Nature’s Hitchhiker: Ticks

May 02, 2017

You might have heard that Lyme disease is on the rise this spring, but do you need to worry? Not so much, if you're in Nebraska or western Iowa.

Lyme disease is a bacterial infection spread by the black-legged tick, also known as a deer tick.

"We don't have that tick in Nebraska. The only way to get Lyme disease is if you travel outside of Nebraska and get a tick bite," said Renuga Vivekanandan, MD, a CHI Health infectious disease specialist.

Some ecologists are predicting that regions of the upper Midwest and northeast United States could experience an uptick in Lyme disease this spring and summer due to a surge in mice-carrying Lyme-infested ticks. However, that surge isn't likely to include Nebraska and Iowa. According to the Centers for Disease Control, 300,000 people are diagnosed with Lyme disease each year. In 2015, 95% of confirmed Lyme disease cases were from 14 states – and Nebraska and Iowa are not on the list. For Powassan, there were an average of 7 cases were reported annually from 2006 through 2015. And for Rocky Mountain Spotted Fever, there were 6 cases per million in 2010.

Vigilance is essential, especially, if you're vacationing or camping in the upper Midwest – in places like Minnesota or Wisconsin -or go to the upper East Coast.

"Usually the cases we get [at CHI Health] are people who have traveled and come back," Dr. Vivekanandan said.

In those areas, preventing tick bites is vital. But it's a good habit to avoid tick bites everywhere, even in Nebraska and Iowa where ticks can transmit other illnesses like Rocky Mountain Spotted Fever and Powassan virus.


Preventing tick bites is as easy as 1-2-3:

1. Prevent tick bites by covering up. Wear:

  • long sleeves
  • long pants
  • socks
  • sturdy shoes
  • hat

2. Spray yourself with a repellant product containing DEET.
3. After being outdoors, change your clothes and check for ticks in their favorite hiding spots including:

  • ears 
  • scalp and head
  • armpits and groin
  • behind the knees
  • between fingers and toes
  • belly button
  • neck, top of the head

Treatment and Removal

And if you do find a tick, remove it promptly by:

  • using tweezers and squeezing the tick by the head, not the body.
    • Squeezing the body prompts the tick to discharge its stomach contents into your skin, including whatever infections it's carrying.
  • pulling up slowly and steadily, without twisting, until it lets go.
    • Don't use petroleum jelly, solvents, knives or a lit match to kill the tick.
    • Save the tick and place it in a plastic container or bag so it can be tested for disease, if needed.
  • Wash the bite area well with soap and water and apply antiseptic lotion.
  • Call your physician if you're in a region where Lyme disease is prevalent or suspect the tick hitchhiked back home with you from a state where Lyme disease is known.  

A Lyme disease infection can be signaled by a bull's-eye-shaped rash, but that isn't always the case. Others notice more subtle symptoms like fever, joint pain and fatigue. If you've experienced a tick bite in a high-risk area, antibiotic treatment within 36 hours can prevent Lyme disease from developing. A screening test and a confirmatory test are crucial to diagnose the disease.


Early symptoms of Lyme disease infection include:

  • red rash that slowly gets larger
  • rash may have bull's-eye shape
  • flu-like symptoms
  • joint pain
  • facial muscle weakness or paralysis
  • severe headaches and neck stiffness
  • fainting, shortness of breath, heart palpitations or chest pain

Late symptoms of Lyme disease infection:

  • Fatigue
  • joint pain
  • twitching
  • cognitive impairment
  • heart-related symptoms
  • nerve pain, numbness, hot/cold sensations, tingling
  • headache
  • muscle aches
  • memory loss
  • sleep impairment
  • gastrointestinal symptoms
  • depression or mood changes

If in doubt, seek medical attention instead of chancing a tick bite.