Tick, Tick, Boom!
In Tick, Tick, Boom!, world-renowned researchers and medical professionals explore the mysterious link between tick bites and allergic reactions to mammalian products such as beef and pork. What starts with one doctor’s discovery in a small group of people in Sydney, Australia, evolves to impact everything from vaccine development to cancer treatment, revolutionizing our understanding of allergies.
Tick, Tick, Boom!
Episode 3: Exploring Tick Myths and Realities in Australia
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Join us as we sit down with Stephen Doggett, a leading medical entomologist from Sydney, to explore the fascinating world of ticks. Stephen shares his journey from a nature-loving child to a renowned expert on ticks, discussing their ability to cause severe allergic reactions and paralysis. Learn about the proteins and toxins ticks inject during bites and how environmental changes have influenced tick populations. Discover why tick-borne diseases are rare in Australia and how urban landscaping has increased tick habitats. Stephen provides practical advice on protective measures, from suitable clothing to effective repellents, and emphasizes the importance of the “Freeze, Don’t Squeeze” method for tick removal.
Tune in for expert insights and the importance of raising awareness about tick-induced allergies.
Remeber "Freeze Don't Squeeze".
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Exploring Tick Research and Misconceptions
Speaker 1Ladies and gentlemen, welcome to Tick, tick Boom. I'm your host, zach Strachodil. In today's episode it's all about ticks. We'll discuss tick research, some common misconceptions about them and best practices for tick bite prevention and safe tick removal. We're grateful to have Stephen Doggett, who is a medical entomologist in Sydney, australia, with us today. He has over 35 years experience in the field, has authored almost 650 papers and presented over 450 lectures at various local and international conferences. His research background is diverse, having published articles on mosquito surveillance, mosquito-borne diseases, mosquito management, ticks and tick-borne diseases and bedbugs, and has been cited by more than 1,800 scientific papers. Thank you for joining me today, stephen. I'm sure there are other people out there like myself, wondering what is it that a medical entomologist does?
Speaker 2Most of my work involves mosquito and mosquito-borne diseases, so I'm involved in monitoring mosquito-borne disease across New South Wales. Most days I'll be working on that. Other days I might be writing a paper. Some days I'll be identifying specimens that are sent to us for identification advice on their control. Some days I'm travelling to give talks and I've been fortunate. I've travelled around the world to give lectures and talks, particularly in the field of bedbugs. Some days I'm doing research on insects, be it bedbugs or ticks. Some days I'm supervising students, Some days just planning the year ahead. So it's quite a mix. But it all involves medical entomology, namely arthropods, which includes insects, ticks, things that bite, sting and generally irritate the heck out of you.
Speaker 1Why did you decide to become an entomologist of all things, and what sparked a particular interest in ticks?
Speaker 2Yeah, it's a good question, and I have to go back to when I was a child, actually, and even when I was young I had a fascination for the national history and the natural world. I remember having books on spiders and snakes and I was even interested in dinosaurs before they came trendy. And I remember when I was quite young I don't know how old I was, maybe somewhere around 10, somebody said what do you want to be when you grow up? I said a scientist. And I was the only person in my year 12 who ended up doing what they wanted to do, which is fascinating. I don't like the word destiny, but it was always in my blood and so when I was at university, I must admit I was enrolled in science education with the view to become a teacher, and in hindsight I think it was probably not the right thing for me teaching school kids. I can barely control a dog, let alone a classroom of kids, even though, funny enough, I do a lot of teaching these days. But then I did a subject on entomology and I just loved it and I really loved it, and I think when I was at university in the first year and even halfway through the second year I was just rolling along doing it without really having a passion for it. And then I did entomology and I just loved it and suddenly my marks went from pass to distinction to high distinction and I found my place in life.
Speaker 2And then, after I finished my undergraduate degree, I thought I'd have a bit of a gap year. I went and worked testing insecticides as part of New South Wales University and I received a call and I wasn't getting paid very much, it was like $6 a day or some pathetic amount. But I got a call and Sydney University at the time the School of Public Health Tropical Medicine this was 1985, wanted somebody to work on mosquitoes for a short term. I said, well, okay, yeah, okay, I'll go work on that. And so I worked there for four months and really that was my step into the field of medical entomology. And suddenly, 40 years later, I'm there. And so after that four months I worked with the army, with the military, working on biocontrol agents of mosquitoes, things that can control mosquitoes and natural things. And I was there for four and a half years and the money ran out which I was grateful for, because in hindsight it wasn't the greatest job and we didn't really achieve much.
