Home' Australian Pharmacist : Australian Pharmacist February 2012 Contents Australian Pharmacist February 2012 I ©Pharmaceutical Society of Australia Ltd. 117
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COUNSELLING IN PRACTICE
ticks before removal is not recommended.
It is thought that this might cause the tick
to inject more toxins/bacteria, and these
methods have not been found to cause
ticks to detach.3,7
Additional notes on tick removal:
• In people with a history of allergic
reactions to tick bites, ticks should
be removed as soon as possible, but
only by a doctor and in a place where
resuscitation facilities are available.4
• The tick's body should not be grasped or
squeezed, as this may result in injection
• After the tick has been removed, a
disinfectant cream/liquid should be
applied to the area and the hands should
be thoroughly washed.25,27
• The whole body (including ears, hair
and skin folds) should be checked for
• If possible, the tick should be placed
with a leaf or blade of grass in a sealed
jar labelled with the date removed and
the location where the tick was acquired.
The tick can then be identified later if
this becomes necessary to determine the
cause of symptoms should they develop.3
• If, after removal of the tick, the person
develops a rash, persistent headache,
fever, aching joints or other troublesome
symptoms, a doctor should be consulted
How can I prevent tick bites?
The best way to prevent tick bites is to
avoid tick-infested areas. When visiting a
known tick area:1,4,5
• wear long pants tucked into socks,
and long-sleeved shirts tucked into
pants. Ticks are more visible on light-
• apply an insect repellent containing
diethyl-meta-toluamide (DEET) or
picaridin to clothing and the skin.
The repellent should be applied
and re-applied according to the
On returning from a known tick area:1,4,5
• remove all clothing and check the body
for ticks, paying particular attention to
the area behind the ears, the back of the
head and neck, the backs of the knees,
and the groin and armpits.
• ticks found on clothing can be killed by
placing the clothes in a hot dryer for
In gardens where ticks are prevalent,
maximise sunlight penetration to the
ground by mowing lawns regularly,
reducing mulch and leaf litter, minimising
watering, and trimming shrubs which
overhang outdoor play areas and paths.
Check pets regularly for ticks -- many dogs
and cats are infested each year and can
die from tick paralysis.4
Where can I find more
These websites and resources provide
• Tick Alert Group Support Inc. (TAGS)
website. At: http://pandora.nla.gov.au/
• NSW Department of Health. Tick Alert
pamphlet. At: www.health.nsw.gov.au/
• Department of Medical Entomology.
University of Sydney. Ticks fact sheet.
• SA Department of Health. Public Health
Fact Sheet - Ticks: Prevention and
treatment. At: www.health.sa.gov.au/
• Centers for Disease Control and
Prevention. Ticks information.
• Karl McManus Foundation for Lyme
Disease Research & Awareness website.
• International Lyme and Associated
Diseases Society (ILADS)
The tick should be removed as soon as
possible using fine-tipped tweezers. Patrick,
and any other members of the family
who were on the walk, should be carefully
checked for ticks. The clothes they were
wearing during the walk should also be
checked. Mrs Hales should be counselled
about the possible effects of tick bite,
and what to do in the event of an allergic
reaction (e.g. cold compresses, analgesics,
antihistamines, hydrocortisone cream,
taking Patrick to the doctor/hospital --
depending on the severity of the reaction).
She should be advised to monitor Patrick
carefully for any signs of tick paralysis
(e.g. unsteadiness, weakness, lethargy).
If symptoms appear, or if she is in doubt,
she should immediately take him to her
doctor or the local hospital emergency
department. Spotted fever may develop
up to two weeks after a tick bite. Mrs Hales
should be counselled on symptoms to look
out for (e.g. fever, myalgia, headache, stiff
neck, nausea, vomiting, rash, a scab at the
site of the bite). If any of these symptoms
appear, she should take Patrick to the
doctor. She should also be given advice
about future prevention of tick bites and
told about websites/resources where she
can find further information about ticks
and tick bites.
Key learning points
Although there are over 70 tick species in
Australia, the tick which most commonly
causes health problems in humans (as
well as native and domestic animals) is
the paralysis tick, Ixodes holocyclus.
I. holocyclus is found along coastal eastern
Australia in a 30--100 km wide band
extending from Far North Queensland
to Victoria. Bites can be inflicted by
larval ticks, nymphs and adult ticks.
Most tick bites cause only local irritation.
However, possible complications of
a tick bite include allergic reactions
(which can range from mild localised
itching and swelling to life-threatening
anaphylaxis), tick paralysis and tick-borne
infectious diseases (e.g. spotted fever,
Lyme disease). Mild allergic reactions
can be treated symptomatically, but
severe allergic reactions, tick paralysis
and tick-borne infections require
medical attention and, in some cases,
hospitalisation. People who live in or visit
tick-endemic areas should know what
familiar with strategies to avoid tick bites.
1. Department of Medical Entomology. Ticks fact sheet [online].
Sydney: Department of Medical Entomology, University of
Sydney and Westmead Hospital; 2011. At: http://medent.usyd.
2. Edlow JA. Tick-Borne Diseases: Introduction to Tick-Borne
Diseases [revised Dec 2008]. Medscape Reference [online]. 2011.
3. Tick Alert Group Support Inc. (TAGS) website. At: http://pandora.
4. NSW Department of Health. Tick Alert pamphlet [online].
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