Tick Bite Prevention & Awareness Campaign 2016 – Tick Season March – October
To: All Branches
Lack of awareness
Many people have never heard of ticks. Others do know what they are but are unaware that British and Irish ticks can carry and transmit a number of diseases to all manner of wildlife, livestock, domestic pets and humans. Other people have grown up in situations where they have been in regular contact with ticks but perhaps feel that, so far, they have only been a mild irritation and are nothing to worry about. Unfortunately, various combined factors now mean that we are at increased risk of contracting a tick-borne infection.
Tick Bite Prevention Week has launched the annual awareness campaign to coincide with the onset of Tick season (March to October) and provides information to help prevent ticks from biting people and pets. It also gives advice on what to do if ticks do attach. The campaign week is held in early spring when the weather gets warmer, people spend more time outdoors and ticks become more active. Once again this year the CWU Health, Safety & Environment Department will be working with the two main Charities involved in Ticks and Tick-borne disease issues in the UK.
There are two Charities striving for greater awareness of Lyme disease and associated tick-borne diseases.
‘BADA-UK’ (Borreliosis and Associated Diseases Awareness UK) Charity
BADA-UK Campaigns to address the increasing problem of Ticks and Tick-borne disease in the United Kingdom. BADA-UK believes that public and professional awareness is key to combating the rise in cases of tick-borne disease. Formed by a group of people who were brought together by the effects of Tick-borne disease (Borreliosis/Lyme disease and other associated infections) they understand, perhaps better than anyone, the devastating effects that these diseases can have.
Therefore we are glad to support their efforts to help prevent others from falling victim to them.
‘Lyme Disease Action’ Charity
The Lyme Disease Action Charity exists to address the current lack of awareness of Lyme disease amongst the public, the medical profession and the Department of Health and its Agencies. They say that: The Public is often unaware that ticks can carry disease. Patients may ignore a rash and being unaware of the significance of some symptoms, do not relate them to their GP. Thus easily diagnosed early Lyme disease can become very difficult-to-diagnose late and chronic Lyme disease. Doctors often believe that Lyme does not exist in their area, they do not recognise the rash and they are unaware of the wide variation of symptoms that can affect almost every part of the body. The Department of Health is guided by the Health Protection Agency and believes that awareness and diagnostic capability amongst doctors is adequate. The Health Protection Agency (HPA) believes that Lyme disease is rare, easily curable if caught early and readily diagnosed by their tests. The HPA also believes that chronic Lyme disease does not exist. The LDA website provides information on these issues and to keep everyone aware of what the charity is doing to improve the situation for those who suffer from Lyme disease and other tick borne diseases.
‘Warning’ to both outdoor workers and outdoor-pursuits enthusiasts
The BADA-UK Charity is ‘Warning’ both outdoor workers and outdoor-pursuits enthusiasts to be vigilant about the potential increased risk of Tick Bites this spring through the annual awareness campaign. If you are involved in outdoor activities working or leisure which take you into the countryside or into parks or gardens or areas of vegetation and foliage where there’s lots of wildlife (such as squirrels, hedgehogs, foxes, badgers mice, deer, birds), you may be at risk of tick bites. Farm animals can also carry Ticks. The NFU report that Sheep act as a “mop” as Ticks attach themselves to the animals as they graze. Ticks can carry a number of infective organisms which can sometimes make people and pets ill if they get bitten. Simple precautions can help to keep you safe. There are several species of tick in the UK, but the one most likely to bite humans is the sheep tick. Despite its name, the sheep tick will feed from a wide variety of mammals and birds. The Tick bite itself is usually painless and most people will only know they have been bitten if they happen to see a feeding tick attached to them. Once a tick has started to feed, its body will become filled with blood and can swell to many times its original size.
Reports suggest that the Tick population in the UK and its distribution is increasing and with it comes the risk of contracting Lyme Disease (Borreliosis) and other Tick-Borne diseases. New research published in January suggests that the prevalence of Lyme Disease Bacteria in the UK Tick Population is considerably higher than most recent estimates indicated. We do know that the number of confirmed cases of Lyme disease is on the rise. The reason for the increase can’t be pinpointed exactly, but factors may include an increase in the UK’s deer population, damper summers, milder winters, higher recreational use of parks and countryside and a modest increase in awareness of the disease.
More contact with ticks – Recent increased risks could be due to a number of probable factors
• An increasing number of residential and business estates are encroaching on rural surroundings.
