Warmer weather means ticks are active and looking to suck your blood; they can make you sick; here's how to deal with them

Mosquito Squad of Louisville graphic, adapted by Kentucky Health News; click on it to enlarge

State wildlife officials are reminding Kentuckians to take precautions against tick bites, which can transmit disease.

“Ticks are common across the state, and whether you’re hunting, hiking or spending time in your backyard, you’re probably going to encounter them,” said Dr. Christine Casey, wildlife veterinarian for the Deparment of Fish and Wildlife Resources. “The key to avoiding any health risk from a tick bite is by taking steps to protect yourself from being bitten in the first place.”

The most common tick species in Kentucky are the blacklegged tick or deer tick, the American dog tick and the lone star tick. The type of tick can determine whether you get sick from a single bite; other factos include where it was acquired and how long it was attached.

"While few ticks transmit disease, tick bites should always be taken seriously," the department said in a news release. "Lyme disease, transmitted by infected blacklegged ticks and common in the northeast and north central U.S., is of growing concern to Kentucky.

"Ticks don’t have to ruin a day outdoors," the department says, offering these precautions to avoid tick bites and deal with them if you are bitten:

Before going outdoors

• Use Environmental Protection Agency-registered insect repellents containing DEET (the oldest, most common and most effective insect repellent), picaridin, or oil of citronella.

• Treat clothing and gear with products containing 0.5% permethrin, which kills ticks on contact. Permethrin should not be applied directly to the skin.

• Take extra precaution if walking through wooded or brushy areas, tall grasses, woodpiles and leaf litter.

After spending time outdoors

• Perform tick checks. Ticks are known to be found under the arms, in and around the ears, the back of the knees, in and around hair, between the legs and around the groin and waist. Be sure to check gear and pets as well.

• Shower soon after coming indoors; this can remove any unattached ticks.

• Tumble-dry clothes in a dryer on high heat for 10 minutes to kill ticks attached to clothes.

If you are bitten by a tick

If a tick is found attached to the skin, remove it as soon as possible. Use tweezers to grab the tick close to the skin and gently pull on the tick with steady pressure. Do not jerk or twist the tick; this can cause mouth parts to break off and remain in the skin.

After removing the tick, clean the bite site and wash hands with soap and water or use an alcohol-based hand sanitizer. Dispose of a tick by submersing it in alcohol, placing it in a sealed bag or other container, wrapping it tightly in tape, or flushing it down the toilet. Do not attempt to crush a tick between the fingers.

If symptoms of a fever, rash, muscle or joint aches, or other types of illness arise within several weeks of removing a tick, consult a health-care professional and tell them about the recent tick bite, when it occurred and where the tick was acquired.

Kentuckians who are interested in contributing to the study of tick-borne diseases and their distribution across the state are encouraged to submit samples of ticks to the Kentucky Tick Surveillance Project. This project, produced by the University of Kentucky Martin-Gatton College of Agriculture, Food and Environment, aims to improve knowledge about where ticks are found and the diseases they might carry.

For more information about ticks and tick prevention, visit www.cdc.gov.

Kentucky has an uptick in ticks, and people are getting ticked off; UK entomologist says state seems to be 'becoming Kenticky'

Norton Healthcare graphic; to enlarge any image, click on it.

By Melissa Patrick

Kentucky Health News

A warmer February in Kentucky has likely contributed to an uptick in ticks, and Kentuckians aren’t happy about it. Some even sound ticked off.

“We just had the seventh hottest February on record, so some of our [tick] species are going to be more successful because they weren’t exposed to as harsh of a winter as they might otherwise have been,” said Jonathan Larson, an extension entomologist at the University of Kentucky. “They got a head-start on the season.”

The longer season, combined with with Kentucky's tick-friendly living conditions, has resulted in more calls about ticks than Larson has had in the four years he’s been at UK.

“The tenor of calls and inquiries, they're sort of angrier” than in previous years, Larson said. “It seems like people are seeing more of them on their property and getting more on themselves and their animals and are just very agitated by it – understandably so.”

William May of Versailles is one of those ticked-off people. In late April, he told Kentucky Health News that he was overrun with ticks on his 17 acres and said he believes they are largely being carried onto his property by deer. Just about any wild animal can carry ticks, including birds and mice, of which Larson said Kentucky has an abundance.

May was recovering from a bout of Rocky Mountain spotted fever when he talked to KHN, and said he had had Lyme disease last year. Both diseases are carried by ticks.

“Ticks didn’t used to be like this,” he said. “Just in my yard, the numbers are astronomical. It was never like this before.”

Joe Lacefield, a regional wildlife biologist at the Kentucky Department of Fish & Wildlife, said most of Central Kentucky has a “very high deer density."

He said some counties control the tick population is by allowing hunters to get tags to harvest unlimited numbers of antlerless deer, but these unlimited harvests have resulted in a 50/50 split between male and female deer, so it has done little to control the population growth.

The tick problem in Kentucky isn't going away because Kentucky provides a perfect home for the arachnids – with its warm, humid summer days, an abundance of wooded, leafy areas in both rural and urban places, and plenty of other hosts to feast upon.

Jonathan Larson, UK entomologist

“It’s just kind of an unfortunate situation that Kentucky seems to becoming Kenticky,” said Larson. “There’s just a lot of opportunity for them here in the state.”

What can Kentuckians do to protect their property from ticks? Larson said any sort of brush management will reduce the tick population because it removes their habitat and places for their hosts to hide. He also suggests fencing to deter deer and other wildlife that carry ticks. A fence also helps with perimeter spraying with an insecticide-arachnicide such as Bifenthrin every few weeks, he said.

Larson said the best way to avoid getting bitten by a tick is to wear an insect repellent, such as diethyltoluamide, or Deet, when they are outside. And for those who don’t like to wear Deet, he suggested using oil of lemon eucalyptus, IR 3535, or picaridin. All of these products are readily available at stores.

"Putting on that 40 percent Deet product that you find at the store will give you a good level of protection," Larson said. "If you're sweating a lot, or if you're going to be outside for an extended period, maybe moving up to the Deet 80 percent or Deet 100 percent would be advisable, because they'll last longer and give you the longer-term protection that you need."

Other ways to protect yourself from ticks include wearing light-colored clothing, so ticks can be spotted more easily; tucking pants legs into socks or boots and shirttails into pants; taping the area where pants and socks meet, so ticks can't crawl under your clothes; walking in the center of trails, and avoiding other tick-likely areas.

