Date: July 9, 2008

Death of Wilkes County Resident a Tragic Reminder of Need for Tick Safety Diligence

RALEIGH – The recent death of a Wilkes County resident believed to have been caused by Rocky Mountain spotted fever (RMSF) is a sad reminder that North Carolinians and visitors to our state must be especially diligent in protecting themselves from tick bites and in monitoring their health if bitten.

“Unfortunately, North Carolina often has the highest number of reported Rocky Mountain spotted fever cases in the country,” State Health Director Leah Devlin said.  “There were 665 cases reported statewide during 2007 – with one death – and we expect to have a similar number this year.  Sadly, the death of the Wilkes County resident demonstrates that the disease can sometimes be fatal, so we urge everyone in our state to take precautions seriously.”

Rocky Mountain spotted fever is a disease caused by the bacterium Rickettsia rickettsii (rick-ETT-see-uh rick-ETT-see-eye) and is carried by ticks.  If bitten by an infected tick, a person will usually start having fever, severe headaches and nausea within about a week or two.  A few days after the illness begins, they will often develop a red-spotted rash, usually starting on their arms or ankles.  They also may have pain in their joints, stomach pain, and diarrhea. Sometimes people with this illness become very sick and have to go to the hospital.

Although deaths from RMSF are rare, this case highlights the need for preventing tick bites.
According to Dr. Devlin, while it is possible for a person to be bitten by a tick and not know it, those who do know should be sure to mark the date they found and removed the tick.  RMSF is treatable with antibiotics, but complications can still occur.

“This information could be a tremendous help to doctors should you become ill,” she said.  “It is also helpful if the tick can be saved so its species can be identified.  People who become ill should promptly consult their doctor, so treatment is started early.”

People can protect themselves from Rocky Mountain spotted fever by limiting their exposure to ticks:

• Wear light-colored clothing, which allows you to see ticks that are crawling on your clothing.
• Tuck your pants legs into your socks so that ticks cannot crawl up the inside of your pants legs.
• Apply repellents to discourage tick attachment. Always follow package directions. Repellents containing permethrin can be sprayed on boots and clothing, and will last for several days. Repellents containing DEET can be applied to the skin, but will last only a few hours before reapplication is necessary. Use DEET with caution on children because using doses larger than recommended may cause adverse reactions.
• Conduct a body check upon return from potentially tick-infested areas by searching your entire body for ticks. Use a hand-held or full-length mirror to view all parts of your body.  Remove any tick you find on your body.
• Check children for ticks, especially in their hair, when returning from potentially tick-infested areas.  Ticks may also be carried into the household on clothing and on pets, so both should be examined carefully to exclude ticks.

Even when a tick is infected, several hours of attachment are required (at least 4 to 6) before it may transmit the infectious agent that causes RMSF.  If you are bitten by a tick, remove the tick immediately to reduce the chance of infection. To remove a tick:

• Use fine-tipped tweezers, and protect your fingers with a tissue, paper towel, or latex gloves. Do not remove ticks with your bare hands.
• Using the tweezers, grasp the tick as close to the skin surface as possible and pull upward with steady, even pressure. Do not twist or jerk the tick; this may cause the mouthparts to break off and remain in the skin.
• Wash the bite area thoroughly with soap and water. Also wash your hands.
• Note date of removal. If you develop symptoms, this could be important information to share with your doctor.
• Tape the tick to a white card, and write the date on the card, so if you become sick later the species of tick can be identified.

For more information about RMSF and other tick borne illness, see the N.C. Division of Public Health web site at www.epi.state.nc.us/epi/tick.  For more information on ticks, visit the Public Health Pest Management web site at www.deh.enr.state.nc.us/phpm/index.html.