The warmer weather means Alabamians are spending more time outdoors, which can lead to more exposure to ticks which then can transmit diseases.

Tick-borne diseases and illnesses have been on the rise nationally and in Alabama, and several tick species found in Alabama carry illness-causing bacteria.

Alabama Senate Joint Resolution 85 proclaims June 2024 as Tick-borne Disease and Illness Awareness Month in Alabama. The resolution states that these illnesses are often misdiagnosed because the symptoms of Lyme disease and other tick-borne illnesses are similar to flu and cold symptoms. Researchers have also identified emerging threats from ticks including illnesses in humans which were previously believed only to infect animals. The resolution states that the best prevention is through encouraging awareness of the symptoms and variety of diseases and illnesses that ticks carry.

The Alabama Department of Public Health (ADPH) advises the public to avoid tick bites, check themselves and their clothing after being outside, and remove any ticks correctly and as soon as possible.

According to the Centers for Disease Control and Prevention (CDC), the most common symptoms of tick-related illnesses are as follows:

• Fever/chills — All tick-borne diseases can cause fever.
• Aches and pains — Tick-borne diseases can cause headache, fatigue and muscle aches. People with Lyme disease may also have joint pain.
• Rash — Lyme disease, Southern tick-associated rash illness (STARI), Rocky Mountain spotted fever (RMSF), ehrlichiosis and tularemia can cause distinctive rashes.

The CDC offers the following recommendations for preventing harmful infections from tick bites:

Before you go outdoors

Know where to expect ticks. Ticks live in grassy, brushy or wooded areas or even on animals. Spending time outside walking your dog, camping, gardening or hunting could bring you in close contact with ticks. Many people get ticks in their own yard or neighborhood.

Treat clothing and gear with products containing 0.5% permethrin. Permethrin can be used to treat boots, clothing and camping gear and remain protective through several washings. Alternatively, you can buy permethrin-treated clothing and gear.

Use Environmental Protection Agency (EPA)-registered insect repellents containing DEET, picaridin, IR3535, Oil of Lemon Eucalyptus (OLE), para-menthane-diol (PMD) or 2-undecanone. EPA's helpful search tool can help you find the product that best suits your needs. Always follow product instructions. Do not use products containing OLE or PMD on children under 3 years old.

Avoid contact with ticks. Avoid wooded and brushy areas with high grass and leaf litter. Walk in the center of trails.

After you come indoors

• Check your clothing for ticks. Ticks may be carried into the house on clothing. Any ticks that are found should be removed. Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks on dry clothing after you come indoors. If the clothes are damp, additional time may be needed. If the clothes require washing first, hot water is recommended. Cold and medium temperature water will not kill ticks.
• Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine pets, coats, and daypacks.
• Shower soon after being outdoors. Showering within two hours of coming indoors has been shown to reduce your risk of getting Lyme disease and may be effective in reducing the risk of other tick-borne diseases. Showering may help wash off unattached ticks and it is a good opportunity to do a tick check.
• Check your body for ticks after being outdoors. Conduct a full body check upon return from potentially tick-infested areas, including your own backyard. Use a hand-held or full-length mirror to view all parts of your body. Check these parts of your body and your child's body for ticks:
  • Under the arms
  • In and around the ears
  • Inside belly button
  • Back of the knees
  • In and around the hair
  • Between the legs
  • Around the waist

If you find a tick attached to your skin, remove the tick as soon as possible. Several tick removal devices are on the market, but a plain set of fine-tipped tweezers works very well. If you develop a rash or fever within several days to weeks after removing a tick, see your health care provider.

ADPH investigates reports of suspected tick-borne illness cases. Of the 124 cases identified in 2023, the majority of investigations were for spotted fever rickettsiosis, 81 cases, which include Rocky Mountain spotted fever. Other tick-borne diseases and illnesses identified included 36 cases of Lyme disease; four cases of ehrlichiosis; and one case each of anaplasmosis, babesiosis and tularemia.

The CDC has developed the Tick Bite Bot, which is an interactive tool to assist individuals in removing attached ticks and determining when to seek health care after a tick bite, if appropriate. The online mobile-friendly tool asks a series of questions covering topics such as tick attachment time and symptoms. Based on the user's responses, the tool then provides information about recommended actions and resources. The Tick Bite Bot can be found at https://www.cdc.gov/ticks/communication-resources/tick-bite-bot-1.html.

For more information, go to alabamapublichealth.gov/tick/index.html.