Also important: Check for ticks every time you come inside from being outdoors as long as 10 minutes. And if you’ve been out longer, Larson said you should disrobe and check your whole body, especially around ankles, waist, navel, armpits and the nape of the neck. And check pets for ticks.

How to remove a tick (State health department diagram)

If you get a tick, Larson said it's important to remove it properly by grasping it as close to the skin as possible with a pair of tweezers and pulling it straight out with gentle, even pressure.

He said it is also important to not use home remedies to remove ticks, such as burning them off or putting alcohol or peanut butter on them, because those remedies only aggravate the situation.

“All of that agitates the tick as they're feeding on you and it could induce them to puke . . . into your bloodstream,” Larson said. The tick’s gut is where disease-causing agents reside.

Larson also encouraged people to save any ticks they remove from their bodies in alcohol or nail-polish remover to help health-care providers make a diagnosis if they see symptoms of a tick-borne illness. This is important because symptoms don’t always show up immediately.

The state Department for Public Health says, "Watch for symptoms for 30 days after tick bites. Call your healthcare provider is you get any of the following: rash, fever, fatigue, headache, muscle pain, or joint swelling and pain."

Click here to learn more about tick-borne diseases in Kentucky. The website has much information, including these maps, which show the average annual case rates, by county, for the top three tick-borne diseases in Kentucky: Rocky Mountain spotted fever, ehrlichiosis and Lyme disease.

Tick season nears. 10% of ticks carry debilitating diseases; quick action can prevent them. And UK wants you to send in your ticks!

Lucie Conchou works in UK entomologist

Zainulabeuddin Syed’s lab. (Photo by Matt Barton)

Kentucky Health News

Ticks are a threat in Kentucky year-round, but especially in the summer months. The next time one bites you, stop and think before flushing it down the toilet. You could help other people by mailing it to the University of Kentucky entomology department to see if it carries disease or not. 

Here's how: If you find a tick on yourself or your pet, remove it with tweezers, place it in alcohol in a sealed container or bag, and mail it to the university's entomology department. Those are the instructions Professor Reddy Palli, who chairs the department and serves as state entomologist, told Aaron Mudd of the Lexington Herald-Leader.

A university spokesperson told Mudd to check with your local UK Extension office to see exactly where to mail a specimen for study. 

“We will contact the person who submits the specimen if we detect pathogens in the tick and encourage them to contact their physician,” Palli told the Herald-Leader in an email.

Mudd reports, "As a leader in his field, Palli is overseeing several researchers who are studying tick populations in Kentucky, monitoring the diseases they spread and potentially engineering ways to repel them or even stop them from searching for blood in the first place."

Katie Pratt of the UK College of Agriculture, Food and Environment also wrote about the work of Palli and his colleagues. 

She reports that one of the Palli's graduate students is Anna Pasternak, who leads the Kentucky Tick Surveillance Program. She collects ticks analyze their genetic material and any disease-causing pathogens hiding within them. The program has been collecting information on ticks in the state since January 2019. 

“Preliminary results show that the greatest number of ticks exist in wooded areas of the state and at Land Between the Lakes, and 10 percent of them carry a pathogen that cause diseases like Lyme disease, Rocky Mountain spotted fever, alpha-gal and others,” Palli said. The last disease he mentioned can cause an allergy to red meat.

“We really did not expect pathogen presences in these ticks to be that high,” Palli said.

“Our goal is to take Anna’s data and educate farmers, loggers, physicians and health care workers about the ticks in the state and ways to minimize their effects. For example, if someone gets bitten by a tick carrying the Lyme disease pathogen and they get an antibiotic within 72 hours, it is likely the antibiotic will kill the bacteria that causes Lyme disease. Not many people know that, and by the time symptoms appear, it’s often too late.”

University of Kentucky graphic; for a larger version, click on it.

Blacklegged ticks, tiny bugs otherwise known as deer ticks, are the main transmitter of Lyme disease, the top insect vector-borne disease in America. And as these ticks expand their region from New England to the eastern half of the United States, cases of Lyme disease are growing too, Pratt reports. 

Signs and symptoms of Lyme disease include fever, chills, headache, fatigue, muscle and joint aches and swollen lymph glands. Upwards of 80% of infected persons have a distinctive "bull's eye" rash that appears at the site of the bite three to 30 days after infection.

The American dog tick and the brown dog tick can carry and transmit the bacteria that causes Rocky Mountain spotted fever.

Signs and symptoms of RMSF are fever, headache, nausea, vomiting, stomach pain, muscle pain, lack of appetite and a spotted rash. The rash usually develops several days after the onset of a fever and can vary between splotches and smaller pinpoint dots.

The Lone Star tick caries the bacteria that causes ehrilichiosis. Signs and symptoms of ehrilichiosis are fever, headache, chills, cough, malaise, muscle pain, nausea, vomiting, diarrhea, confusion and red eyes. A rash is common in children, but less so in adults.

The Lone Star tick is also a vector for alpha-gal syndrome, known as the red-meat allergy, which is becoming increasingly more common.

Ways to protect yourself from ticks are:

• Avoid grassy, wooded and leaf-covered areas
• Keep grass and shrubs trimmed and cleared away
• Walk in the center of walking trails
• Wear light-colored clothes, which make it easier to spot ticks
• Wear long pants tucked into boots and tuck in your shirts
• Use tick repellent that has the repellent DEET or picaridin
• Treat your clothes with permethrin, which repels and kills ticks
• Do a body check along the way and at the end of each day
• Check your pets and equipment for ticks
• Shower within two hours of potential exposure, if possible

To kill ticks on clothing, tumble dry for 10 minutes or wash them in hot water. If clothes can't be washed in hot water, tumble dry for 90 minutes on regular heat or 60 minutes on high.

Some Kentuckians say ticks are worse than ever; experts can't say that, but offer ways to protect yourself from tick-borne illness

By Melissa Patrick
Kentucky Health News

Some Kentuckians are saying ticks are more plentiful than ever this year. Some states are having one of their worst tick seasons ever, but it's too soon to declare that definitively for Kentucky, largely because the state has only been doing tick surveillance for about three years. 

"In a couple more years, [we'll] have a clear understanding of how ticks and tick-borne disease dynamics are shifting and changing through time so that we can understand how to best protect the public and understand what kind of diseases are of concern and how to best control ticks," said Anna Pasternak, a graduate researcher of ticks at the University of Kentucky.

Lone Star ticks on Anna Pasternack's wrist (photo provided; click to enlarge) 

Pasternak is part of the Kentucky Tick Surveillance Program, which has been collecting information on ticks in the state since January 2019. 

