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.

Study says allergy to red meat is under-diagnosed, probably due to clinicians' limited knowledge of it, and Ky. is a national hotspot

Map from CDC research report, adapted by Kentucky Health News; click on it to enlarge.

Lone star ticks are the main source. (CDC photo)

Kentucky Health News

Thousands of Kentuckians are likely living with an allergy to red meat, and many of them probably don't know it because it hasn't been diagnosed in them, a new study suggests. Another study says most of the people who do the diagnoses -- health-care providers -- have little or no working knowledge of alpha-gal syndrome.

The studies were published Thursday by the Centers for Disease Control and Prevention. In the first one, scientists reviewed laboratory results of people who had been tested for antibodies that identify the syndrome since 2020. They found 110,000 suspected cases, but that figure is probably a significant underestimate," reports Emily Anthes of The New York Times. 

The second study, also done by CDC disease ecologist and veterinarian Dr. Johanna Salzer, "found that 78 percent of health-care providers who were surveyed had little or no knowledge of the condition, and many clinicians who had heard of the syndrome were not sure how to diagnose it," Anthes reports. "When the researchers factored in this knowledge gap, they estimated that the true toll of the syndrome might be closer to a half-million, although Dr. Salzer acknowledged that the figure was 'a crude estimate'."

Extrapolating the national estimate of 450,000, about 6,000 Kentuckians would have the syndrome if they reflected the estimated national prevalence, but a map with the study shows that Kentucky is one of the states with the highest prevalence of the allergy, based on the available antibody tests.

Anna Buckman of the Adair County Community Voice reported in 2019, "Dr. Kourtney Gentry Gardner, an allergist-immunologist in Bowling Green, diagnoses about five people a month with the alpha-gal allergy, and it’s becoming increasingly more common, she says."

Buckman noted that the syndrome "is relatively new to the allergy world," having been identified in scientific literature about 15 years ago. Anthes reports, "Until August 2021, a single commercial lab did nearly all of this antibody testing in the United States. In one of the new studies, researchers reviewed the results of the antibody tests performed at this lab from 2017 to 2022."

The allergy "takes its name from galactose-alpha-1,3-galactose, a sugar present in beef, pork, lamb and the meat of most other mammals. (It is not present in humans or other apes.) Lone star ticks, which scientists believe are the primary culprits of the disease in the United States, can transmit the sugar to people through a bite. Some people’s immune systems may then label this foreign sugar a threat and overreact to its presence the next time they eat meat," Anthes writes.

The more a person is bitten, the more at risk they are of developing the allergy, Buckman reported.

"The symptoms, which often take hours to appear, are wide-ranging, and may include hives, nausea, diarrhea or anaphylactic shock," Anthes reports. "Even patients who have the syndrome may not feel sick every time they eat meat."

Ticks can't jump, but static electricity can throw them onto hosts

Static electricity that is naturally produced by animals,
humans included, can attract ticks onto their hosts.
(Video by England and Lihou, Current Biology)

By Melissa Patrick

Kentucky Health News

One more thing to know as you work to guard against the influx of ticks in Kentucky this year: Static electricity that is naturally produced by humans and other animals can cause a tick to be pulled onto them, a new study shows. 

“Until now, we had no idea that an animal could benefit from static electricity in this way, and it really opens up one’s imagination as to how many invisible forces like this could be helping animals and plants live their lives,” lead author Sam England of the University of Bristol said in a news release.

The findings, published today in Current Biology, are the first known example of static electricity being implicated in the attachment of one animal to another, the release says. 

The study also offers an explanation for how ticks make contact with hosts that seem beyond their reach, because ticks are not capable of jumping.

The researchers first tested the potential of static electricity to help ticks bu using electrically charged rabbit fur and other materials. They found that the ticks were pulled through the air for several millimeters or even centimeters toward the charged surfaces. (One inch has 2.54 centimeters.)

They said the distance the ticks were pulled, compared to their size, was like humans being pulled up several flights of stairs. 

The study also determined that the minimum strength of a static-electricity field needed to attract a tick was comparable to the field between a charged animal and grass, suggesting that this is a likely way some ticks end up on their hosts. 

The researchers suggested that these findings likely apply to other parasitic animals, like mites, fleas and lice.

They also say this study could lead to new ways to prevent tick bites, like creating anti-static sprays.

