Aaron: Might as well make this parasite month. Evidently I could spend the rest of my life making videos like this, but I'm cutting it off here. One more, and then we're done. Well, unless you guys vote this back on Patreon, but that's on YOU. Ticks are the topic of this week's Healthcare Triage.

Ticks are small arachnids, like spiders. They're closely related to mites and found all over the world. Unlike some of the other parasites we've covered, there are lots and lots and lots of varieties. So many that I can't possibly review them all. Like bedbugs and lice, ticks feed on blood. They need it to live, and they need it to move from one stage of life to the next. They sense their hosts- or dinner- either through their breath, their smell or heat, moisture, or vibrations.

Ticks can't fly or jump but they can quest. They hold on to grass, leaves, or other stuff with their back two pairs of legs and then reach out with the front pair. When something like you walks by, they grab on and go to work. Depending on the tick, they might start to feed fast or they might look for a nice spot with thinner skin. This preparation can last from 10 minutes up to two hours.

Ticks come in two main flavors, though: hard and soft. They all have eight legs, but hatch with six. After their first blood feast, they grow the other two. Which is insane.

Ticks go through four life stages. They start as eggs and then they hatch into larvae. At that point they require their first blood feast to grow into a nymph. Interestingly, ticks seem to like a different host- for instance a mammal, bird, reptile, or amphibian- at each stage of development. Nymphs need another blood feast, and then they get to grow into adults.

Most ticks don't make it all the way to adulthood, because getting a blood feast is hard, and if they fail at any stage, they die. So we've got that going for us at least. Some of the soft ticks need to go through many stages of nymph-hood, and they need a blood feast at every stage, so things are even more difficult for them.

Female ticks need another blood fest in order to lay eggs. Males need one to mate. Female hard ticks can lay about 3,000 eggs. They do so on ground. But I know why you're here. Let's get to the diseases. Now I'm gonna stick to the United States cuz it would take waaaay too long to do any more. There are seven main ticks to worry about in the United States.

First up, the American dog tick, which is found all over, East of the Rocky Mountains and on the Western edges of California. It's responsible for Rocky Mountain Spotted Fever and tularemia. Rocky Mountain Spotted Fever is a bad disease, usually involving fever, headache, vomiting and belly and muscle pain. Not everyone gets the rash which can make it hard to diagnose, and if you don't get treated in the first few days, you can die.

Tularemia is a bacterial illness, and how it shows up depends on how you get it. Ironically, one of the least worst ways to get it is from a tick bite. It's much worse to breathe it into your lungs or get infected blood in your eyes. From a bite, you usually see ulcers and nearby lymph node swelling. With antibiotics, you're usually fine, but without it, it can also be really serious.

The black-legged tick, or deer tick is mostly a concern in the northeastern and upper Midwestern states. It's the one that can give you Lyme disease, as well as anaplasmosis and babesiosis. Lyme disease is the one that freaks people out. Initial symptoms include fever, headache, fatigue, and erythema migrans, which is a bullseye-like rash that expands over time.

Without treatment, the infections start to spread. It can lead to Bell's palsy, where you loose muscle tone on half or the whole face. You can also get meningitis, pain and swelling in the joints, heart palpitations, and dizziness. This can go on for months if you don't get your Lyme disease treated.

Long-term, people who aren't treated properly can develop arthritis and chronic pains, numbness, tingling, as well as short term memory problems. Some will have cognitive difficulties, sleep problems, and fatigue, and at that point problems aren't caused by bacteria. Antibiotics don't help, it's thought to be an auto-immune problem, and it's hard to treat. Neither anaplasmosis or babesiosis is nearly as concerning. The former is almost never fatal, and the latter sometimes doesn't even need treatment.

The brown dog tick is found all over the United States and the world. It's also responsible for Rocky Mountain Spotted Fever. Dogs are the more common host for this tick, though. Thus, the name.

The gulf coast tick is found, obviously enough, along the gulf coast. It's larvae and nymphs like to feed on birds and small rodents, it's the adults who might go after you. They can also cause a form of Rocky Mountain Spotted Fever, but can also cause other rickettsial diseases. Some of these leave eschars, which are pretty nasty spreading growths of dead skin.

The lone star tick can be found in the southeastern and eastern United States. They love them some white-tailed deer. They can cause tularemia- already discussed- as well as ehrlichiosis and STARI. Ehrlichiosis, like so many other tick-relateddiseases, shows up as fever, headache, fatigue, and muscle aches. It's rarely fatal, but early treatment is best. STARI, or Southern tick associated rash illness, shows up as fever, headache, fatigue, and muscle aches-- you're sensing a pattern, right? You also get a red, expanding bullseye lesion. We don't even know if antibiotics really help, but because everyone panics that it could be Lyme disease with those symptoms and the rash, antibiotics get used.

Finally, there's the western black-legged tick. It's found on the Pacific coast. It can cause anaplasmosis, which isn't too much of a cause for concern, and Lyme disease which is. The best thing you can do is prevent a bite. If you're in a wooded or bushy area, or places with high grass, be concerned. Walk on trails. Use DEET on skin and clothing, and Permethrin on clothing to repel the ticks. As soon as you can after getting inside-hopefully less than two hours later- bathe or shower. Find any ticks and wash them off. Check your whole body with a mirror to help. Ticks love getting under your arms, around or in your ears, in your belly button, behind your knees and especially in your hair. Check your pets too, as well as clothes and bags.

If you find a tick: don't panic. You want to get them off, but you don't want to leave the mouth embedded. You do want to get the tick off as quickly as possible. Don't waste time Googling weird and fancy methods. Grab the tick with a fine pair of tweezers as close to the skin as possible and pull straight up; no twisting or jerking, cuz that can lead to the mouth ripping off. Don't squeeze it between your fingers cuz you could make things worse. Clean off the bite area thoroughly with soap and water, an iodine scrub, or rubbing alcohol.

You can kill a tick by drowning it in alcohol. Some people save them in bags, jars, or wrapped in tape cuz they need to identify them later, but again, don't put yourself in danger. Call your doctor to discuss if you need treatment with medications. Bottom line: ticks are more dangerous than the other parasites we've talked about. You may get some serious diseases from them. Prevention is best, but if you find a tick sucking on your blood, get it off, wash the site thoroughly, and call your doctor. Most people will be fine, but better safe than sorry.

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