. Symptoms typically last 1 to 3 days. But symptoms can be biphasic-that is, recur a second time for a couple days early in recovery. The incubation period is 1 to 3 weeks after a tick bite. The virus cannot be cured by antibiotics. So the treatment is supportive: maintain hydration and treat the fever throughout the illness. Fatigue is usually short term, but has rarely been known to persist for weeks after the illness. If you develop such symptoms during the summer and have been exposed to ticks, it is recommended to see a doctor. Our doctors at our 7 day a week clinic, Steamboat Urgent Care and Pine Grove Clinic are very experienced in evaluating tick borne and other summer illnesses. Because there are so many other causes of “flu like illness”, the main role of the evaluation is to make sure the victim does not have a medical condition that does require specific medical treatment, such as antibiotics for a bacterial infection. For instance, Rocky Mountain Spotted Fever is a serious bacterial infection spread by ticks. Only 3 cases were noted in Colorado last year. The severe flu like symptoms are accompanied by a rash that typically develops over wrists and ankles, then spreads to palms, soles and toward the center of the body.
Tick bites can largely be prevented. One way is to avoid heavily infested tick areas. Clear away leaves, brush, grass and wood piles around the house and edge of the yard. Still, heavy tick areas develop often in places people love to go because they are drawn to the CO2 people exhale. The tick likes to hang out on low vegetation and watch for it’s prey. When the person walks by, the tick jumps on board and within 12 to 14 hours will typically migrate to an area of the body for it’s next tasty blood meal. Ticks feed by latching on with barbed teeth. They remain latched on for several days until they are engorged with blood from the victim and then fall off. In the feeding process, they typically inject secretions into and under the skin. The secretions are how the tick can spread viral illness to it’s victim. When walking through brushy areas and grass where ticks live, it is advised to cover the body by wearing a hat, long sleeves, and long pants with the pant legs tucked into the socks. Ticks can be seen easier on light clothing. Insect repellents with Deet (Off and Cutter) can be applied directly to the clothing. At the end of the day, check for ticks, especially in the groin, arm pits, and head. Use a fine tooth comb to brush hair. Check children and pets. If ticks are found on clothing, they call be killed by putting clothing in the dryer or hanging in the hot sun for 15 minutes.
If a tick is found unattached, simply remove it. If it is embedded with those barbed teeth, use fine tipped tweezers and gently apply pressure right where the tick’s head and mouth is next to the skin. Then gently pull straight out until he releases his grip. If you pull to fast, his teeth may remain in the skin. If you squeeze his whole body, the blood contents may be squeezed back into your skin. If tweezers are not available, you can use your fingers, but cover them with gloves or a plastic bag. Save the tick in case you become ill. The tick species can then be identified. Gently cleanse the bite site with clean warm water. Cover the site with vasoline and a nonstick bandaid. Do not remove the tick using old wives tales: do not try to smother the tick with petroleum jelly, apply nail polish, rubbing alcohol or “burn” the tick out. These techniques increase the risk of secretions being deposited into your skin.
In addition to Colorado Tick Fever, a really rare but freaky illness that can develop is Tick Paralysis. Tick paralysis is the sudden development of difficulty walking, limb numbness and difficulty breathing that develops over hours. If the tick is in the head, symptoms can be facial paralysis, double vision and difficulty swallowing or talking. Fortunately, the cure is to find the embedded tick and remove him. The symptoms will resolve quite rapidly.
WEST NILE
The dreaded West Nile virus is spread by infected mosquitoes. Peak occurrence is from June to September. Over 70 to 80% of victims will get no symptoms. The symptoms are the typical nonspecific “flu like illness” symptoms: fever, headache, body aches, joint pain, vomiting, diarrhea, and possibly a rash. Symptoms typically last under 10 days, but very rarely symptoms have been reported to last weeks or months. Like many viruses, unfortunately a very small number of people {well under 1%) can develop a brain or brain covering infection called encephalitis or meningitis, presenting with severe headache, high fever, neck stiffness, confusion, seizures or coma. Hopefully that person seeks care. A few persons who become infected can develop persistent fatigue and achiness for several weeks after the initial fever resolves. A pink spotty rash occurs in half the victims. Unfortunately, viral testing is expensive, not readily available and results do not come back for weeks, so blood testing and spinal fluid testing are used in limited casesgenerally for neurologic cases. You can reduce your chances of getting bitten by mosquitoes by using insect repellents, as you do with tick prevention. Young children can again be dressed in light weight long sleeves and pants with pants tucked into socks. In that way, bug repellent can be applied to areas of the clothing where it will minimize chances of skin contact with the face and hands.
ENTEROVIRUS
And finally, another popular class of summer time fever and flu like illness are a class of viruses known as enterovirus. Check out these names: Coxsaches and ECHO virus-they have many different cousins. Polio is in this group of viruses. So is Hand, Foot and Mouth disease. Fortunately, polio vaccine was highly effective. And hand foot and mouth disease is fairly benign. The main source of these viruses are from contaminated water from human feces (poop), especially swimming pools and lakes. Flu like symptoms can develop, but so can upper respiratory infections, diarrhea, vomiting, pink eye, rashes and blisters. Underchlorinated public recreational water is a high risk source. Avoid dirty lakes and overcrowded swimming pools to minimize your risks. And don’t drink the water in pools and lakes.