For now, you can protect yourself from ticks by wearing an insect repellent, such as diethyltoluamide, or Deet, when outside. And for those who don’t like to wear Deet, you can use oil of lemon eucalyptus, IR 3535, or picaridin. All of these products are readily available at stores.

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.

It's also important to check for ticks every time you come inside from being outdoors, even for just 10 minutes. And if you’ve been out longer, 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.

And if you get a tick, 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.

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.

Ticks are active in Kentucky year round, but this is prime time, and they are getting more common and more dangerous

Everyday Health photo

By Melissa Patrick

Kentucky Health News

Public-health officials say ticks are emerging earlier and staying active longer because of changes in climate and land use, resulting in a rising risk of infection carried by the parasites. 

"There are more tick-borne disease cases every year," Dr. John Aucott, director of the Johns Hopkins Lyme Disease Clinical Research Center, said during a June 8 Association of Health Care Journalists webcast. "This is an insidious epidemic. It hasn't been as dramatic as Covid-19, so it has crept up on us."

According to the Centers for Disease Control and Prevention, the total number of tick-borne diseases reported to the agency rose by 125% to 50,865 in 2019 from 22,527 in 2004. These numbers are generally considered to be underestimated because most aren't reported to the agency. For example, the CDC estimated that between 2010 and 2018 the number of Americans with Lyme was closer to 467,000 based on an analysis of health insurance records.

Anna Pasternak, a tick researcher at the University of Kentucky, said the Kentucky Tick Surveillance Program has only been collecting information on ticks in Kentucky since 2019 and doesn't have enough year-to-year data to confidently say that Kentucky is seeing more ticks and tick-borne disease cases or say that they are emerging earlier from winter hibernation and staying active longer. 

"However, I think important things to note are that 1) we do have ticks active in the winter months in Kentucky and 2) the prime months for tick activity so far seem to be April through August," Pasternak said in an e-mail. "This, of course, doesn’t mean that you only need to be wary of ticks in these months, just that these months are when I have collected the majority of ticks each year." 

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.

Ticks can carry pathogens that can cause a number of illnesses. In Kentucky, the most common tick-borne diseases are Rocky Mountain spotted fever, ehrlichiosis and Lyme disease. 

Another disease caused by the lone-star tick that is increasing is called alpha-gal syndrome, which causes an allergy to red meat. Research published in the January 2021 in Annals of Allergy, Asthma and Immunology found that Arkansas, Virginia, Kentucky, Oklahoma and Missouri had the highest number of positive cases per 100,000 people.

An article that examined current information about this syndrome, published in last year's Frontiers in Cellular and Infection Microbiology, says up to 3% of the population has this condition, the Daily Mail reports.

A new tick to watch for is the Asian longhorned tick, which was first found in the U.S. in 2017. Kentucky is one of 17 states that this tick has been found in. Research is ongoing to determine if an how often these ticks are able to pass on germs that are harmful to humans and can make them ill, says the CDC. 

Also of concern is that symptoms of Lyme disease and other tick-borne diseases -- like headache, fatigue, fever and rashes -- can mimic Covid-19 symptoms, which could result in a delayed diagnosis and risk for complications. 

Looking forward, progress is being made on the development of a Lyme disease vaccine, as well as other technologies and treatments to prevent the disease. 

"Pfizer and its partner Valneva announced in April 2022 that they had completed Phase 2 of a clinical trial of a Lyme disease vaccine, setting on the path for a larger Phase 3 trial. Two Yale researchers have developed a vaccine based on mRNA technology (the platform used to create the Covid-19 vaccine) to reduce the risk of developing Lyme disease. CRISPR technology has been used to edit the gene of black-legged ticks, which may help scientists with developing vaccines and treatments. Researchers are investigating vaccinating mice that carry ticks, and genetically engineering mice to prevent them from becoming reservoirs of diseases that ticks ingest when they feed on mice," Bara Vaida writes in a tip-sheet on tick-reporting for AHCJ. 

The best protections against tick-borne disease is to not get bitten. Here are some ways to protect yourself from ticks:

• 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.

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.

Tick that can clone itself is found on cattle in Southern Ky. and wildlife in Eastern Ky.; it's also a threat to pets, and hard to identify

Asian longhorned tick (Photo by Anna Pasternak, UK)

By Katie Pratt
University of Kentucky College of Agriculture, Food and Environment

The Asian longhorned tick, which preys on a variety of hosts including humans and wild and domestic animals, has been found in Kentucky. This new tick is known to attack animals in large numbers and will be a concern to livestock producers, wildlife enthusiasts and pet owners.

