Deb Hudman is getting ready to go outside. She pulls on her boots and grabs a large sheet of flannel.
But this flannel is not for a summer picnic. It’s for tick-hunting.
Hudman, a wildlife health program supervisor for the Missouri Department of Conservation, steps into the woods behind her office on a recent morning in south Columbia, dragging the flannel behind her. After just a few moments, she stops and points to the flannel where a small, dark dot is crawling around.
“This is the lovely Lone Star (tick); you can see the white dot," Hudman said. "So, we know she's an adult female. It wasn't too long ago, they were not considered a medically relevant species.”
Hudman conducted a two-year Missouri Ticks and Tick-borne Pathogen Surveillance Research study starting in 2021. People from across the state mailed her the ticks they found on themselves, their pets and in their homes.
Her project was trying to find out what kinds of ticks were present in Missouri, where they were most prevalent and what diseases they carried.
“The average was 152 ticks per county,” Hudman said.
She added that 71% of those were Lone Star tick, 26% were the American Dog tick, 2% were the Blacklegged (Deer tick) and the remaining 1% consisted of five different species.
In total, Hudman said that at least two ticks were submitted from every county and 17,466 usable ticks were submitted through the mail.
She said it’s important for Missourians to note that ticks are more than just a “woods problem,” as they were found throughout the state – not just in rural areas.
The study, Hudman notes, was limited by what ticks were sent in, but many tick diseases were found to be present in Missouri. Bacterial diseases like Ehrlichiosis, Rocky Mountain Spotted Fever, Southern Tick-Associated Rash Illness, and Lyme disease, as well as several viral infections like Bourbon virus and Heartland virus.
“The good news is that with all of these bacterial pathogens, they're all treated the same," Hudman said. "So, the diagnosis is not that hugely important. They're all treated with doxycycline. So, that's the good news. If it's viral, well, then you're just on for the ride anyways.”
William Roland, a professor of clinical medicine and an infectious disease expert with MU Health Care, said not everyone who gets bit by a tick will contract a disease and develop symptoms.
But even if they do, most are mild illnesses that usually only present serious problems for those who are older than 40, very young or immunocompromised.
“These are more acute illnesses, they're not associated with long-term morbidity or mortality,” Roland said. “That being said, we have seen patients fever more than 60 days with Ehrlichiosis. So, these can lead to death when not treated, or (when) improperly treated.”
He said the most common tick-borne illnesses in Missouri are Ehrlichiosis, Tularemia and Rocky Mountain Spotted Fever. According to the Centers for Disease Control and Prevention, Missouri is one of the hotspots for both Ehrlichiosis and Rocky Mountain Spotted Fever — ranking among the top five states for both illnesses.
Roland said they do see cases of Lyme, as well as Alpha-Gal, which is an allergy to red meat caused by a bite from a Lone Star tick.
He added that while some symptoms can be very specific to each disease — like spots for Rocky Mountain Spotted Fever, a skin ulcer for Tularemia or the well-known bullseye rash of Lyme disease — almost all tick-borne bacterial diseases begin the same.
“Usually they'll present with high fever, real high like 104 degrees, bad headache, aches all over plus (or) minus a rash,” Roland said.
Serious illness can be prevented in most cases by treatment with the antibiotic doxycycline within days of symptoms.
Molly Baker, the Vector-Borne Disease Surveillance Coordinator with the Missouri Department of Health & Human Services, keeps track of tick-borne disease in the state.
She said the most effective way to prevent tick-borne illness is to keep ticks off you in the first place by wearing light colored clothes, wearing long pants, using EPA-approved bug repellant, avoiding shaded areas along the edge of forests where ticks are more common and doing regular tick checks after being outside.
Baker added that ticks should also be removed as soon as you see them “because the longer it's attached, the higher the chances are that disease could be transmitted.”
And ticks need to be removed properly. This is done by either carefully using tweezers to remove the tick from the base or using a tick remover, which looks like a small crowbar.
She warned that removing a tick improperly by smothering them with Vaseline or pulling them out by the body can actually cause the tick to effectively throw up any pathogen they’re carrying into your body.
So, what should you do if you find a tick on you?
First, don’t panic. Ticks are just a part of living in Missouri.
Baker said to remember that not everybody who gets a tick-borne disease is going to develop symptoms.
Second, remove the tick. Hudman suggested that after removing ticks residents should consider keeping the tick to that it can be identified later, in the event they later any flu-like symptoms or rashes.
“Put it between some scotch tape and ... if you have a wall calendar, stick it on the date you found it,” Hudman said. “And then forget about it. If you don't get any symptoms for 10 to 14 days after that tick bite, throw it away.”
But if symptoms do develop, seek medical care quickly.
Hudman said that people should be aware of the risks that ticks and tick-borne diseases present, but she hoped that it wouldn’t keep people from going out and enjoying the outdoors.
“I think being in the woods is like the best thing you can do,” Hudman said. “So, I think it's just being careful. I've pulled thousands of ticks off me and I'm alive. It's just recognizing there's a risk, but there's also a whole lot of benefit.”
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