Doctors’ Notes



Fall is the season of colors and cool brisk walks to enjoy nature’s beauty. It’s also a prime time for an arachnid to find blood hosts.

I’m talking about ticks, and these tiny creatures are present in our backyards and parks here in Western PA, ready to attach to a host to survive. Let’s take a moment and explore some basic facts about these creatures, prevention for all at risk, and removal if they’ve become attached.


There are different species of ticks. Here’s a nice listing and description of the ticks.

Pennsylvania is one of the 12 states where 94% of all Lyme disease cases occur.

Ixodes scapularis is the most recognized tick in the Eastern US because of its risk to transfer the organism to cause Lyme Disease. It’s an 8-black-legged tick which cycles thru 4 stages in its lifetime. The nymphal stage is the most likely to transmit Lyme disease and other infections. This stage is typical for May and early June months. It can take a tick 3 years to complete a life cycle. Most importantly, ticks need blood at each stage of the cycle to survive. They will feed for 3 or more days at a time.

Ticks like to live in wooded areas, brushy fields, tall grass, and leafy litter.

They are most active during warmer months from April through September.

Ticks attach to hosts using a “feeding pipe” inserted thru the skin. They secrete a local anesthetic to numb the area as they cut thru the skin to insert this “pipe” — and possibly transmit a disease. Most often the host does not feel the tick’s attachment.

Time Attached  |  % Risk of Disease Transfer

TIcksRates of transmission of a disease are as follows:

24 hrs                   0%

48 hrs                   12%

72 hrs                   79%

96 hrs                   94%


Keeping ticks from finding a host and attaching themselves is key to limiting exposure to tick-borne diseases like Lyme disease and Rocky Mountain Spotted Fever.

Dogs, cats and other animals close to your home can be carriers of ticks. Dogs are the most common. There is a vaccine for dogs to protect against Lyme disease, but it will NOT prevent dogs from being carriers of ticks.

Humans should wear long pants and closed toe shoes to limit direct contact to ticks.

Use of topical agents (for example Frontline) and external devices (collars) on pets can help repel ticks, but make certain to use the appropriate repellent for the specific animal to limit adverse reactions from the medicines.

Inspect your pets and children within two hours of possible exposure. Common sites of attachment to humans are under arms, in/around ears, belly buttons, in creases like behind knees, groin, waistline, neck lines, and hairy areas. See section on REMOVAL for more details if a tick should become attached.

Use of repellents on humans can be helpful to repel ticks. Essential agents against ticks include DEET (20% at least), Permethrin, and IR3535. Apply any of these agents to the skin, being careful around the face. Permethrin can be applied to existing clothing and can last up to 5 washings. Pretreated clothing with permethrin can last up to 70 washings. Here’s a very good listing of repellents.

High heat can kill ticks by putting objects/clothing in dryer for one hour.


If a tick becomes attached, calmly gather your necessary items to help remedy the problem. You will need a good pair of tweezers with fine tips to grasp the tick as close to the skin as possible. A moderate pull should dislocate the tick intact from the skin. Inspect the site and make certain no remnants of the tick remain. Wash the skin with soap and water and observe. If a bullseye rash develops surrounding the original attachment site, seek help from the office. Here’s an excellent resource on tick removal.

More Resources

For concerns about Lyme disease, including what to look for and how it’s treated, see my Lyme Disease Doctor’s Note. Lyme Disease and other tickborne illnesses are treatable as long as families notify our office if a child has had a tick bite or a current tick attachment.

For even more detail on Ticks & Lyme Disease, listen to our Kids + Podcast episode with nationally renowned tick and infectious disease expert Dr. Andy Nowalk:

So enjoy the Fall colors, but remember to inspect anyone or any animal at risk for exposure to ticks.

Dr. Lucas Godinez, a Kids Plus Provider since 2004, spends a lot of time outdoors, so his expertise on this subject is both personal and professional.