“This tick is an aggressive biter and frequently builds intense infestations on domestic hosts that can cause stress, reduced growth and severe blood loss,” said Jonathan Larson, UK extension entomologist. “One reason for their rapid buildup is that the female ticks can lay eggs without mating. It only takes a single fed female tick to create a population of ticks. Potentially, thousands can be found on an animal.”

The tick has been found in small numbers on elk in Martin County and black bear in Floyd County. It was found in large numbers on a bull in Metcalfe County in the south-central part of the state.

“The Metcalfe County ticks were submitted by a veterinarian who answered a call about a bull so infested that it was showing signs of severe fatigue,” said Anna Pasternak, UK entomology graduate student who manages the Kentucky Tick Surveillance Program. Pasternak and Monica Cipriani, a student in the UK College of Public Health, sampled the Metcalfe County field and found more Asian longhorned ticks.

Metcalfe County (Wikipedia map)

“The Metcalfe County finding is particularly troubling,” Pasternak said. “It means the tick may have already spread farther across the state.”

The tick was found in the U.S. in 2017. It has also been confirmed in Arkansas, Tennessee, the Carolinas, West Virginia, Pennsylvania, Maryland, Delaware, New Jersey, New York and Connecticut.

In addition to wildlife, the asian longhorned tick preys on cats, dogs, horses and chickens. Humans also are a host. It is a known or suspected vector of several important livestock viral, bacterial and protozoan agents. Scientists are conducting tests on ticks collected in the United States, and it is likely that some ticks will contain germs that can be harmful to animals. 

The tick is hard to identify because it has no distinctive markings and unfed adults are smaller than other common adult ticks in Kentucky.

If you find an unusually large number of ticks on a pet or livestock, contact a veterinarian. If you think a tick might be an Asian longhorned tick, work with your county extension agent for agriculture and natural resources to submit the sample to UK entomologists for positive identification.

Ticks are a bigger problem than they once were, Kentucky Health News reported recently. UK has information on tick-bite prevention and removal at https://entomology.ca.uky.edu/ef618 and at county offices of the Cooperative Extension Service.

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.”

Rural weekly reports on increasing tick-borne allergy to red meat

Map shows cases entered by site users and is not verified. For a larger version of the map, click on it.

A tick-borne allergy to red meat is becoming more common, the Adair County Community Voice reported Oct. 31, in a pair of front-page stories: one on the main front and the other leading its occasional Health and Wellness section.

The allergy is caused by a sugar molecule called alpha-gal. Anna Buckman writes, "Dr. Kourtney Gentry Gardner, an allergist-immunologist in Bowling Green, diagnoses about five people a month with the alpha-gal allergy, and it’s becoming increasingly more common, she says."

Close-up of the Lone Star tick, which
is much larger when it is full of blood.

People who are bitten by the Lone Star tick, especially those bitten repeatedly, are at risk of "having allergic reactions to the molecule, which is found in most mammalian or red meat," Buckman notes. "It is relatively new to the allergy world," having been identified in scientific literature only 10 years ago.

Buckman deals with the science but brings the story home by writing about some local victims, illustrating the varying manifestations of the allergy:

"Tiffany Bean can no longer hang out at summer gatherings where friends grill burgers because, following a tick bite, she developed a food allergy so severe that she even has reaction being around the fumes of cooked beef. . . . Rick Wilson is also allergic to red meat but can eat dairy products. He only had occasional reactions when he was still consuming red meat."

Joshua Wethington (Adair Co. Community Voice photo)

"Five-year-old Joshua Wethington doesn’t like dairy-free pizza, but that’s the only kind he can have. Because of a tick bite at some point in his short life, he is so allergic to red meat that allergists recommended removing dairy from his diet because it is a byproduct of cows." Joshua’s mom, Dana Wethington, told Buckman, “I’m having a hard time getting him to eat things because it doesn’t taste the same to him.”