That said, Kentucky provides a perfect home for ticks, with its warm, humid summer days, an abundance of  wooded, leafy areas in both rural and urban places, and plenty of hosts to feast upon, she said. And though they are most prevalent in the summer, in Kentucky, she said, "It's always tick season."

Kacy Tongate of Lebanon Junction told Alexis Mathews of Louisville's WLKY-TV in May that he thought ticks are worse than usual this year and one had given him Rocky Mountain spotted fever. 

“We can walk to the mailbox down the gravel driveway and come back with ticks on us,” said Tongate. “They fall out of the trees, they're in the grass; they just keep getting worse every year, it seems."

Pasternak said the best way to minimize your risk for tick-borne disease is prevention, which includes things like spaying your clothes, shoes, socks and hats with an insect repellent like Permethrin before heading outdoors, and doing regular tick checks throughout the day.

"The first line of defense that you have against ticks and tick-borne disease is making sure they don't get on you or your pets or children," she said. 

And if you do get bitten, she said it's important to remove the tick properly, grasping it as close to the skin as possible with a pair of tweezers and pulling it straight out with gentle, even pressure. 

She cautioned that an embedded tick will offer some resistance when you try to remove it, but it will let go after a few seconds. "You are much stronger than the tick," she said.

She said many of the home remedies used to remove ticks end up agitating them, which causes it to vomit its gut contents, which is where the disease-causing agents reside, into your bloodstream. "You don't want to speed up the disease process," she said.

Pasternak also encouraged Kentuckians to take a picture of the tick or to save it in alcohol or nail-polish remover to help your health-care provider make a diagnosis if you have symptoms of a tick-borne illness. She said this is important, since symptoms may not show up for week after the initial bite. 

Ways to protect yourself from ticks are:

• Avoid grassy, wooded and leaf-covered areas
• Keep grass and shrubs trimmed and cleared away
• Walk in the center of walking trails
• Wear light-colored clothes, which make it easier to spot ticks
• Wear long pants tucked into boots and tuck in your shirts
• Use tick repellent that has the repellent DEET or picaridin
• Treat your clothes with permethrin, which repels and kills ticks
• Do a body check along the way and at the end of each day
• Check your pets and equipment for ticks
• Shower within two hours of potential exposure, if possible

Pasternak said you can run a lint roller over your clothes and exposed skin to locate very small ticks. 

"The smaller ones, I think, pose a little more danger than the adults, because they are so small that a lot of people don't notice them until they've been attached for a day or two," she said. 

To kill ticks on clothing, tumble dry for 10 minutes or wash them in hot water. If clothes can't be washed in hot water, tumble dry for 90 minutes on regular heat or 60 minutes on high.

Tick species and the diseases they carry

The most common tick-borne diseases in Kentucky are Rocky Mountain spotted fever, Lyme Disease and ehrlichiosis, which causes fever and muscle aches.

Reported cases of the diseases are relatively low in Kentucky, but Pasternak said, "There is a big issue with tick borne diseases being under-reported." 

University of Kentucky graphic; for a larger version, click on it

In Kentucky, the American dog tick and the brown dog tick can carry and transmit the bacteria that causes Rocky Mountain spotted fever. 

Signs and symptoms of RMSF are fever, headache, nausea, vomiting, stomach pain, muscle pain, lack of appetite and a spotted rash. The rash usually develops several days after the onset of a fever and can vary between splotches and smaller pinpoint dots. 

The Lone Star tick caries the bacteria that causes ehrilichiosis. 

Signs and symptoms of ehrilichiosis are fever, headache, chills, cough, malaise, muscle pain, nausea, vomiting, diarrhea, confusion and red eyes. A rash is common in children, but less so in adults. 

The Lone Star tick is also a vector for alpha-gal syndrome, known as the red-meat allergy, which is becoming increasingly more common. 

In Kentucky, the blacklegged tick, which is commonly called the deer tick, carries the bacteria that causes Lyme disease. 

Signs and symptoms of Lyme disease include fever, chills, headache, fatigue, muscle and joint aches and swollen lymph glands. In addition, upwards of 80% of infected persons have a distinctive "bull's eye" rash that appears at the site of the bite three to 30 days after infection. 

A Centers for Disease Control and Prevention study released in February estimated that the average number of people diagnosed with Lyme each year in the U.S. in 2010-18 was 45 percent higher than those diagnosed in 2005-10. Kentucky reported 22 cases of Lyme disease to the CDC in 2019.

As you spend more time outdoors with summer in full swing, remember the ticks; they're a bigger problem than they once were

University of Kentucky illustration, adapted by Kentucky Health News; click on it to enlarge.

By Melissa Patrick

Kentucky Health News

As outdoor venues in Kentucky have opened up after months of being closed due to the coronavirus, more Kentuckians than ever are heading outdoors. And picking up ticks.

Experts caution that it's important to take precautions through September, when ticks are still active, and to learn how to remove them properly to decrease the risk of tick-borne disease.

Jonathan Larson, a UK extension entomologist, said the best way to remove a tick is to grasp it as close to the skin as possible with tweezers and to pull it straight out with gentle, even pressure.

He stressed that it is important to not use alcohol, essential oils, matches, liquid soap or petroleum jelly, because they agitate the tick and cause it to vomit from deep in its gut, where the disease-causing agents reside.

Larson explained that in the process of feeding, a tick passes stuff from its body into its host's blood and then sucks blood back into its body. Typically, the disease-causing agents take several hours or days to make their way into its host, but when a person agitates the tick, that happens more quickly.

"If you speed that process up by say pouring alcohol on it while it is plugged into you or essential oils or trying to burn it with a match or a lighter, it will possibly puke into you and increase your chances of picking up that pathogen," Larson said.

Tick researcher Anna Pasternak (UK photo)

When you remove a tick, it's important to take a picture of it, and save it in alcohol or nail-polish remover to keep it hydrated, said Anna Pasternak, a graduate tick researcher at the University of Kentucky.

"If you do find a tick on yourself, monitor your health for the next month or so," Pasternak said. "Certain ticks only carry certain diseases and if you can have that tick or a picture of the tick, that will help the doctors diagnose you and makes knowing what to look for a whole lot easier."

Pasternak is part of the Kentucky Tick Surveillance Program, which has been collecting information on ticks in Kentucky since January 2019. She said Kentucky has a high tick population, largely because the state offers an ideal environment with its forests, humidity and large populations of livestock, deer and other wildlife.

