IN THE PUBLIC HEALTH Ticks pose avoidable health risk Tick borne illnesses are on the rise, but precautions can prevent

PLYMOUTH - Good things don't always arrive in small packages. And, when it comes to ticks, some of the smallest ones can wreak the most havoc.

Several cases of Lyme disease have already been reported in Plymouth. And deer ticks, also called black-legged ticks, are the major culprit for carrying this and other potentially deadly diseases. They also happen too be really tiny - among the smallest ticks in the region.

Plymouth Health Agent Karen Keane said the best way to prevent tick-borne illnesses is to check yourself, your family and your pets after going outside.

"If you think you have a new freckle, check again," Keane said. "It's probably a tick. We find that parents are very good about checking their child and not good about checking themselves. They go to the Little League baseball game and check the kids. The kids look great. But no one is checking the parents."

Deer ticks can spread Lyme disease, Babesiosis and Anaplasmomsis. And a new, potentially deadly tick-borne illness known as Powassan virus has surfaced on Cape Cod and in the Northeast in general. The virus is spread through deer ticks as well.

"We have known about the presence of Powassan/Deer Tick virus in deer ticks in Massachusetts since 1996," Tufts University School of Veterinary Medicine Professor of Infectious Disease and Global Health Dr. Sam Telford said. "Why we have not seen many cases until the last five years is not understood."

According to the Centers for Disease Control and Prevention, POW virus can infect the central nervous system and cause encephalitis (inflammation of the brain) and meningitis (inflammation of the membranes that surround the brain and spinal cord.) Signs and symptoms of POW infection can include fever, headache, vomiting, weakness, confusion, seizures, and memory loss. Long-term neurologic problems may occur. There is no specific treatment, but people with severe POW virus illnesses often need to be hospitalized to receive respiratory support, intravenous fluids, or medications to reduce swelling in the brain.

Telford said the POW virus is an encephalitis virus, and it is a relative of the West Nile virus, which is transmitted through mosquito bites.

"Physicians have been looking for and reporting to the Department of Public Health any encephalitis cases due to enhanced surveillance put in place when West Nile virus emerged in the early 2000s," Telford said. "Even with this wider net for encephalitis, Powassan disease remained rare until relatively recently."

Teleford added that ticks have increased their distribution and density, meaning there is a greater probability that people will contract even rare infections transmitted by ticks.

Rates of POW disease found in deer ticks have been roughly 0.5 percent to 1 percent, in comparison to Lyme disease rates, which are 35 to 65 percent, According to Telford. Although POW is a rare disease in Massachusetts, 13 cases of Powassan disease have been discovered within the last three years.

If a tick remains attached, most tick-borne diseases are transmitted to humans within about 24 hours, so experts recommend removing ticks as soon as possible.

Unlike fleas, ticks don't jump; they wait for a host to pass so they can attach themselves to it. Ticks cling to grass, weeds and underbrush and are commonly found in woodlands, bushes and tall grass, a fact that may make you think twice about allowing your dog to charge into that open field. Keane has hung posters in her office, cautioning hikers to wear socks, to check themselves and their family members and friends after spending time outdoors. Tucking pant legs right into the socks is an additional precaution, she said, and light-colored clothing and socks makes it easier to spot ticks.

"We have installers who are out in the field all the time and a couple have gotten Lyme disease," Keane added.

Checking dogs, cats and family members for ticks helps to prevent the spread of tick-borne illnesses. Lyme still tops the list of these. Look out for a rash that sometimes appears as a bull's-eye pattern, and remember, it doesn't have to be a big rash or a big bull's-eye; some are quite small. Early symptoms include flu-like symptoms with fever, chills, body aches and heachache. If left untreated, Lyme disease can cause joint paint, neurological issues like meningitis, temporary paralysis, numbness or weakness of limbs and impaired muscle movements. Think you've been bitten by a tick and notice some of these signs? Call a doctor immediately.

"Preventing tick bites should become as routine as wearing a helmet when bicycling or buckling the seat belt in a car. Use repellent as instructed by the product label, take a shower daily, and always have an unexplained fever checked out by a healthcare provider," Telford said.

To prevent tick bites, the CDC also recommends avoiding wooded and brushy areas with high grass and leaf litter, treating clothing and gear with repellant products containing 0.5 percent permethrin, and conducting full-body tick checks.

"As long as you are using these preventative methods, these ticks should not keep you from enjoying the wonderful things Massachusetts has to offer," said Telford.

For more information on tick-borne diseases, visithttps://www.cdc.gov/ticks/diseases/. Keane said a wealth of information is also available at mass.gov/eohhs/gov/departments/dph/programs/id/epidemiology/ticks/.