• A greater number of people are involved in outdoor recreational and sporting pursuits which take them into tick habitat.
• Climate change has resulted in milder winters. Ticks, which are active at temperatures as low as 3.5 °C, have more opportunity to feed and breed.
• Another result of climate change has been an extended growing season for vegetation. This has increased the number of some of the tick’s host species, which in turn means more available hosts for the ticks.
• A reduction in certain practices such as sheep dipping, moorland burning and bracken control have allowed large numbers of ticks to survive. Dipped sheep act as a mop for ticks, which die when they come into contact with the treated fleece. Moorland burning and bracken control kills ticks that are present in the vegetation.
• Following the EU ban of the herbicide Asulam at the end of 2011, bracken spread is expected to increase, providing even more suitable habitats for ticks.
Whatever the cause of the increase, it is important for everyone to know how to effectively prevent being bitten. If a bite does occur, it is extremely important to know how to correctly remove an attached Tick because this can help prevent disease transmission.
Number of Cases Per Year in the UK
The Health Protection Agency believes the figures to be around 3,000 cases of Lyme Disease per year in the UK. The Charity ‘Lyme Disease Action’ believes the true numbers are much higher – probably over 15,000 cases per year – as many go undiagnosed.
A small number of CWU members have unfortunately reported suffering Tick Bites and subsequently contracted Lyme Disease infection which can be transmitted by Ticks. Following contact from these members, the Health, Safety and Environment Department agreed to support the awareness campaign and Tick-Bite prevention week.
Forestry Commission Trade Unions
The Forestry Commission Trade Union; PCS, Unite, Prospect, GMB take the risk seriously and regularly work with the Commission to train, inform and brief their members of the problem and risks. They provided the following report from a member and joint guidance information issued to their members.
A Worker’s Cautionary Tale!
An outdoor worker and Union Member told his own story from personal experience as follows: Do ticks find you palatable? Some people are very attractive to Sheep Ticks, common on many animals including Deer in Forests, Parks and countryside. I am one of the unlucky ones, and occasionally picked up a Tick on clothing when walking through woodland. Last year my job involved working on the Lodge in part of Alice Holt Forest in Hampshire near Farnham, Surrey. Ticks are prevalent there, and I had picked up Ticks there before despite wearing high boots. One day in July I noticed a circular dark red rash on my lower leg about 5cm in diameter – no discomfort, no itching, no ‘flu-like’ symptoms, and no Tick. This was noticed about a week after the most recent possible exposure. I visited my GP the next day and said I suspected Lyme Disease; he agreed, took a blood sample, and immediately started me on a two-week course of antibiotics. The positive blood result came back ten days later. I suppose I’m lucky in that the conspicuous circular rash appeared. It’s by no means universal and in the absence of any other symptoms could have gone untreated, with a plethora of very serious secondary symptoms appearing months or even years later. Caught in the initial stage, Lyme disease is easily treatable. I don’t think that clothing has a significant effect on Tick establishment – once they are on your clothes they will wander until they find exposed skin – usually wrists or neck. Insect repellent may help in making clothing less attractive, but ticks can attach at any height that you brush against vegetation.
Raising awareness, and checking for feeding Ticks in the evening following fieldwork is the best route to prevention. If feeding Ticks are removed, monitor the feeding site for rash development, though it must be born in mind that a rash doesn’t always develop. The tick season is now in session again – stay vigilant!
Awareness and Early Diagnosis Crucial!
In some cases, the absence of any early symptoms and misdiagnosis of symptoms has meant that in some cases, infection has gone untreated, with a number of serious secondary symptoms appearing months or even years later. If it’s caught at an early stage, Lyme Disease is easily treatable with antibiotics. The prognosis for a patient is usually good if Tick-borne diseases are treated early and adequately. However, misdiagnosis, delayed diagnosis, incorrect treatment, or total lack of treatment, has resulted in Tick-Bite victims being ill for many years. For some this can lead to permanent disability. Therefore once again this year CWU are supporting the campaign to raise awareness and ensure that as many CWU Members and families are “Tick Aware”
What is Lyme disease?
Lyme disease is an infectious disease caused by a bacterium carried by mammals and birds. It is transmitted by the bite of an infected Tick. If it is transmitted to humans it can lead to serious illness if not quickly diagnosed and treated. Lyme disease was given its name in 1975 after a cluster of cases were reported at ‘Old Lyme’ in Connecticut, USA. The disease has now been reported in a number of European countries including Great Britain and Ireland, although still rare, the number of reported cases is rising each year.