Other differences: "Bean went from just having an itchy tick bite to having a stomach illness for hours or breaking out into a rash if she consumed anything with alpha-gal. She has lost 40 pounds due to the allergy," Buckman reports. "Joshua got hives all over his body every day that he consumed red meat. Wilson experienced severe itching and nearly passed out during one of his few reactions. Speak to three people with alpha-gal and you’ll discover one thing is certain: it’s complicated. The only similar experiences that Bean, Wilson and the Wethingtons have are the difficulty of living with the allergy and dealing with its affects when they go out publicly."

Bean told Buckman, “People don’t seem to take it seriously. You tell people that you have it and that you could die from it, and people are like, ‘Oh no, you can’t die from eating a hamburger or bacon.’ Well, yeah, you can.”

Alpha-gal victims use technology to help each other, including a smartphone app ("Is it Vegan?"), a Facebook groups (“The AlphaGal Kitchen” and “Alpha-Gal Support Kentucky”) and an interactive map that locates cases (above).

"Recommended by a member on a Facebook support group, the Munfordville Pool Hall and Grill is a relief to alpha-gal sufferers and also sets a great example for other restaurants for being allergy-friendly in general," Buckman writes. "The pool hall has designated one fryer where no red meat or cheese is prepared. They have designated skillets to cook foods for separate consumption because people with alpha-gal allergy can have a negative reaction from even the residue from a mammal product.

Pool-hall employee Justin Minton told Buckman that employees acted after notiing that several people in the community have the allergy. “Speaking from experience, going to Subway is pretty much the only place my grandpa can go,” Minton told Buckman.

Even though "people with alpha-gal are helping one another with useful information, Kandace Webster, an advance-practice registered nurse at T.J. Health Columbia Primary Care, "urges sufferers to seek professional guidance," Buckman reports.

Scores of reported cases of Rocky Mountain spotted fever in Lincoln Trail area; awaiting state health department confirmation

Kentucky Health News

Rocky Mountain spotted fever, the main tick-borne disease in Kentucky, has affected scores of people in the area served by the Elizabethtown-based Lincoln Trail District Health Department.

The six-county department "has investigated a total 79 cases of Rocky Mountain spotted fever for June in the district, which comprises Har­din, Meade, LaRue, Nel­son, Washington and Mar­ion counties," Mary Alford reports for The News-Enterprise in Elizabethtown.

In Grayson County, which is in the Lincoln Trail Area Development District but has a separate health department, 26 cases were reported from July 7 to 17. All the numbers are subject to confirmation by the Kentucky Department for Public Health. In a typical year, the entire state has 10 to 30 cases, Grayson Brown, director of the University of Kentucky Public Health Entomology Laboratory, told Kentucky Health News as the summer tick season began.

Dog ticks (middle) are the usual carriers of Rocky Mountain spotted fever.

"Reports of tick-borne illnesses that make it to the health department stem from people with a known tick bite who go to the doctor, exhibiting symptoms such as fever, rash, headaches, muscle aches and tiredness, and are tested for Rocky Mountain spotted fever, Lyme disease and other ailments,"Alford reports. The district health department has also found a few cases of tick-borne Lyme disease.

How can you protect yourself from these diseases, which can be debilitating and in rare cases fatal? Use insect repellents, shower soon after being outdoors, and check for ticks daily, especially in hard-to-see places, Rebecca Morris writes for The Record in Grayson County, citing material from the federal Centers for Disease Control and Prevention web page about ticks.

CDC recommends "a full body check upon return from potentially tick-infested areas," Alford writes. "Ticks most commonly attach around the ears, inside the belly button, behind the knees, between the legs, around the waist and especially in and around the hair. To remove a tick, people should use tweezers to grab the tick close to the skin and gently pull on the arachnid with steady pressure, and wash hands and the bite site with soap and water after the tick is removed. Also, apply an antiseptic to the bite."

Other tips, from UK's Brown:

• Check your pets.
• Keep grass and shrubs trimmed, and clear 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 clothes, 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, or use permethrin-based clothing sprays.

Rocky Mountain spotted fever "can take three to 12 days to incubate," Morris notes. "Initial symptoms appear in one to four days, and include a high fever, severe headache, swelling around the eyes and on the backs of the hands, nausea and vomiting." The spotted rash usually appears two to five days after initial symptoms, but 10 percent of victims never develop a rash.

"After five days without medical treatment, patients can have altered mental states, lapse into a coma, develop respiratory problems or even have organ failure," Morris writes, citing the CDC. The disease "can lead to death if patients aren't treated early."

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.