Speaker 2And a position came up with the former boss from Sydney University and that was to investigate the etiology or the origins of Lyme disease in Australia. And that position was a NHMRC grant, a National Health and Medical Research Council grant. That was for three years and we just had to investigate the origins of Lyme disease in Australia. And because Lyme disease in Australia and because Lyme disease is transmitted by ticks, that was my foothold into ticks and so for three years we investigated Lyme disease where basically I went out collecting ticks, getting bitten by lots and lots of ticks I mean literally hundreds of ticks. And in fact one of my first field trips was down to this remote place called Dignam's Creek down on the far south coast, where there was a patient that was reported to have Lyme disease and I came back with about 300 larval ticks on me after that trip. So we found no evidence for Lyme disease and we published it. And the fact is we don't have Lyme disease in Australia. We know that. There's so much information to say it's not here, although some dubious individuals suggest it's still present, but clearly it's not.
Speaker 2And since then I've been involved in other projects with ticks over the years. A whole range from doing risk assessments. I remember one of the hospitals on Northern Beaches were having terrible problems with ticks a hospital that's no longer there and I did a site investigation, looked at the tick problem there and then put in recommendations how to avoid ticks, both for the patients and the staff, and a lot of it was about clearing areas, putting out warning signs, because the fact is you can't always remove ticks. So we put up warning signs warning people about the presence of ticks and provide a lot of information to staff and patients about ticks and the areas where to avoid.
Speaker 2One big project I was involved with with my partner who's sitting to my left now, marilyn Geary, was in the lead up to the Sydney Olympics If we go back a step to the Melbourne Olympics in 1956, that none of the horse events were actually held in Australia. They were held in Stockholm, and the reason why was that it was concerned about the introduction of tick-borne disease called equine pyroplasmosis, and it's a blood-borne parasite very similar to malaria in many ways but transmitted by ticks. And so when it came round to the Sydney Olympics, everybody wanted all the events to be held in Sydney, and so a risk assessment had to be undertaken of the sites where horses were first brought into Australia the Eastern Creek Quarantine Station and also at the Equestrian Centre in Western Sydney and so, mel and I, we conducted a survey of the area. We found very few ticks in the area and, lo and behold, the horse events were able to go on in Sydney, and I like to think that it was our work that really contributed to Sydney being the greatest Olympics ever. So since then I've been involved in a range of tick projects. I've had students, I've been fortunate, I've had academic links with Casey's Art University in Thailand, and so I've had some really good students come over and do some work, and I've had two students do some work on ticks and really groundbreaking research in many ways.
Speaker 2So in Australia we have a fairly poor tick fauna compared to many parts of the world, and it's probably because the country's been so isolated geographically. We have about 75 and a few more species that get identified in recent years, but around 75, 77 different species of ticks that we know of have been identified, and there's a range of species, and so in terms of those that bite human, I think we're up to 13 species. We just recently had a new record where we identified a species called Exotis or Nithorinki, which normally bites platypus, and it was actually a lady who was a platypus hander and got one of these ticks on her. And so that was the first record in Australia. And, interestingly, a lot of tick species are quite specific to certain animals. So, for example, say Northern Beaches, we have a tick species called Xadies trichosurae which not many people know about, but it's extremely common and it occurs on brushtail possums.
Speaker 2It tends not to bite humans, but then there's a whole range of ticks on snakes and there's species like Amlioma Apinoma, and they're really very different species in many ways. And so I mentioned before how the Australian paralysis tick has a really long mouth part and it has a barb on its mouth part, and so once it's attached to the skin it's protected by the fur. But these reptilian ticks are not protected by fur, and so these snakes and lizards, they're crawling through the vegetation, they're constantly getting brushed by vegetation. That would knock off an exodus holocyclist. If it was attached it would get bumped off or broken off, and so a lot of these ticks actually glue themselves in place. They actually release a glue. So to forcibly remove a tick you basically rip out a chunk of the animal, the poor snake or the lizard, and so I mentioned before the paralysis tick occurs up and down the East Coast of Australia, but in different parts of Australia we get different tick problems.
