People love Brown County for its deep woods, grassy fields and hidden places.
Unfortunately, ticks and mosquitoes love them, too.
No area of Indiana is more or less safe when it comes to diseases passed to humans by ticks and mosquitoes, said Bryan Price, senior vector-borne illnesses epidemiologist with the Indiana State Department of Health.
Mosquitoes carrying West Nile virus have been found all over the state in past years, he said.
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As of May, the Indiana Department of Health had not recorded any mosquitoes carrying that virus so far in Indiana. However, Marion County, which tracks mosquitoes independently from the state, discovered mosquitoes carrying West Nile in June.
Ticks and the diseases they carry — the most prevalent being Lyme disease — are statewide as well.
One exception is the Lone Star tick — identifiable by the single white dot on its back — which is mostly present in southern Indiana at this time, Price said. It is known to transmit the bacterial infections ehrlichiosis and tularemia.
The CDC also links southern tick-associated rash illness (STARI) to the Lone Star tick.
The exact cause of STARI is not known. Treatment with antibiotics has appeared to help people recover from the flu-like symptoms, but symptoms also fade without treatment.
The Lone Star tick has also been associated with the development of an allergy to mammalian meat, commonly known as alpha-gal, named after the carbohydrate that causes the allergic reaction, according to the American College of Allergy, Asthma and Immunology.
A terrifying night
Margie Cooper still remembers the meal she fixed for herself and her husband, Gene, that night: pot roast.
When Gene woke up itching all over a few hours later, he went to the bathroom and was surprised by what he saw in the mirror.
“It looked like I had measles,” he said.
He woke Margie and she rushed him to the hospital.
“I should have called an ambulance, but I didn’t realize how bad it was,” she said. By the time they reached the hospital, every inch of his body was red and swollen.
At the hospital, his condition was quickly diagnosed as an allergic reaction, but Margie couldn’t help doctors with their questions. Gene had never had an allergic reaction before.
During the next five hours as they worked on him, his heart rate would dip low enough to set off monitors, she said.
Doctors told the Coopers that Gene had experienced anaphylactic shock, a severe, life-threatening allergic reaction when the flood of chemicals released by the immune system sends a person into shock.
They went to an immunologist in Columbus, who had seen other cases of alpha-gal from Brown County, Margie said.
“He didn’t know a lot about it, but he knew enough to test him,” she said.
Weeks later, Margie heard back from the doctor’s office telling her that Gene could never again eat meat from a mammal, she said.
But it’s more complicated than just checking the kind of patty that goes on a sandwich, Margie said. Products derived from cattle are common in a variety of foods, flavorings and even personal care products such as soaps.
The night she found out about Gene’s allergy, Margie spent three hours in the grocery store just reading labels and trying to find something he could eat, she said.
“I’m 76, and I had to learn to cook all over again,” Margie said.
Gene has even had a skin rash develop from using a sheepskin to clean his car.
But the most frightening threat is the possibility of another tick bite, Margie said.
Though medical organizations such as the CDC and ACAAI do not consider the condition well-enough studied to confirm the cause, the current theory is that the Lone Star Tick’s bite transmits the carbohydrate from the blood of a previous host — such as a deer — directly into the blood of the human host.
The human host’s immune system treats the carbohydrate as an invading organism, developing a false immunity to it. The next time the body encounters the carbohydrate in the blood, such as a few hours after eating a steak, it reacts as if it is a massive infection.
As a result, another tick bite could cause a fatal allergic reaction, Margie said.
Known and unknown
No study has confirmed the origins or transmission of the alpha-gal allergy, but ticks common to Indiana transmit about eight other known diseases, several of which can be life-threatening without immediate treatment.
The important thing is to avoid ticks when possible, such as by clearing yards of leaves and tall grass, Price said.
If you spend time outside when the temperature isn’t falling below freezing, always perform a tick check, preferably with the help of a partner.
Ticks are a potential threat year-round in Brown County, said Brown County Department of Health public health nurse Toni Warburton.
Tucking pants into boots or securing the leg openings with a hair tie, wearing long sleeves, and wearing a hat or covering and wrapping or braiding loose hair are all recommended for warding off ticks.
“We try to preach the message that you should consider every tick to potentially be carrying a disease,” Price said.
Brown County Department of Health public health nurse Toni Warburton cautioned against “folk” remedies that involve waiting for a tick to detach on its own.
The preferred method to remove a tick is to grasp it with tweezers as close to the skin as possible, attempting to remove the tick whole without squeezing the body, which will can inject the content of the tick’s stomach into the host.
If any part of the tick remains embedded and can’t be easily removed with tweezers, it should be left alone, she said. The area of the bite and the person’s hands should be cleaned thoroughly, with alcohol, an iodine scrub or soap and water.
A live tick can be drowned in alcohol or flushed down a toilet, but should never be crushed with bare hands, Warburton cautioned.
Anyone who has found a tick on their body and develops a rash, fever or body aches in the following weeks should seek medical assistance, she said.
Mosquitoes are most active around dusk and dawn, said Bryan Price, senior vector-borne illnesses epidemiologist with the Indiana State Department of Health. If you’re outside during those hours, wear repellent.
To ward off ticks and mosquitoes, repellent containing DEET, picaridin, OLE or PMD, and IR3535 are recommended by the Centers for Disease Control.
Parents should follow all manufacturer instructions when applying repellent to children, including age restrictions, Brown County public health nurse Toni Warburton said. An adult should apply the repellent to their hands, then use their hands to apply it to the child, avoiding the mouth and eyes and applying sparingly around the ears.
Repellents should not be applied under clothing or into open wounds such as scratches or cuts, she said. It should also not be applied to children’s hands, which they may place in their mouths.
More information on repellents can be found at epa.gov/insect-repellents/find-insect-repellent-right-you.
Property owners are advised to eliminate anything that holds water from around their homes — discarded tires, flower pots, even clogged gutters. They can be a breeding ground for mosquitoes, said Brown County Health Department Environmental Health Specialist April Reeves.
Items that sit out in your yard, such as bird baths, should be rinsed out at least once a week.
The Zika virus, which has been linked to birth defects and Guillain-Barré syndrome in Central and South America, has not been found in the continental United States, except in people who had traveled from those areas.
The aedes aegypti mosquito, the primary transmitter of Zika virus, may range into southeastern Indiana, according to the Centers for Disease Control and Prevention. Aedes albopictus, another mosquito capable of transmitting it, ranges over most of the state, including Brown County.
However, the CDC cautions that while the mosquitoes are capable of transmitting the Zika virus, that does not mean they are carrying it.