A challenge to the wilderness leader (or anyone in a remote location) is knowing how to manage common signs and symptoms such as fever, headache, nausea, diarrhea, sore throat, cough, congestion, runny nose, etc. Are these a "stomach bug," a "stomach flu," a "cold" or "flu," or a sign of a more specific illness?
In this case you’re suspicious about the tick bite, and worried about the fever. As a biologist you know the local ticks, relatives of spiders and scorpions, are the hard tick, genus Dermacentor. As with all ticks, it requires blood meals to molt from larva to nymph and from nymph to adult. The various diseases that the tick carries are transmitted to the host (possibly your patient) during the blood meal. These diseases include Tick Fever, Relapsing Fever, Spotted Fever, Tularemia, Babesiosis, and Lyme disease. Tick season in the central Rockies is April through July, although ticks are active throughout the warm months.
The ticks seem to be everywhere this spring, and it’s been common for you to find a dozen of these little buggers on you every day, especially after you walk through the sage. They’re on the horses as well.
The old hands have been touting prevention. You’ve been visually inspecting yourself morning and night (usually). Your jeans are unfortunately dark blue. The common recommendation is to wear light-colored clothing so you can see the ticks better, but even if you chose light pants, the dirt and grime would soon make them dark.
Some of the group has tried Permethrin, spraying it on their pants below their knees and on their boots. Permethrin is a contact insecticide, not a repellent. It kills ticks or other insects. It's the same active ingredient as shampoos for head lice. It’s FDA-approved for use on skin, but is commonly used on clothing, where it binds to the fabric. Permethrin is very effective at keeping ticks from attaching.
A visual inspection of all body parts at least twice daily is recommended, as adult ticks generally stay on the body for a few hours before attaching. Even after a tick has attached itself, prompt removal may prevent the transmission of disease.
To remove a tick, grasp it as close to the skin as possible with tweezers or gloved fingers. Pull the tick out with steady pressure. Clean the bite site thoroughly with an antiseptic soap. Traditional tick removal methods (a hot match head, nail polish, or alcohol) are not recommended.
Treatment Principles
- Diagnosis of tick-caused illness in the field is difficult. If a tick bite is accompanied by a rash, fever, flu symptoms, or muscle aches and pains, the patient should be seen by a physician.
- If you have a fever without the obvious tick bite, you can try to make the patient more comfortable with acetaminophen or ibuprofen. If the fever persists for more than 48 hours, or is greater than 102°F/39°C, or is associated with a severe headache or stiff neck, the patient should be evacuated.