Speaker 2So if you go west of the Great Dividing Range then we get a species called the kangaroo tick, amblyoma triglutatum, and particularly in Western Australia it's really common. And it's such a different tick because, first of all, it can really survive dry conditions, and Western Australia is dry as a dead dingo's donger, as I say, it's so dry during particularly the summer months. Yet the tick's still active and so it's presumably got various adaptations thicker skin, thicker exoskeleton. And the other key difference is that it's not a passive tick, it's an active hunter, and so if you sit down they'll come to you and we can do things like get blocks of dry ice. So carbon dioxide so carbon dioxide that we breathe out as we normally respire attracts things like mosquitoes, it can attract ticks. So you can get a block of solid dry ice, put it on the ground and the ticks come to it. So very different species and so there are different species in Australia.
Speaker 2So dogs are particularly prone to the brown dog tick, rhebocephalus anginius.
Speaker 2The species name refers to the fact that if you get this tick you get lots of them, and you get so many of them the dog can be sucked dry, so to speak, lose so much blood it can be exsanguinated, and that's where the name comes from.
Speaker 2But now we've seen the emergence of some of these nasty dog pathogens, where dogs are dying from these diseases carried by this species. And there is always this sort of threat of the introduction of exotic ticks. And I remember some years ago my partner and I we had this paper where we reviewed 30 years of specimens to our lab and we had something like five or six exotic species submitted to our laboratory, things like Ixodes brisonus, ixodes persilcatus, ixodes scapularis, involved in the transmission of these nasty diseases like Lyme disease, tick-borne encephalitis. And we do have introduced tick species in Australia and the last thing we want is other species that come into Australia. So we have to say we're pretty fortunate that our tick species they're not tickly nice but they're not as bad as some of the species overseas. But we've still got to be extremely wary of our friendly female, particularly the friendly female Xotis holocyclis, the Australian paralysis tick.
Speaker 1Out of all the different types of tick in Australia, are there any that we should be particularly concerned about?
Speaker 2So the main species of concern in Eastern Australia is the Australian paralysis tick Ixodes or Ixodes holocyclus, and it occurs right up and down the east coast of Australia, so up until about the Great Dividing Range. Now the population is quite disrupted, it's quite disparate and they only tend to occur in more natural areas. So where we are in Macquarie University it's just too built up so we don't get Ixodes holocyclos. And so there's a couple of things Ixodes holocyclos need to survive. One it needs animal hosts. So there's got to be a lot of animal hosts around, and the main animal host are bandicoots, but they'll get on other animals as well. You also need moist environments, and that's why they're along the coast, so west of Great Dividing Range it's just too dry for the species, and so this species occurs right up and down the coast of eastern Australia.
Speaker 1Are paralysis ticks particularly hazardous to humans In?
Speaker 2terms of Australian ticks, the paralysis tick is no doubt the most deadliest. In Australia there's a range of tick species that bite humans, and in other parts of Australia there's other ticks. But the paralysis tick does many things and has many clinical impacts. It's no surprise that the paralysis tick caused paralysis, and from about 1925 to 1945, there were some 20 deaths, and most of the deaths were in children, and often the ticks were in the ear canal which people didn't know. The child went into a comb and then died. What caused the death? And it was only later when the tick was found. But we now have an antivenin and death from tick paralysis occurs because of respiratory failure, so our lungs fail. But these days we just put on a respirator, a ventilator, and so we survive. So we haven't had a death since 1945.
Speaker 2So the biggest risk from ticks is allergic reactions. So when a tick bites it injects all sorts of complex proteins, and so any insect, the first thing it does when it inserts its mouth part is go. It spits into you and the saliva contains all these sort of different chemicals vasodilators, so that the blood doesn't stop flowing. Platelet inhibitors so the platelets don't clot. Factor 10, all sorts of other things, and one is holocyclotoxin. It's a toxin that can cause allergic reaction. One is holocyclotoxin it's a toxin that can cause allergic reaction. We have alpha-gal that can be ejected and that can lead to mammalian meat allergy.
