Off North Road

Tick bite

By Russell Hoxsie - April 20, 2006

We named our new puppy Ticker, that is, I prevailed in the naming over my wife Mary Ann. She said, "We don't want to think of ticks every time we call her in for supper." Well, we don't think of tick-ticks every time but we do think of ticks when we apply her tick killer and repellent once a month. Her name comes from a genetic trait which produces scattered black spots (ticking) on a white back ground in our predominantly black dog. Perhaps I should have been thinking more of ticks than black spots last week when, to my embarrassment, I let my defenses down and a single deer tick attached to that tender place where my right leg joins my torso. I watched while my wife gently lifted up the intruder by the hind end and pulled him out of me. What he left was a cigarette butt's diameter of angry red and swollen sore. I could feel the bump with my fingers. Surrounding skin was pale as milk.

Embarrassment shares some of the endowments of the quality of fear. In my case the embarrassment came from having written recently of sharpening up my vigilance against ticks: tucked in pants' legs, careful bright-light inspection of body when undressing at bedtime and performing this ritual particularly after being out in moist heavy grass which prevails in many areas bordering on Menemsha Pond where we live. Through this winter Ticker and I pretty much stuck to walking on Flander's Lane. For one thing, the Boston Globe was at the North Road turn-around and our activity served a useful purpose other than exercise. For another it was routine and Ticker enjoyed visiting her every favorite roadside burrow or path while I stuck to the dry gravel. Why had we ventured into the marshy surrounds of the pond this particular week? "Forgettery" was my mother's answer to senior slips in judgment. My answer was boredom. Perhaps Mother had it right.

Once having more freedom to romp in exciting and different back yards while summer people were away, Ticker expended all the more energy shaking her butt and wagging her tail at the least provocation. So I thought I was doing her a good turn. Her most dramatic confrontations came with a dozen wild turkeys. Fear came into my equation when I realized too late the consequences of our change in routine would be exposure to an explosion of ticks in marshy grass. Fortunately, quick administration of the appropriate antibiotic within 48 hours prevents the most common disorder of deer tick bites, Lyme disease.(LD) However, I'll need to be uneasily watchful for several weeks before relaxing entirely, even after I swallowed those pills within hours of tick removal.

Fear envelops any sensible person who knows what Martha's Vineyard ticks bring with them. Living up-Island-from South Road along the Cross Road to Menemsha and all the rolling countryside containing woods, fields, marshes, ponds and streams in between and to westerly Aquinnah,-most families have been affected at least once if not many times with tick-born illness. Their illnesses have varied from mild to severe, their disabilities from short-lived to permanent; death has been mercifully rare. When I was young and visited Cape Cod in June and July, we knew about dog ticks. I remember one old codger of a dog. He hung out at the village store in Brewster. Large blood-filled grayish pearls festooned about his neck and one summer we returned to learn that he had died "from the ticks." We knew nothing then about particulars.

Since the late 1960s' knowledge about ticks and, especially their cousin deer tick, has grown successively. On the Vineyard the dog tick also continues in abundance and its ability to spread serious disease. One such disease has changed its MO (method of operation) lately. Tularemia is a bacterial infection related to plague. The disease is present in wild rodents, rabbits and hares. In southwest United States the name derived from tules, implying reference to "out in the tules" or literally out in the weeds. Humans contract the infection from a dog tick bite or after direct contact with infected game like rabbits or the carcasses of dead rodents and small mammals. Usual signs of the disease are skin ulcers with lymph node swelling, sore throat, eye infections and a typhoidal form causing chills, high fever and internal organ failure. Rabbit hunters have been a vulnerable group but, more commonly since the first such known epidemic in 1978 on Martha's Vineyard, landscapers and others have been acquiring tularemia infection in the lungs (pneumonia) in significant numbers. They apparently inhale infected material in the course of cutting brush and grass. Early treatment with tetracyclines or streptomycin is effective and should be started presumptively before confirmation by lab results which often take several weeks until turning positive in reaction to the disease. The frequently recommended commercial breathing masks to eliminate inhaled dust for workers in the field is more often observed in the breach because of discomfort in performing physical work in hot weather with a heavy impediment to breathing from the device.

As far as I know, a rarer syndrome, similar to one named for Guillain-Barré, called tick paralysis has never been seen on Martha's Vineyard. It causes an ascending paralysis which begins in the legs and may move upward to paralyze muscles of respiration and cause death. The onset of illness is similar to tetanus, botulism and some forms of shell fish poisoning. Apparently of toxic origin from tick itself, recovery is rapid and complete after simple removal of all tick parts from the skin. A search for an attached tick should be accomplished quickly any time a patient from a tick-endemic region has unexplained difficulty in breathing or swallowing. In the second part of this article I will share some of my experience with other important tick-born diseases of the Vineyard.

This is Part I of a three-part series. Look for Part II in the May 4 edition of the Times and Part III on May 18.