Officials Offer Advice – But Not Quite That
Thomas Petitt, 48, who lives in Glasgow, said that all it took for him to end up with alpha-gal syndrome (AGS) was one bite from a tiny tick on his stomach after he did yard work.
“I pulled the tick and thought nothing of it,” Petitt said. “But I eventually started having serious issues.”
For two years, he went to every doctor he could think of: six emergency room visits, six days in two different hospitals, two primary care doctors, pulmonologists, sleep doctors, a cardiologist, ENTs and finally an allergist, who recognized he had AGS.
For Petitt, something as simple as a day of yard work led to a devastating, disruptive illness.
Dr. Thomas Kerkering, chief of infectious disease at the Carilion Clinic health care system in Roanoke, said the absolute best way to avoid an AGS diagnosis is to avoid tick bites, especially from the lone star tick, altogether.
But how can people avoid tick bites, especially in rural, outdoor paradises like Rockbridge County?
Kerkering had some rather dour advice.
“Lock yourself in a closet and never come out,” he quipped.
In all seriousness, Kerkering warns that people always need to be aware of the risk of tick bites every time they go outside, especially when being outdoors is part of people’s daily lives and careers.
Lone star ticks, one of the most common found in Virginia, are known to carry a myriad of difficult and sometimes long-term diseases including ehrlichiosis and other spotted fever group rickettsioses as well as AGS, the tick-borne allergy to mammal meat products.
Dr. Julia Murphy, the state public health veterinarian with the Virginia Department of Health, said lone star ticks in Virginia are extremely common at under 1,500 feet elevation and their populations fluctuate from year to year based on temperature, humidity and landscape changes.
The reasons? First, a major problem with lone star ticks is that they are extremely aggressive when it comes to seeking out and biting people. Murphy said another reason lone star ticks are such a common problem in rural Virginia is the large deer population.
“Deer are a key species that the adult stages of lone star ticks feed on, and they’re an important species in the ability for lone star ticks to meet and reproduce and start their life cycle over again,” Murphy said.
In other words: The more deer, the more ticks.
Murphy said the first step to protect yourself from a bite is to recognize where you may find lone star ticks in the first place.
“That’s going to be in leaf litter, on shaded forest floor, on partly shaded grass, and in brushy habitats,” Murphy said.
If you do have to be in a known tick habitat, Murphy advises to wear light-colored clothing so you can better spot ticks before they get to your skin and tuck your pants into your socks.
“They don’t come at you from above,” Murphy said. “If you can protect your skin and create a barrier against those ticks on your lower limbs, they’ll have to crawl up you further to access any bare skin.”
Both Murphy and Kerkering said another good first line of defense is as easy as applying over-the-counter tick repellent, though some are more effective than others.
“Even as hot as it has been, your skin should probably be covered,” Kerkering said. “Your clothing can be sprayed with an insect repellent that contains permethrin, and then on your skin goes DEET.”
Even with the protection of repellents, Murphy recommends that people thoroughly check themselves after they come inside from being in a tick habitat, then shower off with soap and water.
“That scrubbing action may really help decrease the likelihood that any ticks will remain on you or stay attached for too long,” Murphy said.
Washing clothes and gear and then drying them on high heat for 10 minutes will also kill any ticks that remain on your clothing.
Murphy also offered up some good strategies on keeping ticks out of your yard, including keeping your lawn trimmed and removing piles of brush, leaves and vegetation.
Ticks And Pets
Cat owners beware: while permethrin is great for protecting people from ticks, it is extremely toxic to our feline friends.
Murphy said pet owners, particularly cat owners, should take extra care when applying permethrin. People should apply the repellant outside in a well-ventilated area and away from animals. Once the spray is dried, it should be safe for pets.
“If you wanted to take an added precaution, you could just keep that clothing in a separate container or area where the cats can’t have access to it,” Murphy said.
Since our furry friends are also prone to bringing hitchhiking ticks into our homes, Murphy said residents should consult their veterinarian about the best flea and tick treatment.
Need For Future Study: While lone star ticks are the primary carriers of alpha-gal in the U.S., other ticks have also been shown to cause AGS in other countries, according to the Centers for Disease Control and Prevention.
Murphy said there’s more research needed in regard to other ticks potentially carrying alpha-gal, as well as how to best prevent and treat AGS. She said the VDH is working with partners, stakeholders and health care providers to help people manage symptoms and get diagnosed as early as possible.
“That is a long way of saying, there’s a lot more to come,” Murphy said.