The best ways to protect yourself from ticks are:

• Avoid grassy, wooded and leaf-covered areas
• Keep grass and shrubs trimmed and cleared away
• Walk in the center of walking trails
• Wear light-colored clothes, which make it easier to spot ticks
• Wear long pants tucked into boots and tuck in your shirts
• Use tick repellent that has DEET or picaridin
• Treat your clothes with permethrin, which repels and kills ticks
• Do a body check at the end of each day
• Check your pets and equipment for ticks
• Shower within two hours of potential exposure if possible

To kill ticks on clothing, tumble dry for 10 minutes; wash dirty clothes in hot water. If clothes can't be washed in hot water, tumble dry for 90 minutes on regular heat or 60 minutes on high.

Ryan Mynatt, a clinical infectious disease pharmacist at UK HealthCare, offered some guidelines for seeking medical care related to a tick bite.

"Persons known or suspected to be bitten by a tick who also have symptoms of potential tick-related diseases (rash, fever, chills, flu-like symptoms, aches, pains, etc.) should seek prompt evaluation by their health-care provider prior to deciding on a course of therapy," Mynatt said in an e-mail. "It is also recommended to seek evaluation from your medical provider if you cannot remove all of the tick."

Tick species and the diseases they carry

Fortunately, only a small percentage of ticks in Kentucky transmit disease, and most who get bitten by one won't develop a disease, Pasternak said.

She said Kentucky's most common tick-borne diseases are Rocky Mountain Spotted Fever, erlichiosis and Lyme disease.

RMSF cases have been increasing in Kentucky, she said. A state Department of Public Health report  found that between 2012 to 2017, annual cases in the state increased 290 percent. In 2012, Kentucky had 64 probable and confirmed cases; in 2017, it had 250. In 2018, Kentucky had 48.9 cases of RMSF per million persons, according to the Centers for Disease Control and Prevention. 

RMSF is caused by the bacteria Rickettsia rickettsii. In Kentucky, the American dog tick (Dermacentor variabilis) and the brown dog tick (Rhipicephalus sanguineus) can carry and transmit this bacterium.

Signs and symptoms of RMSF include: fever, headache, nausea, vomiting, stomach pain, muscle pain, lack of appetite and a spotted rash. The rash usually develops several days after the start of fever and can vary between splotches and smaller pinpoint dots.

Ehrlichiosis is caused by several bacteria of the Ehrlichia genus. These bacteria are transmitted by the the lone star tick (Amblyomma americanum).

Signs and symptoms of ehrlichiosis include fever, headache, chills, cough, malaise, muscle pain, nausea, vomiting, diarrhea, confusion and red eyes. A rash is also common in children but less common in adults.

The CDC reports that Kentucky had 16.8 cases of erlichiosis per million people in 2018.

The lone star tick is also a vector for alpha-gal syndrome, known as the red meat allergy, which is becoming increasingly more common, Dr. Kourtney Gentry Gardner, a Bowling Green allergist-immunologist, told Adair County Community Voice last fall that she diagnoses about five people a month with the allergy.

Pasternak said, "The lone star actually has the potential to carry the longest list of diseases; however, not all of those diseases have been found in Kentucky."

Lyme disease is caused by the bacterium Borrelia burgdorferi, which is carried by the blacklegged tick (Ixodes scapularis), commonly called the deer tick.

Signs and symptoms of Lyme disease include fever, chills, headache, fatigue, muscle and joint aches and swollen lymph nodes. The distinctive "bull's-eye" rash, or erythema migrans in medical terminology, occurs in 70 to 80 percent of infected persons, and appears at the site of the bite three to 30 days after infection.

Lyme disease was once rare in Kentucky, but expansion of the blacklegged tick's range and distribution may have caused more cases in the state, but the CDC reports that Kentucky still has a low incidence of Lyme disease, with four confirmed and 18 probable cases in 2018, the latest count available.

However, the CDC says the actual number is likely much higher, noting that its research shows Lyme disease affects about 10 times as many Americans as previously indicated by confirmed case reports.

The black-legged tick is active year-round in Kentucky, Pasternak said, so if you or your pets spend time in wooded and bushy areas that have tall grass or leaf litter or anywhere there might be wild animals in the winter, you should check yourself and your pets for this small tick year round.

Ticks and covid-19

Because both covid-19 and tick-borne disease have similar symptoms, including fever, muscle aches, headache and sever fatigue, Dr. Sorana Segal-Mauer of the New York Presbyterian Queens health care system told CNN that it is important for providers to not assume a patient has the coronavirus, and to ask about a patient's travel and other activites. "You have to cover all your bases," she said. "We don't want to be covid-blinded." CNN reports that patients should also be asking about both possibilities.

In addition, health-care experts are regularly warning Kentuckians to not delay care because they are worried about contracting the virus, stressing that it is safe to seek care and that facilities are taking every precaution to decrease the spread of the virus.

Having Lyme disease can put a person at greater risk for serious illness due to covid-19, Shannon L. Delaney, director of child and adolescent evaluation at Columbia University’s Lyme and Tick-Borne Diseases Research Center, told The New York Times.

“We already know people with underlying conditions are more vulnerable for complications with coronavirus,” she said. “Certainly, people with tick-borne illness fall into that category.”

Tick-borne disease in Ky. is relatively rare, but does occur; best defense against these tiny disease-carrying vectors is prevention

Top three tick posters from a contest held by the Kentucky Department of Public Health and Northern Kentucky Health Department, which attracted more than 700 entries (Click on it for a larger version.)

By Melissa Patrick
Kentucky Health News

Ticks and summertime go hand-in-glove, but that doesn't mean you can't enjoy outdoor summer activities; you just have to take extra precautions. Tick season in Kentucky runs through August.

“Spring and early summer are peak times for tick bites, which coincide with people venturing outdoors in the warmer weather,” Dr. Jeff D. Howard, commissioner of the state Department for Public Health, said in a news release. “It's important that people take preventive measures against tick bites and also check for ticks after visiting affected areas.”

Ticks are most likely to be hanging out in wooded areas; the boundaries between woods and fields; low-hanging tree limbs; under leaves, plants and ground cover; and around stone walls and woodpiles that are home to mice and other small mammals that carry ticks.

The health department recommends that Kentuckians remember four steps when it comes to protecting themselves from ticks: Protect; Check; Remove; and Watch.

Protect: To protect yourself from tick bites, avoid tick-prone areas, but if you are going to be in those areas use a tick repellent that has 20 percent DEET, picardin, IR3535 or lemon eucalyptus. Wear light-colored, long-sleeved shirts and pants tucked into socks. Use permethrin-based clothing sprays, unless you have cats, to which permethrin is toxic.

