It's time for ticks. What can you do to keep yourself safe and when should you be worried.

Dr. Robert Adams, an emergency medicine physician with IU Health Bloomington, knows there are ticks out across south-central Indiana. It's not only people who come into the emergency room but also his children and pets who have found the little arachnids crawling on them.

With a wet spring and warm temperatures, Adams said it's going to be a good year for ticks — something that everyone who lives and travels through Indiana should realize and take precautions to stay safe — safe from the diseases they carry and spread to people.

"People really get freaked out about ticks," Adams said.

Can you get sick from tick bites?

If a person has a tick on them for less than 48 hours, Adams said the risk of having a disease transmitted to them by a tick, even one who has bitten the person, is low. He and other doctors don't usually treat someone who comes to them for a tick bite if they don't have any symptoms, such as a fever, rash and body aches. Most times, doctors will take a blood sample to test for tick-borne diseases if they think there is a possible risk.

Even if someone does have symptoms or tests positive for a tick-borne disease, antibiotics can treat the disease, whether it's Lyme disease, ehrlichiosis or Rocky Mountain spotted fever.

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"Getting the tick off is key," Adams said about what people should do. If the tick has not attached but is just crawling on a person's skin, there's no cause for alarm.

"The tick-borne illnesses are not as prevalent as people think they are," Adams said.

While many people have heard of Lyme disease, Adams said it's not as common in tick-bitten people in the Bloomington area, where Rocky Mountain spotted fever and ehrlichiosis are more common. Lyme disease is found in a higher concentration in the northern part of the state, he said.

On a recent Friday afternoon, Lee Green, senior medical entomologist at the Indiana Department of Health, was out looking for ticks. Using a special cloth that's dragged across a grassy, bushy area where ticks are likely to be waiting for an animal or person to walk by, Green was collecting ticks to see what's out there across the state. The Indiana Department of Health had 315 cases of Lyme disease reported in 2021.

Besides the lone-star, American dog and black-legged ticks, Green said another tick — the Gulf Coast tick — is now found in Indiana.

"It's a tick that really likes grasslands," Green said, adding that the Gulf Coast tick can transmit diseases to people. Oftentimes the ticks collected in the drag clothes are sent to the Centers for Disease Control and Prevention for pathogen testing. All that data is available on the department of health's website. One of the maps gives a tick infection map for black-legged ticks (formerly known as deer ticks) from 2017-2020. During those years, Monroe County had 55 ticks tested with 24 infected with Borrelia burgdorferi, which causes Lyme disease.

"We do have black-legged ticks in every county in the state," he said. "There are parts of southern Indiana with pretty high infection rates."

According to Green, for most ticks, a mild winter doesn't affect the populations in the next year.

"Ticks survive the winter by getting into microclimates and can survive," he explained. "It's more of how fast spring comes on and when it gets warm and they get active."

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Another tick-related health issue affecting Hoosiers

In addition to the fevers, body aches and other health issues that ticks can transmit to people, there's something fairly new: alpha-gal syndrome. It can come on without any warning and causes allergic reactions, sometimes severe, to red meat including beef, pork, rabbit, lamb and venison.

IU Health's Dr. Adams said doctors are "still learning about" alpha-gal, including what actually causes the reaction and which ticks transmit it. The current thinking is that the red meat allergy occurs after the bite of a lone-star tick. Adams said the first cases were discovered in 2018-19 and are not common. There is a blood test to let people know if they have the syndrome.

"It's pretty immediate," Adams said, adding that IU Health physicians have not yet seen many cases. People who do contract the syndrome can have symptoms appear 2-6 hours after eating meat or dairy products or after exposure to products containing dairy.

But if someone has a sudden allergic reaction, from red hives to swelling of the throat, after eating red meat, they should see a doctor to get tested. The CDC webpage about alpha-gal syndrome states that people may not have an allergic reaction after every alfa-gal exposure.

Now is the 'time to be really vigilant'

April is when the black-legged, lone-star and American dog ticks are all becoming active.

Now is the "time to be really vigilant" in taking precautions, with Green noting, "This is the time when the immature or the nymphs are looking for a blood meal and they are tiny."

Tiny as in the size of a poppy seed and more difficult to see. The nymphs are more likely to be overlooked on people's bodies, often finding an arm pit, back of the knee or the groin area. They also travel to areas around the waist, in hair, in ears and even in belly buttons.

Ticks don't just live in rural areas but can be found across Indiana, even in your yard.

"You can encounter ticks in your own backyard," Green said, adding that the Indiana Department of Health's website has suggestions that people can take to reduce the likelihood of having ticks on their property, including keeping grass mowed, removing dead leaves, and stacking wood neatly and in a dry area.

How do you prevent ticks?

Green's advice is to prevent them from getting on you in the first place.

"When I'm in tick areas the best things you can do is treat your clothes and gear with .5% permethrin," he said. The clothes will be good for several washings before the chemical needs to be reapplied.

Permethrin is not something for people to apply to their skin, Green said. Insect repellent is needed. He uses IR3535 and tucks his pants into his socks and his shirt into his pants. Light-colored clothing is better because ticks are easier to see and remove.

Even with all the precautions, Green still does a thorough tick check and puts all his clothes in a dryer on high heat for 30 minutes to ensure any ticks are killed.

Retired Monroe County naturalist Cathy Meyer shared what she's done to keep ticks at bay. While hiking in the Smoky Mountains earlier this month, Meyer said she pulls socks over her pant cuffs and changes clothes and showers after being outdoors. She sprays permethrin on her pants and boots.

If Meyer finds a tick attached, she kills it and tapes it to her wall calendar. "If I had a reaction later I could see the tick that bit me," she said in an email.

The web page with all the tick bite prevention information is at https://bit.ly/3BPqyME.

This article originally appeared on The Herald-Times: Experts share what to do keep yourself safe from ticks in Indiana