Prevention is the Key to Avoiding Tick Bites

Alpha gal syndrome is triggered by the bite of lone star ticks. —James Gathany

Tick talk is serious business on Martha’s Vineyard, and there is cause for concern once again, as tick activity is on the rise heading into the warmer summer months.

The Island sees a significantly higher rate of tick-related visits to the Emergency Department compared with the rest of the state. In a recent study, Dukes County/Nantucket had by far the highest rate per 10,000 people of tick-borne disease visits to the Emergency Department, at 135.34. The next highest county was Plymouth County, with a rate of 14.41 per 10,000 residents.

Comparing March 1 to May 10, 2024, to the same time frame last year, the number of tests ordered at Martha’s Vineyard Hospital for tick-borne diseases has increased about 19 percent, and the number of positive cases is about 38 percent higher year-over-year.

Tick-borne diseases are most frequently diagnosed in children and older adults, but it’s important for everyone to protect themselves.

“For outdoor activity, make sure you wear protective clothing to cover as much skin as possible,” said Dr. Karen Casper, Emergency Medical Department director at Martha’s Vineyard Hospital. “Application of EPA-registered insect repellents is helpful and recommended. Wearing permethrin-treated clothing and boots is a good idea.”

Ticks must be attached for multiple hours before the bacteria can be transmitted. Symptoms may begin anywhere from three to 30 days post–tick bite, and may include a red, expanding rash with a bull’s-eye, fatigue, chills, fever, headache, muscle and joint aches, and swollen lymph nodes.

The most common tick-borne diseases in Massachusetts are Lyme disease, babesiosis, and anaplasmosis. Other diseases that are rarer, but still occur, are tularemia, Rocky Mountain spotted fever, Borrelia miyamotoi, and Powassan virus. 

Last year, the hospital reported a growing number of positive cases of alpha-gal syndrome. A person with alpha-gal develops an allergy to meat, and can sometimes have reactions to dairy and hidden meat. The allergic reaction can be anaphylactic shock, requiring individuals to carry an EpiPen.

Growing evidence suggests that alpha-gal syndrome may be triggered by the bite of lone star ticks; however, other tick species have not been ruled out. On Martha’s Vineyard, lone star ticks are active, and abundant, from March through October.

Lyme disease is also very prevalent in Massachusetts and Martha’s Vineyard. Lyme is transmitted by the deer tick, also known as the black-legged tick. American dog ticks transmit tularemia and Rocky Mountain spotted fever.

For more on the types of ticks and tick-borne diseases, visit the CDC website:

Dr. Casper emphasized the importance of daily tick checks. Make sure you check these high-risk areas:

  • 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 have a tick bite, remove the tick as soon as possible. 

Dr. Casper said unless you are experiencing a life-threatening emergency, it is a good idea to reach out to your primary care physician first. “They should be able to advise you when to come to the Emergency Department,” she said.

Although not every tick is carrying a disease, it is important to take steps to avoid all tick bites, including:

  • Use insect repellents that contain an EPA-registered active ingredient like permethrin or DEET,
  • Wear light-colored clothing to spot ticks more easily,
  • Do daily tick checks (see above), and,
  • Promptly and properly removing any attached ticks.

“Please protect yourself from getting a tick bite,” said Dr. Casper. “Prevention is key.”