What are Ticks?
Ticks are tiny, parasitic, spider-like creatures commonly found in woodland and heathland areas but can also now be found in parks and gardens. They feed mainly on blood from mammals, such as deer and sheep, and birds, rabbits, foxes, hedgehogs, rodents etc., but will occasionally bite humans. Ticks become infected with the bacteria that can cause Lyme disease when they feed on animals carrying the bacterium in their blood. There are many different species of Tick living in the UK but humans can become infected with Lyme disease if they are bitten by ‘hard-bodied’ ticks – sometimes known as ‘deer’, ‘sheep’ or ‘wood’ ticks. Humans are bitten by both ‘nymph’ and ‘adult’ Ticks which have eight legs (the tiny larvae have only six!) Adults vary slightly in colour, ranging from reddish brown to dark brown or black, and differ in size, depending on the species, age and sex of the Tick, and whether or not it has fed. An unfed adult female tick is around 3mm long and is small, oval and flat. After feeding, female ticks can grow to up to 11mm long. Males are smaller, at around 2.5mm, and the nymphs smaller still, at around 1.5mm.
Who is at risk?
The risk of contracting Lyme disease in the UK is small, although anyone coming into contact with Ticks through work or leisure activities may be exposed to tick bites that could potentially transmit Lyme disease. At least 50% of infections acquired in the UK are known to have been acquired in southern counties of England. High risk areas for Lyme disease are considered to be the New Forest, Thetford Forest, Exmoor, the South Downs, North York moors, the Lake District and the Scottish Highlands and Islands. However, any area where hard-bodied ticks are present should be regarded as a potential risk area.
When are the risks highest?
Peak times of year for tick activity are late spring, early summer and in the autumn (March – October). The risks of being bitten are higher at these times. If you are bitten the risk of contracting Lyme disease can be reduced by removing the tick promptly. Ticks usually take between three and five days to complete their feed and the risk of an infected Tick transmitting bacteria is low during the first 24 hours that it is attached to the skin.
Where are ticks found?
Ticks are found throughout the UK, and are common in woodland, heathland and moorland areas. Ticks will also be found in Country Parks where deer are now common, including London City Parks (such as Richmond Park in suburban London) as well as in rural areas; you can be just about anywhere in the UK and a tick can latch on to you. They are less frequently found in coniferous forests. Areas inhabited by deer or livestock are particularly suitable habitats for Ticks. Late spring, early summer and autumn are peak times for feeding – Ticks are often found at these times seeking suitable hosts in areas of bracken and long grass. Although cold temperatures reduce Tick activity, in warmer areas of the UK during mild weather conditions elsewhere, Ticks will be active throughout the year. They can occasionally get into rural gardens as the hedgehog tick and fox tick also carry and transmit Lyme disease so, wherever there are hedgehogs or foxes, there is a risk of Lyme disease – in overgrown urban gardens and town parks alike.
How can I avoid getting bitten?
If you are likely to be exposed to Ticks you should ensure that your skin is covered. Wear trousers instead of shorts – preferably made from light-coloured, closely-woven, smooth material. Gaps between footwear and trousers should be avoided – if possible wear gaiters. Consider using a spray-on insect repellent on trouser legs and to protect any uncovered areas of skin. Inspect your clothing and skin regularly for Ticks – they can be brushed off easily before becoming attached to the skin. Check again carefully when you undress – Ticks often attach themselves in skin folds, behind the knees and in warm, moist parts of the body such as the armpits or groin.
What should I do if I am bitten? and How should I remove a tick?
Don’t panic! If you do find a tick attached to your skin you should remove it as soon as possible. Even if the Tick is carrying an infection it is very unlikely to transmit it in the first few hours of its feed, so early removal is a very effective prevention measure. It is best to use a special Tick removal tool or small long-nosed tweezers or forceps to remove the Tick. Grip the head of the tick as close to your skin as possible. If you don’t have a tick removal tool or long noses tweezers, use a thread of cotton wound round close to the skin and pull upwards or, alternatively, cut a slit in a plastic card and slide that under the Tick’s body. Pull steadily upwards and away from the skin, taking care not to squeeze or crush the body of the Tick. Clean the bite area afterwards with hot, soapy water or an antiseptic wipe. Specially designed and inexpensive ‘Tick Remover Tools’ can be bought from pet shops and veterinary practices – these may be useful for people working in areas where they will have frequent exposure to Ticks. Do not burn a tick off! Never apply heat (e.g. using a lit cigarette or match). Squashing it with your fingers or smothering it in Vaseline or lemon juice is totally the wrong way to handle Tick removal. Irritants such as these may stimulate the Tick and cause the Tick to regurgitate the contents of its stomach, potentially infected material into the bloodstream of the person on whom it is feeding – increasing the chance of infection by transmission of the Borrelia bacteria that can cause Lyme disease. Do Not cover an attached tick with volatile oils, perfume, alcohol, Vaseline or other chemicals.