Speaker 2So it's a big problem, and so reactions from tick bite can be quite variable. It can be from very minimal reaction and we often talk about grass itch or scrub itch from the larval stage, and it's common to get lots of larval ticks on you to quite a more nasty reaction. And I've seen I remember there was one guy who worked quite close to me in the same building I work at, and he came with his tick bite and his whole arm was just one big erythematous rash, one big rash. It was horrendous, and he became so hypersensitive that the next tick bite could cause anaphylaxis and potentially death, and we've seen several deaths from allergic reactions. The other thing that the paralysis tick can do is transmit pathogens.
Speaker 2Now we're pretty fortunate in Australia that we don't have many pathogens transmitted by ticks. And overseas ticks can transmit a range of pathogens, from bacteria to viruses to rickettsias. But in Australia the only pathogen we really worry about is Queensland tick typhus, one called Rickettsia australis, and it has caused deaths. And some of these rickettsias are quite nasty that if you're not treated, some of them overseas, like scrub typhus, have very high death rate 30% but fortunately it can be treated very rapidly and treated very effectively with antibiotics.
Speaker 2And so if you get bitten by a tick and then suddenly develop fevers and a spotted rash, then you need to go off to your clinician, your GP, for a dose of doxycycline and a short course of that five to seven days will very rapidly resolve it. But as I said, if you don't get treated then you can die and people have died. So of all the ticks in Australia there's no doubt Xadius holocyclis is the most dangerous. But if we compare it to, say, overseas ticks, where really the big issue is infectious diseases, pathogens, and overseas there's diseases like tick-borne encephalitis, where 30% of people who are unvaccinated will die. We have Lyme disease, we have babesiosis, ehrlichiosis and a whole stack of other pathogens. So we're really fortunate. In Australia we just don't have these diseases.
Speaker 1Is it only paralysis ticks that cause MMA? Can other tics cause it as well? Well, we have to say the tic itself doesn't.
Speaker 2It's the passing on of this carbohydrate onto you and then you develop antibodies and that can lead to a malignant meat allergy. So tics are just a vector for conditions. For the condition, I sort of think they're the innocent go-between, if you like. But it's not nice to get bitten by ticks, I assure you. As to other species, there's a whole stack of other species around the world Amblyoma americana in the US, exodes mycinus in Europe. In Australia there's still some doubts and maybe some of the Amblyomas, but we don't have a lot of good, solid clinical evidence. There's been the isolated, I think, one case in Western Australia and we're not 100% sure what the tick was. But if we're talking about Eastern Australia, there's no question, it's X-80 solar cyclists.
Speaker 1How do changes that we as humans make to our environment impact the overall tick population? Yeah, it's a good question.
Speaker 2There's no doubt humans have destroyed a lot of land, as we know, a lot of natural habitat, and thereby have reduced tick populations dramatically. If we think, say, george Street in Sydney would have had ticks once but there's none now because it's just so built up, it's so dry, there's no animal hosts and so we don't see ticks. But in some areas there's actually been re-greening. So we think of the northern beaches of Sydney, which is extremely green, very moist, and of course the other thing is that people plant things and change the environment and of course there's a tap roughly every 10 metres and people water their lawns and water their yards. That helps to boost the moisture up. They also mulch so that boosts the moisture up and can encourage, almost like an ecosystem for these native animals to feed in. And then if you've got the native animals, you've got moisture, you get ticks.
Speaker 2So some areas of east coast of Australia have probably seen an increase in tick problems. But we saw a dramatic increase in tick problems starting about 20 years ago and many councils started a program of baiting foxes. And we know foxes have decimated wildlife and it's a major, major predator of natural wildlife. And when council started baiting foxes the fox population declined and we saw a dramatic increase in wildlife numbers. And it's incredible to think that you go back 20 years you never saw bush turkeys in Sydney. I mean they're everywhere. Even in Western Sydney, where we live near Parramatta, we now see bush turkeys on a regular basis. We see increased numbers of wallabies and other macropods and other smaller hosts and, as I said that these paralysis ticks.
