Part 3: Tick bite prevention

Many have heard of the “red meat allergy” (alpha-gal syndrome – AGS), the result of a lone star tick bite. Sharon Forsyth, founder of Alpha-gal Alliance, provides information to help those who live in areas where there’s potential for contact with the lone star tick.

As someone who has been diagnosed with AGS, Forsyth has first-hand experience with tick bite prevention.

Most tick avoidance strategies are aimed at black-legged (deer) ticks. While these ticks transmit Lyme disease and other serious diseases, lone star ticks are different, and the same tips don’t always work.

“Lone star ticks are like a cross between a lentil and a velociraptor,” said Forsyth. “They are aggressive, fast and will detect and hunt you. Most ticks don’t bite humans, or if they do, not much. Lone star tick larvae gather in ‘bombs’ which are congregations of hundreds or thousands of tick larvae. When you brush up against vegetation that has these tick bombs, they will come off on your clothing, resulting in hundreds of thousands of bites. Multiple bites are more likely to result in AGS, so we think it’s often these larval tick bites that lead to AGS.”

Adult female lone star ticks have a characteristic white dot in the center of a brown body. Male ticks have spots or lines of white on the outer edge of their bodies, but these markings aren’t always easy to see. Nymphal stages lack the white markings and are the size of a poppy seed; larvae are slightly larger than the head of a pin. In most areas where lone star ticks are found, nymphs are active May through early August, while adults are most active April through June.

People should think about tick bite prevention before entering areas that may harbor ticks. “Permethrin-treated clothing, shoes and gear is the single best way to avoid lone star tick bites,” said Forsyth. “There are three options: spray items at home – spray shoes and gear with a permethrin spray. Or buy clothing that has been commercially treated with permethrin. This treatment is more effective and can survive 70 wash cycles compared to clothing sprayed at home, which survives six wash cycles. Alternatively, clothing can be sent to Insect Shield® for tick prevention treatment.”

Lone star tick experts disagree about the effectiveness of DEET, an ingredient in some insect and tick repellants. Some say lone star ticks drink DEET for breakfast; others think it’s worth using. In any case, Forsyth recommends against relying on repellants such as DEET, picaridin or home remedies.

Other tick prevention tips include wearing long socks, long pants and long-sleeve shirts. Light-colored clothing can help the wearer see ticks, especially larval and nymph stages, more easily. Tuck pants into socks and tuck shirts into pants. Forsyth also recommends wearing tall boots with double-sided carpet tape at the top. When ticks crawl up the boots, they become stuck on the tape and can’t go further.

“It’s difficult to see tick larvae, which are extremely small and might look like red dust or brown sugar,” said Forsyth. “Carry a lint roller and use it to roll up larval tick bombs. It’s hard to get that many tiny ticks off any other way.”

Check for ticks frequently. Prior to entering your home or vehicle, run a lint roller over every inch of your clothing. At home, place clothes in the dryer – ticks are not killed by water but heat kills them. Check your entire body and remove any ticks properly. Check children for ticks carefully and teach them how to prevent tick bites.

Using a tick removal tool that can be slipped between the skin and the tick’s head is ideal. Pull upward with steady pressure rather than with a quick jerking motion, which can result in the tick’s mouthparts remaining in the skin. Alternately, use fine-tipped tweezers and pull steadily upward.

After removing the tick, wash your hands and the bitten area with warm, soapy water. If you plan to submit the tick for testing, place it in a clean, sealable plastic bag and mail as soon as possible. Record the date the tick was removed so you can provide your health provider with information.

Take photos of the tick before removal, and photos of the bitten area after removal. If the tick has been in the skin for more than a few hours, contact your healthcare provider to find out whether prophylactic treatment is recommended.

The CDC recommends seeking immediate medical care if any of these symptoms arises: fever or chills, rash, nausea or vomiting, headache, body aches, joint pain, fatigue or swollen lymph nodes. Remember that symptoms of AGS are usually delayed for weeks following a bite.

If you are bitten, watch for signs of tick-borne disease. “It isn’t just alpha-gal,” said Forsyth. “Ticks cause some other terrible diseases.”

Familiarize yourself and your family with the habits and lifecycle stages of tick species in your region and when ticks are most active. In some areas, some stages of certain tick species remain active during winter. Nymph ticks tend to remain close to the ground, which allows them to easily hitch a ride on the shoes (or paws) of a host that passes by. All tick species and stages move upward once they’re on a host. Ticks can reach a human host’s upper part of the body in just minutes, which is why they’re often found on the chest, neck and scalp.

For more information on AGS, visit alphagalinformation.org.

Part 4 will include personal stories of those with AGS.