Check: After you've spent time outdoors, do a head-to-toe check for ticks using a hand-held or full-length mirror. Parents should check children. Common places to find ticks are behind the knees, around the waist, under arms, and on the neck and head. It is also important to check your gear and pets for ticks. If possible, change your clothes and shower after going outdoors. To kill ticks on dry clothes, put them in a dryer on high heat for 10 minutes. If clothes require washing, use hot water.

CDC illustration

Remove: Remove an embedded tick as soon as possible by grasping it as close to the skin as possible with tweezers and pulling straight out with gentle, even pressure. Do not jerk or twist the tick. Wash your hands with soap and water after the tick is removed. Apply an antiseptic to the bite site. Do not use alcohol, matches, liquid soap or petroleum jelly to remove a tick. Dispose of the tick by submerging it in alcohol, placing it in a sealed bag or container, wrapping it tightly in tape, or flushing it down the toilet. Never crush a tick with your fingers. Don't delay; remove a tick as soon as it is detected, because the longer it is attached, the higher the risk that it may transmit disease.

Watch: Watch for symptoms of tick-borne illness, including sudden fever and rash, severe headache, muscle or joint aches, nausea, vomiting, and diarrhea. Symptoms can arise within several weeks of removing a tick. Contact your health-care provider if symptoms occur.

Tick types and diseases in Kentucky

Overall, the incidences of tick-borne disease remains low in Kentucky, but that doesn't mean you shouldn't take precautions to protect yourself.

The lone star tick and the American dog tick are the most common ticks in Kentucky. And though bites from these ticks typically just cause local irritation and itching, a small percentage of them carry disease.

In particular, the adult female lone star tick, which has a white spot on its back and is about the size of a pencil eraser, can carry erlichiosis, a disease that can cause fever, headache, chills, muscle pain and in some cases a rash. Symptoms generally occur within one to two weeks of a bite. The first line of treatment is an antibiotic; if not treated properly, it can be fatal.

The CDC reports that Kentucky has one of the highest rates for cases of this disease, 9.7 per 1 million people. The lone star tick can also cause some people to become allergic to red meat.

The American dog tick is reddish-brown with mottled white markings on the back and is about the size of a pencil eraser. It can carry Rocky Mountain spotted fever, which usually begins with a sudden onset of fever and headache two to 14 days after being bitten by an infected tick.

Kentucky had 249 probable cases of Rocky Mountain spotted fever and one confirmed case in 2017, according to the state health department. Though rare, the bacterial disease can be deadly if not treated with the right antibiotics, with children under 10 making up most of the deaths, the CDC says.

Earlier this month, a 2-year-old Kentucky boy came down with a case of Rocky Mountain spotted fever that caused him to be unconscious for nearly a week, Lindsey Bever reports for The Washington Post. Kayla Oblisk told Bever that her son, Jackson, was bitten by a tick and they had just pulled it off and thrown it away without much worry. Within three days, he developed a dangerous high fever and developed a light pink rash all over his body. She said he was first diagnosed with a viral infection, but was eventually admitted to the hospital where he was diagnosed and treated for this rare but potentially fatal disease.

Both the American dog tick and the lone star tick can carry tularemia, a disease that infects animals and people and is often spread by rabbits. Symptoms of tularemia vary depending on how long the bacteria have been in the body and where the person contracted the disease. All forms of the disease are accompanied by fever. It can be life-threatening, but most infections can be treated successfully with antibiotics. In 2017, Kentucky had two cases of tularemia, according to the CDC.

A much smaller tick that is becoming more common in Kentucky is the blacklegged tick, also known as the deer tick. It carries Lyme disease, symptoms of which can range from mild to severe, including fever, headache, fatigue and a skin rash that looks like a bull's-eye, although not everyone gets the rash. This tick can also carry ehrilichiosis, which can weaken the immune system.

In 2017, Kentucky had six confirmed cases of Lyme disease and 14 probable cases, the CDC says.

Veterinarians in Kentucky now have access to a new program sponsored by the health department and the University of Kentucky that allows them to submit ticks for identification and testing. For more information about the program contact the program manager at tori.amburgey@ky.gov or the state public health veterinarian: kelly.giesbrecht@ky.gov.

A deeper dive

Elemental, a Medium publication for health-and-wellness journalism supported by science, has produced a multi-part special report about ticks called "Tickpocalypse" that explores in great detail the exploding tick population and the growing number of diseases that come with it.

The introduction to the series alarmingly refers to Lyme disease as a pandemic, a word that is only assigned to diseases that occur over a wide geographic area and affects an exceptionally high proportion of the population.

"It's estimated that 300,000 people contract Lyme each year in the U.S.," with victims found in all 50 states and Washington, D.C., it says. Further, it notes that Lyme is also on the rise in Europe, Africa and Asia.

Lyme disease is so bad that Mary Beth Pfeiffer, author of Lyme: The First Epidemic of Climate Change, calls for a "huge national and concerted international effort to bring it under control," Alex Bhattachari reports in one of the stories, "Lyme Disease Cases Are Exploding. And It's Only Going to Get Worse."

Bhattachari writes, "A public health crisis is hiding in plain sight, with tick-borne diseases creating millions of sick people at an economic cost running into the billions, and little has been done so far to mount a meaningful defense."

Other stories in the series are titled: "What It's Like to Have Lyme Disease Forever"; "Worrying About, Worrying About Lyme Disease"; "When Lyme Kills"; "What It's Like to be a Creepy-Crawler Field Researcher"; "Know Your Enemy: The Blacklegged Tick"; "When That Tick Bites"; "Lyme Prevention 101"; and "The Mouse Cure."

Tick season has arrived in Ky.; here are the most common ticks in our state and how to keep from getting the diseases they carry

By Melissa Patrick
Kentucky Health News

Kentuckians are finally heading outdoors to enjoy the warm weather, but the higher temperatures also means that it's tick season again, which lasts through August in Kentucky.

Mosquito Squad of Louisville graphic; click on it for larger version

“In tick-prone areas, check yourself, children and other family members every two hours, and very thoroughly after returning home from hikes and other outdoor activities,” Lee Townsend, extension entomologist in the University of Kentucky College of Agriculture, Food and Environment, said in a news release. “Common places to find ticks are behind the knees, around the waist, under arms, neck and head.”

Tick-prone areas include wooded areas; the boundaries between woods and fields; tall grass; low-hanging tree limbs; underneath leaves, plants, and ground cover; and around stone walls and woodpiles that are home to mice and other small mammals that have ticks.

The state health department recommends that Kentuckians remember four steps when it comes to protecting themselves from ticks: Protect, Check, Remove and Watch.