Speaker 2They need hosts to survive, they need blood, they need blood for development and the adult tick requires blood for protein to produce eggs and without hosts you don't get ticks.
Speaker 2You get a lot more hosts, then you get a lot more ticks. But climate has a dramatic influence on tick populations and so in the last three years, excluding this summer, we've had La Nina years, and La Nina years are associated with very wet conditions across eastern Australia and when we have these wet years it favours tick survival. They can live much longer and if they live longer they're more likely to find a host, more likely to feed, develop to the next stage, develop to the adults, lay eggs and so on. So it's a complex interaction. Will climate change? What will that do in terms of tick population? It's a bit of an unknown. It's currently forecast that Southeastern Australia is going to get drier, and if it gets drier then we may see a reduction in tick population. So it's a really complex matter and populations vary from year to year. But no doubt the human factor of watering yards, planting, mulching has a huge impact on tick population in that it encourages ticks.
Speaker 1What are some of the most common myths that you've heard about? Ticks in your career.
Speaker 2I mean there's lots of common myths about ticks. I remember on the northern beaches there was this elderly man who used to collect ticks, actually as part of some of his Lyme disease work, and I remember him saying to me oh you see, the larval ticks fall out the trees. And I was looking at him and he had the huge cataracts and I don't believe he could have seen anything fall out the trees, let alone larval ticks. And I've collected larval ticks so many times, and every time I collect them I sort of think geez, they're small and they're so tiny. And the thing about Ixodes holocyclos is it's really susceptible to desiccation, so they don't climb very far in the environment, and so studies on similar species have shown that they rarely rise more than a metre and they're very passive in their search for hosts. They hunt by stealth, so to speak. So they tend to stay in the one spot and they'll just move on up and down in the vegetation. So when they're searching for a host they'll move up in the vegetation, they'll put their front legs out, wave it about in a behavior called questing, and their front leg has this structure called Haller's organ which can detect moisture and heat and carbon dioxide. And when something big and hairy comes along, they'll just latch onto it and grab it, whether that's an animal or whether that's a human. So ticks do not climb into vegetation, they don't fall out of the trees. So that's a huge myth.
Speaker 2Another myth is about how to remove ticks and about the mouthparts. Some people say ticks burrow. They don't burrow at all. They have a mouthpart which is quite a fascinating structure in that it's a long sort of straw-like structure with a saw. And so they have a saw blade which they cut into the flesh and they draw the mouth parts in. And the mouth part is quite long on a paralysis tick For an adult tick it's about a millimeter and the mouth part has these backward pointing barbs, and so it captures the tick and holds it in place.
Speaker 2And some people say when you remove a tick you've got to remove the head, and if you forcibly remove a tick, their mouth parts always break off. But is that a problem? Well, no, it's not so, because the problem with ticks is not the mouth parts, it's the saliva and the salivary glands in the body. And so if the mouth part breaks off, well, you can wipe it over a bit of antibiotic if you're worried about a secondary infection. But as the skin naturally sheds and naturally sloughs, the mouth part will just naturally go, so you don't have to dig it out.
Speaker 2And we have seen general practitioners, particularly those from overseas who are not familiar with it, use things like punch biopsies, which is like a cylinder which is sharpened which they go whack into the skin and take a hunk of flesh out. And I've seen GPs even surgically remove them. I mean that's just butchery, it's just not needed. And there's so much misinformation about how to remove ticks, from using kerosene, vaseline et cetera. And we know that if you disturb a tick, the first thing it does is actually it starts spitting to you and it spits into you more rapidly.
Speaker 2And so if you've got a child with, say, paralysis, who's just completely out of it and it's just not conscious, you forcibly remove a tick. At that stage you could kill the child. And it's the same with pets, and so that's why we need to kill the tick in situ. And so there's something about ticks that everybody seems to think they know what's correct. I hate to say the old folks' tale, but it's everybody's tale. It's not old folks' tale. And in Australia there's been really so little science done on the paralysis tick and much of the science dates back years and it's only in the last few years we've done anything in terms of tick control and tick avoidance. And it seems extraordinary how we know that ticks are a problem, how government spent zero dollars on this problem.
Speaker 1It's terrible. So, stephen, how preventable are tick bites?