Will I know if I’ve been bitten?
Not necessarily. Ticks are tiny – and, because they inject their host with an anaesthetic, their bite does not cause irritation and can easily go undetected. UK studies report that about one in three people do not notice a Tick bite and, as tick bites do not itch like mosquito bites, awareness is important to aid diagnosis.
Do all ticks carry Lyme disease?
No. There have been few studies in the UK, but those that have analysed Tick infection rates have found between 2% and 17% of ticks to carry Lyme disease. This is why awareness of Lyme disease is so vital, as people need to know what symptoms to look out for.
How do I know if I am at risk of Lyme disease?
If any of the signs or symptoms described below appear within days or weeks of known tick bites or exposure to ticks, you should seek medical advice from your GP. Diagnosed and treated early, Lyme disease can be treated successfully with antibiotics. Tell your GP that you have been exposed to ticks so that they can consider the possibility of Lyme disease. Diagnosis is difficult because symptoms can mimic those of other diseases, and is easiest when there is a skin rash – however this does not occur in all affected people. The GP may take a blood test to assist in the diagnosis. It is important to emphasise that a ‘positive’ blood test does not mean that you have Lyme disease, or that you will necessarily develop the disease. It only signifies that you have been exposed to the infecting organism and your body has produced antibodies to the bacteria concerned.
Lyme disease or Lyme Borreliosis [bore-EL-ee-OH-sis] is caused by bacteria called Borrelia. Early symptoms can develop within weeks. A characteristic skin rash (erythema migrans) may appear a few days after an infected bite. It begins as a red spot at the site of the bite and enlarges as a faint pink ring some 2-3 cm wide leaving a central clear area that results in a ‘bull’s eye’ appearance. It can expand and move around the body. This rash may not occur in all cases, however, or it may be so faint that it escapes notice. Other early signs to look out for are flu-like symptoms, including tiredness, chills, fever, headache, muscle and/or joint pain, swollen glands in the groin, armpit or neck and blurred vision. At this stage the infection responds well to treatment with appropriate antibiotics. If early symptoms are not recognised, in a small number of cases secondary complications can sometimes develop weeks, months, or even years later. These are rare, but the joints, nervous system and, even more rarely, the heart may be affected. However, like the earlier symptoms, these complications respond well to treatment, so prompt and correct diagnosis and appropriate treatment are important. Symptoms of these secondary, but rare, complications include shifting joint pains, muscle pains, abnormal fatigue, a sensation of burning, numbness of the skin, persistent headache and localised loss of muscle power.
Does everyone with Lyme disease get a rash?
Contrary to popular belief, not everyone who is bitten by an infected Tick will get the text-book circular red rash – surveys have shown that around one in three do not see a rash. Other symptoms include headaches, a stiff neck, extreme fatigue, muscle and joint pain, and disturbances of sight, hearing, digestive system and sleep. If left untreated it can progress to the joints, the heart and the nervous system.
Diseases that can be caught from a Tick bite in the UK
There are over 53 types of virus carried by certain Tick species in the UK. There are a number of bacterial, viral, rickettsial and protozoal diseases carried by UK Ticks. Several of these can cause debilitating symptoms in humans. However, there are no vaccines available to defend against them. Therefore, awareness and preventative measures are the best defence. Three of the diseases that can be caught from a Tick Bite in the UK are: Lyme disease (borreliosis), Babesiosis and Ehrlichiosis. Some Ticks carry all three of these diseases at the same time and can transfer them to you in a single bite. Other infections carried by UK Ticks include TBE, Louping ill, Anaplasmosis, Ehrlichiosis, Bartonellosis. The resulting symptoms can be extremely confusing and liable to misdiagnosis. Treatment in such cases can be difficult. Globally, the list of diseases is much longer.
What precautions should I be taking to avoid Tick Bite and Lyme disease?