Protect: To protect yourself from tick bites, avoid tick-prone areas, but if you are going to be in those areas use a tick repellent that has 20 percent DEET,  picardin, IR3535 or lemon eucalyptus. Wear light-colored, long-sleeved shirts and pants tucked into socks. Use permethrin-based clothing sprays, unless you have cats, which find it toxic.

Check: After you've spent time outdoors, do a head-to toe check for ticks using a hand-held or full-length mirror. Parents should check children. It is also important to check your gear and pets for ticks. If possible, change your clothes and shower after going outdoors. To kill ticks on dry clothes, put them in a dryer on high heat for 10 minutes. If clothes require washing, use hot water.

CDC photo

Remove: Remove an embedded tick as soon as possible by grasping it as close to the skin as possible with tweezers and pulling straight out with gentle, even pressure. Do not jerk or twist the tick. Wash your hands with soap and water after the tick is removed. Apply an antiseptic to the bite site. Do not use alcohol, matches, liquid soap or petroleum jelly to remove a tick. Dispose of the tick by submersing it in alcohol, placing it in a sealed bag or container, wrapping it tightly in tape or flushing it down the toilet. Never crush a tick with your fingers.

Watch: Watch for symptoms of tick-borne illness, including sudden fever and rash, severe headache, muscle or joint aches, nausea, vomiting, and diarrhea. Symptoms can arise within several weeks of removing a tick. Contact your healthcare provider if symptoms occur.

Overall, the incidences of tick-borne diseases remain low in Kentucky, but that doesn't mean you shouldn't take precautions to protect yourself.

The most common tick species in Kentucky are the American dog tick and an aggressive biter called the lone star tick. Bites from these ticks typically just cause local irritation and itching, but a small percentage carry diseases.

In particular, the adult female lone star tick, which has a white spot on its back and is about the size of a pencil eraser, can carry erlichiosis, a Lyme-like disease that can cause fever, headache, chills, muscle pain and in some cases a rash. It can also cause some people to develop an allergy to red meat.

American dog ticks, which are reddish-brown with mottled white markings on their backs and also about the size of a pencil eraser, have the potential to carry Rocky Mountain spotted fever, which usually begins with a sudden onset of fever and headache that appears from two to 14 days after being bitten by an infected tick. The fever can be fatal if not treated correctly.

A much smaller tick that is becoming more common in Kentucky is the blacklegged tick, also known as the deer tick. It carries Lyme disease, symptoms of which can range from mild to severe, including fever, headache, fatigue and a skin rash that looks like a bull's-eye, although not everyone gets the rash.

In 2016, Kentucky had 16 confirmed cases of Lyme disease, and 17 probable cases, according to the federal Centers for Disease Control and Prevention.

The news release also notes a recent confirmation of tularemia, a bacterial disease that can be transmitted by tick bites, in a captive wild rabbit in Butler County. Tularemia can be life threatening, but most infections can be treated successfully with antibiotics, according to the CDC.

The state Cabinet for Health and Family Services is hosting a Facebook Live event to discuss tick awareness and prevention at 1 p.m. ET June 4. It can be found at facebook.com/kychfs. Questions can be emailed in advance to chfs.communications@ky.gov or posed in the comments section during the event.

New state public-health veterinarian appointed; her responsibility is diseases that spread from animals to humans

Dr. Kelly Giesbrect

According to the World Health Organization, nearly 75 percent of the new diseases that have affected humans over the past 10 years originated from an animal or an animal product. Kentucky has just appointed a new public health veterinarian, Dr. Kelly Giesbrecht, to help protect Kentuckians and the state's animal populations from such diseases.

“We are very pleased to have Dr. Giesbrecht join our staff at the Cabinet for Health and Family Services,” Health Secretary Vickie Yates Brown Glisson said in a news release. “Her wealth of experience in public health and veterinary science is a perfect fit for this extremely important role and will be a tremendous asset to our work to improve the public health of Kentucky.”

Among other things, Giesbrecht is tasked with identifying and evaluating diseases that are spread between animals and humans, called zoonotic diseases.

The federal Centers for Disease Control and Prevention says every year tens of thousands of Americans get sick from diseases spread between animals and people, which are caused by harmful germs like viruses, bacteria, parasites and fungi.

Zoonotics are transmitted in several ways, including direct contact with the body fluid of an infected animal; indirect contact from touching a contaminated surface; being bitten by a tick, flea or mosquito; or eating contaminated food.

Some of the more recognizable ones in the United States are Zika virus, West Nile virus, bird flu (Avian influenza), rabies, cat scratch disease, Lyme disease, E.Coli and Salmonella, though there are many more.

Giesbrecht, who will be part of the Division of Epidemiology and Health Planning in the state's Department of Public Health, will develop policies, guidelines and strategies to control zoonotic and foodborne diseases and share information as needed to health experts and the public.

Giesbrecht comes to the department with over 22 years of combined experience in veterinary medicine and public health. She has a doctorate in veterinarian medicine from the University of Florida and a masters of public health from the University of Texas. After clinical practice, she spent 11 years in the U.S. Air Force as a public health officer and most recently worked at the Northern Kentucky Health Department as a regional epidemiologist.

Lyme disease, caused by deer-tick bite, is called a 'great imitator' because symptoms can mimic other ailments; often misdiagnosed

Wendy Thomas and her son, Griffin, who was diagnosed
with Lyme disease, after seven years and 11 doctors

Kentucky Health News

Cases of Lyme disease have tripled since the 1990s and with tick season expected to be especially heavy this year, it could also be a bad year for Lyme -- a disease that is often hard to diagnose.

Wendy Thomas of New Hampshire told Linda Carroll of NBC News that it took seven years and 11 doctors before her son, Griffin, was diagnosed with Lyme disease, after suffering with "rashes, breathing problems, swollen fingers, back pain, knee pain and ankle pain."

Thomas told Carroll that he had been tested early on for Lyme disease, but it came back negative. And that it wasn't until a friend suggested that Griffin, now 24, could have Lyme, despite the negative test, that she investigated it online and discovered that "every one of Griffin's symptoms was on the list," Carroll reports.

“We wasted so many years," said Thomas, 58. "In hindsight it was so obvious."

Lyme disease is caused by bacteria that are carried and transmitted to humans by black-legged ticks, which are also called deer ticks.

Centers for Disease Control and Prevention illustration

The federal Centers for Disease Control and Prevention says the early signs and symptoms of Lyme disease are fever, headaches, chills, fatigue, muscle and joint aches and swollen lymph nodes. Another common symptom is a rash that looks like a "bull's-eye" as it gets larger, but not everyone who has Lyme disease gets this rash.