Speaker 2Well, if you want to prevent ticks, it can be 100% preventable. We're standing in a room or sitting in a room at Quarry University. Are we going to get ticks? No, and so it's 100% preventable. And so if you don't go into tick-prone areas, you won't get ticks. But of course we do go into tick-prone areas and this can be a real problem and I've had people ring me up and say to me parents ring me up and say to me my child gets anaphylaxis when it gets bitten by a tick and we've got ticks in the backyard. What should I do? And my first reply is well, move, if you really want to protect your child, and I know people who've actually moved because of ticks. Now, if you're in a backyard situation, there are things you can do. You can spray your backyard with insecticides and that can very effectively reduce ticks. And so if you want to reduce ticks, basically if you're in a tick-prone area, you can either move or spray or cement the whole backyard. So what you want to do is make the backyard dry as possible. Not that terribly eco-friendly is it? In parts of the world fire is used Not so good for Australia, as we know so we can use insecticides and that can dramatically reduce ticks, but then it kills every other insect, and if we get runoff from rain it can kill fish, and so we need to use that with some caution.
Speaker 2If you're going out to a tick-prone area, certain times of year you're more likely to get ticks than others. So during the really hot summer months ticks aren't very active because it's just too hot, too dry, and so throughout the year the risk varies. So in case of ticks we talk about the different stages. So we've got the egg stage, the larval stage, which is up to about a millimeter, the nymphal stage was about two millimeter, and then the adult stage, and the adult stage poses the greatest risk. Larval stages are most active during this time of the year, during the autumn months, and nymphs during the winter months, and the adult tick during the spring months, but we can see a bit of overlap through the whole season. But those periods are really distinctive for the different stages, and so the greatest risk is during the spring months, when the adults are present, because it pumps more saliva, it pumps more alpha-gal, it's more likely to pick up some pathogen, and so if you go into a tick-prone area even at that time of year, there can be a risk at different times. So if it's been very dry for a period, the risk of getting bitten by a tick is relatively low. But suddenly, if you get a bit of rain and then next day the rain stops, the habitat's still wet, it's a bit of a cloud cover, there's a lot of humidity. That's the great time ticks say thank you, thank you, rain gods, because that's a time when ticks are most active and that's when you're more likely to get bitten by ticks, and vets know this. Vets suddenly, about five days later, get inundated with pets with paralysis, and so they have to then make sure they're stocked up with antivenin.
Speaker 2So what do you do if you go into a tick-prone area? Well, think about the risk. Obviously, people in certain jobs, particularly bush carers, bush regenerators, will be exposed to ticks on a constant basis, and so we can take personal protection measures. So first thing is that we try to cover up as much of our skin as possible. So we wear long-sleeve shirts, we wear long pants instead of shorts, we tuck our pants into our socks and we get out of the tick prone area, we take our clothes off and we bag it up, and then if we put those clothing into the dryer for 20 minutes on a hot cycle that will kill any tick present. We also may want to get somebody who's a good friend if they're not a good friend, they soon will be to check those places on the body that are a bit hard to check for tics, if you get my drift, and so you can have a tic on you for some time. Particularly children and children are particularly vulnerable to tics. It's a case that they're just less likely to be aware of a tic on their body than an adult. I know if I get bitten by a tic then I start feeling it within seconds, so I'm not so susceptible to these conditions because the tick will be treated pretty rapidly.
Speaker 2The other things that you can do is, if you go into these tick-prone areas is to use repellents, and there's various repellents on the market, and one of my Thai students did a range of testing where he tested the classical diethyl toluamide, which is marketed as DEET picaridin, a relatively new chemical, and an even more new chemical, oil of lemon eucalyptus and if you follow the label directions, then you get about four hours of really good protection, and so you apply the chemical to all exposed areas of the skin. The other thing that you can do and again I had a Thai student work in this area and these Thai students their work has led into basically develop the national guidelines for tick avoidance is that you can use permethrin treated clothing, and there's two forms. You can either buy permethrin packs where you go to your outdoor stores, your anacondas, your BCFs, your Katmandu, et cetera, and you can buy these permethrin impregnation kits and the kit comes in with this little container of a chemical called permethrin, comes with a glove and then a pipette. And so you take so much of the permethrin, make sure you're following the instructions, put it into a bucket with four or five liters of water and put your clothes in there and let it soak, and then you let the clothes dry. And put your clothes in there and let it soak, and then you let the clothes dry and that's really good for protecting against the paralysis ticks, and then you can wash the clothing and it's up to remember rightly, about 10 washes and it's still quite effective. After that you have to retreat. The other option is you can buy clothing that is pre-impregnated. It's impregnated at the factory and this is much more effective at preventing tick bite and you can wash the clothes up to about 30 times before it starts losing its effectiveness.