First and foremost, check yourself for Ticks during the day and very carefully when you wash or shower after walking, working, jogging, playing or cycling outdoors in the type of areas described in this LTB. When possible, avoid exposing the skin, wear long sleeves, trousers, boots when walking through long grass, vegetation etc. Be vigilant – do a Tick check and brush off clothing before going inside. Often ticks will hide in warm dark corners of the body, such as the groin, back of the legs, underarms or hairline and even in your belly button. Remove any ticks found attached as soon as possible. Wear light coloured clothing as you’ll have a better chance of seeing a dark Tick crawling on you before it makes its way to your skin. Use an insect repellent (look for those containing DEET) and try to avoid areas of overgrown vegetation. Sticking to trails and footpaths as Ticks hang out in high vegetation, waiting for a passing host and when your leg brushes through the vegetation, the Tick transfers to your body.
Risks to Travellers Abroad
Tick-borne Encephalitis (TBE) is a potentially life-threatening and debilitating disease of the nervous system. It can lead to meningitis and in serious cases result in paralysis and death, with two in every one hundred cases proving fatal. The Tick Alert campaign states that there are on average 13,000 cases of TBE in Europe every year. The campaign website http://www.tickalert.org contains a ‘TBE Travel Check’ that helps travellers find out if they might be at risk of the disease. The TBE Travel Check gives people a better understanding of the risks before they travel so they can think about the need for precautions against the disease. The Tick Alert website also includes the latest updates on TBE risk, prevention measures taken by health authorities in various countries and an interactive map showing risk areas of Europe. Vaccinations against TBE are available from GP surgeries, health centres and MASTA Travel Clinics. Travellers to endemic areas may be at risk when walking, camping or working in woodland terrain where they will be exposed to the Ticks. 12,000 Cases are reported annually. It is endemic in western and central Europe and is transmitted by Ticks. It is common in forest and mountainous regions of Austria, Estonia, Latvia, Lithuania, the Czech Republic, Slovakia, Germany, Hungary, Poland, Switzerland, western Russia, Ukraine, Belarus, Croatia and Slovenia. It occurs at a lower frequency in Denmark, France, Kazakhstan, Liechtenstein, Italy, Romania, Norway, the Åland archipelago and neighbouring Finnish coastline, and Sweden. It is probable that TBE also occurs in Albania, Bosnia and Herzegovina, Bulgaria, Greece, Serbia and Montenegro and Moldova, although little data are available on the incidence of disease within these countries. Thousands of cases of TBE occur each year from late spring to early autumn; between 2005 and 2009 the total number of annual cases in Western European countries averaged 3,000. In Eastern Europe it occurs in the spring and summer months in eastern Russia and some countries in East Asia, particularly in forested regions of China and Japan. It is also endemic in Siberia and is also transmitted by Ticks. The virus has also been isolated in Kyrgyzstan and Mongolia.
Don’t panic but be ‘Tick Aware’!
There is no need to be afraid or panic about Ticks but an awareness of their presence, the simple precautions that can be taken against tick bites, and how to remove them safely, is key to avoiding contracting tick-borne diseases. It’s more a case of being aware; knowing how to reduce the chances of being bitten, how to remove a tick and knowing what to look out for in the way of symptoms. We do know, however, that the number of confirmed cases of Lyme disease is on the rise.
Lyme Disease Action Charity: http://www.lymediseaseaction.org.uk
BADA-UK (Borreliosis and Associated Diseases Awareness UK) Charity: http://www.bada-uk.org
Attachments Leaflets & Poster
• Ticks in Britain
• Tick-borne diseases in Britain
• Ticks & Lyme Disease
• Lyme Disease the Facts
• Tick Awareness Poster ‘Watch Out! – Ticks About!’
NOTE: All the content of this LTB is provided for general information only, and should not be treated as a substitute for the medical advice of your own doctor or any other health care professional. The contents are based on professional information provided by the Charities and organisations referred to in the LTB and we wish to record our thanks for their assistance and guidance.
National Health, Safety & Environment Officer
Email Attachments – Click to download
· Attachment 1 – 16LTB176 Tick Bite Prevention & Awareness Campaign 2016 – Tick Season March – October
· Attachment 2 – Tick Awareness Poster ‘Watch Out! Ticks About!’
· Attachment 3 – Ticks Leaflet 1
· Attachment 4 – Ticks Leaflet 2
· Attachment 5 – Tick Leaflet 3
· Attachment 6 – Tick Leaflet 4
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