Maggie McKay (Host): Some people say tick season technically never ends because ticks can be found year round. But if you've ever encountered them, you know you want to do everything in your power to avoid them. Today, we'll find out how to avoid getting bitten with Kassandra Foley, Regional Director of Infection Prevention.

 Welcome to St. Joseph's Health Podcast. I'm Maggie McKay. Thanks for being here today, Kassandra.

Kassandra Foley: Thank you so much for having me.

Host: So, let's get right into it. What can be done before you go outside?

Kassandra Foley: Knowing what to wear proper clothing-wise is going to be very helpful before you go outside. Making sure we're wearing long pants, long sleeves. Treating our clothes and our gear with repellent before we go are all going to be good ways to make sure that we're protecting ourselves before we go outside.

Host: And is there any kind of natural repellent?

Kassandra Foley: They say that you can use oil of lemon eucalyptus on exposed skin, which would be some natural repellents. Any kind of repellent, though, that uses DEET or permethrin are also options for treating either your skin and/or your gear before you go out.

Host: And where do ticks live? I mean, where should we expect to see them?

Kassandra Foley: Ticks are typically found in wooded, grassy, and brushy areas. So if you are going out to go for a hike, staying on well-trimmed paths are going to be your best option.

Host: Kassandra, you mentioned clothing, spraying your clothing or have that type that you can buy with stuff already in it. But what about your boots, is that necessary? Or your footwear?

Kassandra Foley: I think spraying any of your clothing or your gear is going to be helpful. Also, wearing light colored clothing makes it a lot easier for you to spot ticks when they are on your clothes.

Host: So, how big are they? Can we actually see them?

Kassandra Foley: So, they do change quite extensively through their life cycle. When they are very small, it is hard to see them, but as they go through their life cycle and also as, unfortunately, they go through what we call a blood meal, so when they are feeding, they also become engorged and are much easier to see.

Host: Eww, kind of like mosquitoes. So, what do you do afterwards, after your hike, or after you've been bitten?

Kassandra Foley: So after you come inside, first, you want to check your clothing for ticks. And that's why when we say that you wear light-colored clothing, it's a lot easier to see at that time. You want to examine your gear. If you're hiking with your pets, you want to take a look at your pets as well. If possible, you want to shower as soon as you come in from being outdoors. Again, that's going to help mechanically get any of those ticks off you if they haven't yet bitten you. It's important to look in all areas of your body, some areas that we sometimes miss are under our arms, in and around our ears, inside our belly buttons, behind our knees, in and around our hairline, between our legs, and around our waist.

Host: Oh my goodness, in your belly button? I would die if I found a tick there.

Kassandra Foley: Yes, they like to find all those hidden areas.

Host: Oh my gosh. So, how do you remove a tick?

Kassandra Foley: You want to use clean, fine tipped tweezers to grasp the tick as close to the skin surface as possible. And then, with kind of one upward steady movement, you want to pull the tick up. We want to try to not break the mouth part, which is the part that they're using to bite you off.

And once you remove the tick, you want to thoroughly clean the bite area with soap and water or rubbing alcohol if you have it. We really don't want to crush the tick with our fingers. There's old wives tales about using petroleum jelly or nail polish over the ticks, we don't want to do that. We want to just try to remove it as soon as possible in one piece.

Host: So, let's say you do get bitten by a tick. How does Lyme disease present itself? How would you know you had it? And are there other illnesses you can get?

Kassandra Foley: There are. So, Lyme is probably the one that we're most familiar with, but there are other bacterial parasitic and viral infections that ticks can transmit. Most of them present in very similar ways, so fever and chills, aches and pains, and most likely with Lyme is going to be that distinctive bullseye rash. Not all cases of Lyme, though, will have that rash. So, it's indicative when you do have it, but it's doesn't exclude if you don't have that rash.

There are also some other tick-borne illnesses that also have different types of rash. So, after you've been bitten by a tick, it's important to monitor yourself for any kind of symptoms. And if you're not feeling well, always follow up with your primary care physician.

On the CDC website, there's a great resource called a Tick Bite Bot. And it actually walks you through a series of questions about how long the tick has been on you, how large the tick is, and if you're having any symptoms or not. And it can direct you in whether or not you should go seek treatment, to call your physician, and it'll walk you through how to remove that tick. So, that's definitely a helpful resource that they've put together.

Host: Oh, it sounds like it. Do you know when you've been bitten? I mean, does it hurt? Is it like, "Ow"?

Kassandra Foley: No, it's not like how you sometimes feel like a stung by a bee or a horsefly or even a mosquito at some point. So, it is hard to tell when you've been bit by a tick. It's usually kind of an incidental finding. Either if you're looking after you've come indoors or, unfortunately, if you all of a sudden see or feel it when it becomes big enough.

Sometimes people don't know that they've been bitten by a tick. And this time of year, they just start to have some of these feelings or again, if they have that bullseye rash, it's always a good idea to go see your provider. And most providers will have this kind of in their differential diagnosis at this time of the year.

Host: Oh, you talked about the bullseye rash. Are there any other symptoms that people should be looking out for? And if so, how do you treat them? What are the options for treatment?

Kassandra Foley: So depending on if it's Lyme or if there are other parasites or viruses, there is treatment. Your doctor would be able to prescribe the most appropriate treatment, whether it be an antibiotic or an antiviral. And a lot of it is just supportive treatment as well, taking care of the symptoms,

Host: And are there people that ticks like more? Does it have anything to do with blood type?

Kassandra Foley: Not that I'm aware of. I haven't seen any studies to support that.

Host: Is there anything else in closing that you'd like to add that we didn't cover?

Kassandra Foley: I just think that it's a great time of year to get out there, enjoy the weather, do exercise outside, but it is a real risk and important for us to make sure we're checking ourselves, checking our children and our pets to make sure we're preventing any of these tick-borne diseases.

Host: Well, thank you so much for sharing these useful tips, Kassandra. I know I learned a lot.

Kassandra Foley: Thank you.

Host: Again, that's Kassandra Foley. To find out more, the CDC has very helpful information. As Kassandra mentioned, you can visit cdc.gov/ticks. That's cdc.gov/ticks. And if you found this podcast helpful, please share it on your social channels and check out our entire podcast library for topics of interest to you. I'm Maggie McKay. Thanks for listening to St. Joseph's Health Podcast.