Speaker 2And all around the world, military, no matter where you are, they'll use permethrin impregnated clothing and DEET-based creams to avoid both tick-borne diseases and mosquito-borne diseases, and if you use both, you're almost 100% chance of being protected against ticks, unless you're somebody like a bush generator, where you're crawling on your hands and knees amongst the bush and you could get the ticks on you, but you could get a hat which you then treat with the permethrin and that'll also provide some protection. But it's always important that if you develop any clinical symptoms or any signs of something, then go to your GP and if you're known to have an allergic reaction, then if that tick has to be treated and has to be killed in place, as we recommended, then you need to go to a safe setting, whether it's your GP or the emergency department, before the tick's treated. Last thing you want to do is have an anaphylactic reaction at home. Having an anaphylactic reaction in the emergency department is a much better location.
Speaker 1Are these products safe to use every day?
Safety Measures and Tick Bite Prevention
Speaker 2Well, I'm not a toxicologist and I can rely on both published information and the Australian regulator, the Australian Pesticides and Veterinary Medicines Authority. So a federal department of health organisation who's responsible for the registration of all chemicals and all insecticides and all repellents. So they determine that if the product is used according to product labels it's safe to humans and if it is, then they register it. In the case of, say, deet, it has been used literally billions, probably trillions of times. It was first introduced by the US military in the 50s. Adverse reactions are about one in 20 million, almost the size of the Australian population. They're so rare that it's almost negligible. And it's like anything. You have to conduct a brief risk assessment. What is worse? So if I'm coming to Macquarie University to do a podcast, will I put a repellent on to avoid tick bite? Well, there's zero chance of me picking up ticks, so I don't use repellents. But if I go to the Northern beaches and I go through a tick-prone area, there's a really good chance I could get bitten by a tick. So it's a good idea to put repellent on. And what is worse, what's the greatest risk? An adverse risk from a repellent 120 million, and that's just an adverse risk or a tick bite, where I could develop a centralization that leads to anaphylaxis and death. And I assure you the use of a repellent is a far safer option than a tick bite, without a question. It's interesting A lot of people say to me when I talk about ticks, I'm really concerned about DEET and using DEET.
Speaker 2I said, well, did you drive here? Yeah, how far did you drive? Oh, I don't know, 20 kilometers. And I say then do you realize that the risk of death from driving that distance outweighs the risk of an adverse reaction from DEET hundreds, thousands of times fold? And again, we have to think about what we do on a normal basis, that so much of our daily activities poses a greater risk of adverse reactions and even death than using repellents.
Speaker 2And not using repellents poses a greater risk and there are even death than using repellents and not using repellents poses a greater risk. And there are other repellents on the market, some of these essential oils, tea tree oil and some of these other products which have been shown to cause adverse reactions, skin reactions, and also they're just not very good at protecting against ticks and they can give us a false sense of security. So I'm a scientist, I believe in science and I follow science, and we've done the science in my laboratory to show that DEET, becarinine all of them in eucalyptus if it's applied according to label directions, you've got really good four hours of solid protection against ticks, and so I would always use repellents.
Speaker 1How effective is lemon and eucalyptus for preventing tick bites?
Speaker 2Well, lemon eucalyptus oil and lemon eucalyptus have been around for a while. It's a bit different to many of the essential oils. It's actually one of the chemicals that's actually been shown very safe to use. Poses low risk of toxicity In fact, the World Health Organization recommends it. Poses low risk of toxicity In fact, the World Health Organization recommends it. So our studies found it's very good. It's registered, appears to be a good product, so it's another option. But at the moment I think there's only the three choices that I would go for D picaridin all of them and eucalyptus. I'm not a toxicologist to say which is the most toxic of all of them, but all of them in eucalyptus.
