Tick killing in situ before removal to prevent allergic and anaphylactic reactions in humans: a cross-sectional study

BACKGROUND: Tick anaphylaxis is a potentially fatal outcome of improper tick removal and management. OBJECTIVE: To investigate whether killing ticks in-situ with ether-containing sprays or permethrin cream, before careful removal by the mouthparts could reduce this risk. METHODS: This was a prospective study at Mona Vale Hospital Emergency Department (ED) in Sydney, New South Wales, over a 6-month period during the peak tick season of 2016. Tick removal methods, allergic/anaphylactic reactions were recorded for patients presenting with ticks in situ or having already removed the ticks themselves. Primary endpoint was allergic/anaphylactic reaction after tick killing/removal. RESULTS: One hundred twenty-one patients met study inclusion criteria. Sixty-one patients (28 known tick-hypersensitive) had ticks killed with Wart-Off Freeze or Lyclear Scabies Cream (5% w/w permethrin) before removal with fine-tipped forceps or Tick Twister. Three patients (2 known tick-hypersensitive) had allergic reactions (5%), none anaphylactic. The 2 known hypersensitive patients suffered reactions during the killing process and the third patient had a particularly embedded tick meaning it could not be removed solely by mouthparts. Fifty patients presented to the ED posttick removal by various methods, none using either fine-tipped forceps or Tick Twister, of which 43 (86%) experienced allergic reactions – 2 anaphylactic. Five patients suffered allergic reactions before presentation despite no attempt at kill or removal, but ticks had likely been disturbed by some other method. Five patients had live ticks removed in ED – 3 refused killing and had no reaction despite 1 having known hypersensitivity; 2 had ticks on eyelids contraindicating killing, 1 with known hypersensitivity but both had allergic reactions post removal. CONCLUSION: Results support killing ticks in-situ before careful removal by mouthparts to reduce allergic/anaphylactic reactions although further research is still required.

An Uncommon Presentation of Human Otoacariasis by Haemaphysalis longicornis

Ticks are obligate parasites on animals and sometimes humans. They usually suck the blood of the hosts and can carry various infectious diseases as a vector. Otoacariasis is the presence of ticks and mites within the ear canal and relatively common in domestic and wild animals. However, tick infestations of human ear canals are rarely reported in the scientific literature and hardly occur in developed countries. Herein, we report a rare case of otoaracariasis involving Haemaphysalis longicornis . A 9-year-old girl living in a suburb presented with otalgia of left ear for 1 day. Otoscopic examination revealed a huge insect occluding the tympanic membrane. Tick removal and washing of external auditory canal was done successfully. The causative tick was identified as the H. longicornis. To our knowledge, this is the first reported case of human otoacariasis by a H. longicornis in Korea.

Investigation of tick bites in outpatients with fever from health care facilities in Tengchong County / 中国血吸虫病防治杂志

Objective To study the prevalence of tick bites and relative factors of outpatients with fever from health care fa?cilities in Tengchong County. Methods From July to August,2014,the outpatients with fever in five health care facilities namely Tengchong Center for Disease Control and Prevention,Hehua Health Center,Jietou Health Center,Qushi Health Cen?ter and Xinhua Health Center were investigated by questionnaires. The factors related to tick bites were explored with the univari?ate analysis and multiple regression models. Results Totally 884 effect questionnaires were acquired. Among the 884 partici?pants,85(9.6%)had experienced tick bites. The frequency of tick bites was associated with locations,gender,age group,own?ership of cattle,working at foreign country,firewood cutting and lumbering in the forest(all P<0.05). The multiple regression revealed that the male and people raising cattle,working at foreign country,engaging in firewood cutting and lumbering in the forest had a more risk for tick bites. Conclusions Tick bites are common in the residents of Tengchong County. The risk of be?ing bitten varies in different populations. The local health departments should promote health education in the high?risk popula?tion to reduce the risk of infecting tick?borne diseases.

Tick Bite by Nymphal Amblyomma testudinarium

Ticks are parasites that usually suck the blood of wild or domestic animals; rarely, they ingest human blood and spread various febrile infectious diseases along with skin problems. Out of 40 cases of tick bite reported in Korea, only 3 were caused by nymphal ticks, and tick bites by nymphal Amblyomma testudinarium have not been reported previously. Herein, we report a rare case of tick bite by nymphal A. testudinarium. A 57-year-old woman presented with an asymptomatic solitary erythematous nodule on the left thigh that had been present for 6 days. The tick, which the patient removed from the lesion and brought to the hospital, was identified as a nymphal A. testudinarium. Doxycycline (200 mg) was used as treatment, and after seven days of use, the patient improved and no other lesions were detected.