Early and accurate diagnosis is important because it can be treated with an antibiotic. But this is a challenge because not everyone remembers being bitten by a tick, and many don't get that bull's-eye rash. And without these, the other symptoms are clinically similar to other diseases, which makes it harder to diagnose.

Symptoms can also linger for months and can come and go. They include severe headaches and neck stiffness, rashes on other parts of the body, arthritis,drooping on one or both sides of the face, intermittent pain in tendons, joints and bones, heart palpitations, dizziness, shortness of breath, brain inflammation, nerve pain and problems with short-term memory, often called "brain fog."

"There are a host of diseases that can be misinterpreted as Lyme and vice versa. Lyme can be present and look like something else, such as MS, fibromyalgia, ALS, dementia. Lyme is called ‘the great imitator’ for that reason," Philip Tierno, a professor of microbiology and pathology at New York University’s School of Medicine, told Carroll.

Rafal Tokarz, an associate research scientist at Columbia University, told Carroll there needs to be a better diagnostic test for Lyme disease because not everyone has enough of an immune response in their system to respond to the current test.

The best ways to protect yourself from ticks is to avoid grassy, wooded and leaf-covered areas; keep grass and shrubs trimmed and cleared away; walk in the center of walking trails; wear light-colored clothes, which make it easier to spot ticks; wear long pants tucked into boots and tuck in your shirts; use tick repellent that has DEET or picaridin in it; do a body check at the end of each day; check your pets and equipment for ticks; and shower after potential exposure.

While the greatest risk for getting Lyme disease remains in the Northeast, mid-Atlantic and upper Midwest, it is spreading to a wider area of the country. Kentucky had 12 confirmed cases and 37 probable ones in 2015, according to the CDC. Tick season in Kentucky runs through August, but a case was reported in February in Knox County. The southeastern Kentucky county has recently reported about eight cases of Rocky Mountain spotted fever, transmitted by dog ticks, reports the Barbourville Mountain Advocate. The weekly newspaper combined its local information with a Kentucky Health News story and graphics to make a strong presentation about the dangers of ticks. For a full-size version of the page, click here.

Tick season is expected to be more dangerous this year; here are lots of tips to keep you protected

Warm weather and outdoor activities go hand in hand, but it also mean tick season is upon us -- and it's expected to be a bad one this year because the winter was so mild. Tick season in Kentucky runs through August.

Mosquito Squad of Louisville graphic; click on it to see a larger version

The lone star tick and the American dog tick are the most common ticks in Kentucky, and are commonly found in wooded or grassy areas.

The dog tick can transmit Rocky Mountain spotted fever, which begins with a sudden onset of fever and headache two to 14 days after being bitten. Other symptoms can include nausea, muscle pain, lack of appetite and a rash that occurs two to five days after the fever. RMSF can be fatal in the first eight days of symptoms if not treated correctly, according to the Centers for Disease Control and Prevention.

The lone star tick is the main carrier of erlichiosis, which causes fever, headache, chills and muscle pain about one to two weeks after being bitten. It is an aggressive biter, and saliva from its bite can cause painful, itchy areas.

The deer or black legged tick is less common in Kentucky, but it is the one that is known to transmit Lyme disease and Powassan virus.

Symptoms of Lyme disease can range from mild to severe, and include fever, headache, fatigue and a skin rash. If left untreated, the infection can spread to joints, the heart or the nervous system. It is most prevalent in the Northeast, Mid-Atlantic and Upper Midwestern states. The CDC estimates there are 300,000 Lyme disease infections each year. "If a tick is attached to your skin for less than 24 hours your chance of getting Lyme disease is extremely small," says the CDC.

While Powassan virus is most common in the Northeast and the Great Lakes region, it's important to be aware of this virus, especially if you are traveling to these areas, because it can cause encephalitis, or swelling of the brain, and can be deadly. It is also dangerous because it can be transferred from a tick to a human within the first 15 minutes of attachment.

The CDC reports that about 75 cases of Powassan virus have been reported in the U.S. over the past 10 years. Some symptoms of Powasan virus infection are fever, headache, vomiting, weakness, confusion, seizures and memory loss.

The Mosquito Squad of Louisville blog says that 10 percent of people the infected with this virus who get encephalitis will die, "and there is no treatment. Only the symptoms are treatable. Fifty percent of those that survive will have permanent neurological damage of some kind."

Removing ticks: A popular social-media video advises dousing ticks in peppermint oil to get them to pull away from the skin for easy removal. Almost half a million viewers have shared the post, but experts say this is one of the worst things you can do, Caroline Picard reports for Country Living.

"Ticks carry all sorts of diseases," entomologist Dr. Neeta Connally recently told KFGO Radio in Fargo, N.D. "Those are actually salivated into the body when the tick attaches, and so we don't want to agitate the tick in any way that is going to make it salivate more and thereby be more likely to transmit anything."

                                 CDC image

Remove ticks by grasping them as close to the skin as possible with tweezers and pulling straight out with gentle, even pressure. Multiple sources say to not use petroleum jelly, gasoline, hot matches or other "folk remedies" to remove ticks. Dispose of the tick by submersing it in alcohol, placing it in a sealed container or bag or flushing it down the toilet. Once removed, wash the bite area, apply antiseptic and cover with a Band-Aid.

"Never crush a tick with your fingers," warns the CDC.

To protect yourself from ticks, here are some tips from experts:

• Keep grass and shrubs trimmed, and clear away overgrown vegetation; 
• Don't walk through uncut fields, brush and overgrown areas; 
• Walk in the center of hiking trails; 
• Wear light-colored clothing, which makes it easier to spot ticks; 
• Wear long pants tucked into boots or socks and tuck your shirt into your pants; 
• Place a band of duct tape, sticky side out, around your lower legs to trap ticks; 
• Use tick repellent that has DEET or picaridin, or use permethrin-based clothing sprays; 
• Check your body and clothing at the end of each day; 
• Take a warm soapy shower after potential exposure; 
• Check your outdoor gear and pets;
• To kill ticks on clothing, tumble dry for 10 minutes; wash dirty clothes in hot water. If clothes can't be washed in hot water, tumble dry for 90 minutes on regular heat or 60 minutes on high.

Prevention is the key to surviving tick season in Kentucky, which runs through August; here are some tips

By Melissa Patrick
Kentucky Health News

With outdoor summer activities in full swing, it's important to remember that tick season, which runs from mid-March through August in Kentucky, is upon us.