Speaker 2It's a relatively new product. Hasn't been around for long, so we don't have a good record of adverse reaction. In the case of DEET, it goes back for a long time. I mean best part of 70 years. Most adverse reactions that have been reported has been due to gross misuse People applying every few minutes, people drinking it. You're not supposed to do that. Folk don't drink it.
Speaker 2In the case of all these chemicals, before you apply it, read the instructions, read how to apply it and, most importantly, read what it says, not what to do, and it's important to know how you should not use it.
Speaker 2And you also want to look at reapplication times. So some may say four hours, some may say two hours, and in the case of diethyltiamide or D, it comes in various formulations. You can buy from 5% formulations up to almost 99% formulations not in Australia but overseas. The key thing is that the higher percentages provide longer duration of protection, the shorter ones less duration of protection, and so it's always important to read the label for reapplication times, particularly if you're doing something like bush gen and you might be out for a day eight hours or so that you will need to reapply the chemical several times. And it's interesting, going back to some of the essential oils, like citronella, and citronella was found in one study against mosquitoes to provide 12 minutes protection. I mean, how many times are you going to reapply that during an eight-hour day? A lot, and you don't want to expose yourself to that sort of level of product and that level of chemical.
Speaker 1Before we were talking about the consequences of tick bites and incorrect removal of ticks. How would you recommend removing ticks safely?
Speaker 2So it's a really good question and the correct removal of tick is so important. And if you don't remove a tick correctly, it can lead to really severe clinical consequences. And I mentioned before that if you've got a child in late-stage paralysis, if you forcibly remove the tick, it can cause a tick to spit and increase the risk of even death. And we know that if a tick's attached and you disturb it, you're more likely to develop some sort of adverse reaction. And some of my great colleagues on Tiara have done a lot of research in this area, and there was a paper conducted at Mona Vale Hospital where they showed that if you kill the tick in situ, then you're less likely to develop an adverse reaction, whereas you forcibly remove it and you suffer an allergic reaction, you're more likely to develop an anaphylactic reaction which could mean that you could die. And so the recommendations are two is you kill the tick in place? You either use an ether-based spray so these are sprays that you use for treating warts and skin tags and now there are specific products for ticks and you can go to your pharmacy and buy them over the counter. You don't need a script, so you basically get these products. Hold it above the tick tick. Give it four or five sprays and kill the tick in place, and there's full instructions on how to do this on the tiara website, tiaraorgau.
Speaker 2The other ways you can use permethrin cream and again, these permethrin creams can be bought over the counter at the pharmacist. They use for treating scabies normally, and so you get these creams. You just dab the tick gently, just put the cream directly onto the tick over the counter at the pharmacist. They're used for treating scabies normally, and so you get these creams. You just dab the tick gently, just put the cream directly onto the tick, leave it for a few hours. That will kill the tick in place and you can either then, after the tick's dead will, either drop off over time or then carefully remove it.
Speaker 2But as I said before, that if you are somebody who's known to have an allergy from tics, is that you make sure you do it in a safe setting, whether you do that with a friend or you go to a doctor's waiting room and then you do it. You don't have to book an appointment. It's just in case you have an allergic reaction. Or you go to an emergency department and just sit in the waiting room just in case you have a problem. But it's always good to have somebody with you if you're known to have a problem, that they can help you and get you through it.
Speaker 1On behalf of Tiara, we would like to thank Stephen Doggett for today's enlightening discussion. Listeners, remember that it is best to try and avoid tick bites. When going outside in areas likely to have ticks, spray yourself with an aerosol repellent containing DEET, dress correctly and have a tick freezing spray in your first aid kit. If you're bitten by a tick, remember freeze, don't squeeze. We would love to hear from our listeners and you can reach out to us at tiaraorgau. We'll also find links to research papers and more information about tick-induced allergies, research and awareness. If you enjoyed listening, don't forget to rate, share and review to help spread awareness. I'm Zach Strachodil and thanks for listening to Tick, tick Boom.