American dog tick

Ticks hang out in tall grass, woods, low-hanging tree limbs and weeds just waiting to attach themselves to you or your pets to "feed," a polite way to say they want to suck some blood. And while that is reason enough to avoid them, the real problem is that ticks can carry potentially life-threatening infections, like Lyme disease, Rocky Mountain spotted fever and Erlichiosis.

"The most prevalent tick-borne disease in Kentucky is and has been for a long time Rocky Mountain spotted fever," or RMSF, Grayson Brown, director of the University of Kentucky Public Health Entomology Laboratory, told Kentucky Health News. "We get somewhere between 10 and 30 cases of that a year."

RMSF is transmitted by the American dog tick, which is about the size of a pencil eraser. It is the second most common tick in the state, according to Kentucky Pest News. The greatest risk of getting RMSF in Kentucky is in the western part of the state, near the Land Between the Lakes, said Brown.

RMSF usually begins with a sudden onset of fever and headache that appear from two to 14 days after being bitten by an infected tick. Other symptoms can include nausea, muscle pain, lack of appetite and a rash that occurs two to five days after the fever. RMSF can be fatal in the first eight days of symptoms if not treated correctly, according to the federal Centers for Disease Control and Prevention.

Lone Star Tick, all images Wikipedia

Kentucky's most common tick is an aggressive biter called the lone star tick, which is also about the size of a pencil eraser, says Kentucky Pest News.

The saliva from this tick can produces painful, itchy areas that can become infected from scratching. It can transmit Erlichiosis, a Lyme-like disease that can cause fever, headache, chills, muscle pain and in some cases a rash. These symptoms usually show up one to two weeks after being bitten by an infected tick. It can also transmit RMSF.

And though it is not very common, Kentucky is also home to the blacklegged tick, which is known to transmit Lyme disease. This tick is much smaller than the other two more common ones.

"The number of Lyme disease cases is increasing quite rapidly, with 13 or so last year that were reported," Brown said. "The blacklegged tick is found most commonly around rivers and so the river areas, along the Ohio River, the Kentucky River . . . that is where the biggest risk is going to be.

Black-legged Tick

Symptoms of Lyme disease can range from mild to severe and include fever, headache, fatigue and a skin rash that looks like a bull's-eye, although not everyone has this rash, says the CDC. If left untreated, the infection can spread to joints, the heart or the nervous system. Lyme disease is most prevalent in the Northeast, Mid-Atlantic and Upper Midwestern states, so be mindful if you travel.

Infection from these diseases is unlikely in Kentucky because very few ticks in the state are infected with their respective diseases. And even if the ticks are infected, they must be attached and feeding for at least 12 to 24 hours to transmit its infection, says Kentucky Pest News. This makes self-inspection and prompt removal of ticks an important line of defense against these diseases.

Getting a tick borne disease in Kentucky "is something like the risk of getting struck by lightning," Brown said.

The best way to avoid being bitten by ticks is to use "common sense precautions," Brown said. Here are some tips:

• Keep grass and shrubs trimmed, and clear away any overgrown vegetation in your yard;
• Don't walk through uncut fields, brush and overgrown areas;
• Walk in the center of hiking trails;
• Wear light-colored clothing, which make it easier to spot ticks;
• Wear long pants tucked into boots or socks and tuck your shirt into your pants;
• Place a band of duct tape, sticky side out, around your lower legs to trap ticks;
• Use tick repellent that has DEET or picaridin in it or use permethrin-based clothing sprays;
• Do a body and clothing check at the end of each day;
• Take a warm soapy shower after potential exposure;
• Check your pets.

It is also important to promptly and properly remove ticks by grasping them as close to the skin as possible with tweezers and then pulling straight out with gentle, even pressure. Multiple sources say to not use petroleum jelly, gasoline, hot matches or other "folk" methods to remove ticks. Once removed, wash the bite area, apply antiseptic and cover with a Band-Aid.

The CDC has recommended washing tick-infested clothes and then drying them for one hour, but new research, published online in the journal Ticks and Tick-borne Diseases, says putting dry, tick-infected clothes in a hot dryer and spinning them for six minutes will kill them, Ann Lukits reports for The Wall Street Journal.

Brown said May is the month when you are most likely to encounter "pathogen-bearing ticks," but you can still get infected at other times. Tick season generally runs through August

He also noted that tick-borne diseases primarily occur in rural settings because wildlife, especially deer, often covered in ticks, and field mice, because ticks can transmit diseases to them and then the infected mice can infect other ticks as they feed.

"So if you are really worried about those things," Brown said, "pay attention to the wildlife that you have or that you attract to your property."

Lyme disease in Ky. probably more common than reported

Nearly anyone who has spent considerable time in the woods this summer has later discovered they carried a visitor back with them — one the size of a freckle who latches on for dear life. Ticks are not uncommon in Kentucky, though Lyme disease, which is spread through the bite of a black-legged deer tick, is not commonly seen in the state.

But those numbers are likely under-reported, Keiara Carr reports for The Courier-Journal, in part because "Current medical guidelines say the disease is so rare in Kentucky that doctors should look for alternative causes for symptoms that might suggest Lyme disease."

Only five cases were reported in Kentucky in each of the past two years and there was just one case in 2009. But it's likely cases went under-reported because doctors don't give the blood test that diagnoses Lyme. They just don't feel it's necessary given the rarity of the disease in the area, Carr reports.

But Mike Gatton of Louisville knows all too well that it's possible. He got bitten by a tick while mowing his lawn two years ago. He developed a rash on his leg but when he went to the doctor he was tested for a variety of diseases, including West Nile, multiple sclerosis and Lou Gehrig disease, but not Lyme. "I was feeling more and more fatigued. I was having severe headaches. I was really concerned," he said.

When he got another tick bite a year ago and had the same reaction he had to the first bite, he put the tick in a vial and brought it to his doctor, who still dismissed the possibility of Lyme. He is now being treated with antibiotics he takes intravenously.

Symptoms of Lyme disease include fever, headache and fatigue. Sometimes, a rash that looks like a bull's eye around the tick bite can develop. Usually, people get better with large doses of antibiotics. If left untreated, "the infection can be painful and debilitating, causing arthritis or spreading to the heart and nervous system," Carr reports.

Guidelines by the Infectious Disease Society of America "to help doctors decide if a patient is eligible for treatment say the patient should have received the tick bite in an 'endemic area," Carr reports, which makes sense according to Paul Mead, a consulting physician for the Centers for Disease Control and Prevention. "For example, a physician in Africa evaluating a child for fever should have malaria at the top of his list; a physician in Kentucky should not," he said. (Read more)