How to treat Tickbite Fever ! (Credit to an article that appeared in the “GO” (Great Outdoors) magazine No. 121 which appeared in 1995 !)

Tickbite fever is one of those diseases that creep up on you when you're not looking and bites hard, putting you out of action for a week or more. The trouble is, you can be victim of hundreds of tick bites and the only result will be a rash and some itching. But, another day you are taking a walk in a wetland close to the urban sprawl (that is the Gauteng), you get maybe a bite or two, and you come down with tickbite fever. The villain of the piece is a small tick that carries the germ Rickettsia rickettsi var pijperi. This bug is transferred to the host via the bite, or can even be rubbed into the wound when you squash the tick. Once this germ (a primitive parasite) enters the circulation, it incubates for seven to fourteen days and then surfaces as tickbite fever.

The symptoms generally start out with a feeling of lassitude and illness. There are also progressive symptoms such as body pains, a headache, light-sensitive eyes and fever with chills.

These symptoms get worse over a period of several hours and vomiting can occur. The headache has been described by some sufferers as the worst they have ever had. A fine reddish rash that joins in several places can develop within two or three days. Painfully enlarged lymph glands also occur, especially in the area that drains the bite site. This site takes the form of a central black hole in the skin surrounded by an inflamed area. This site, together with the inflammation caused by the bite, usually clinches a doctor's diagnosis. However, they can easily be hidden by a fold of flesh or body hair; so don't get uptight if a diligent doctor performs a thorough body search before he gives his final verdict.

When you go to see your doctor make sure you remember to tell him you were in a tick infested area before you started to feel bad. If you have also been to a malarial area, it would be wise to have tests for this disease as well.

The initial diagnosis of tickbite fever can be confirmed by a specialized blood test.

Once the doctor establishes that you have in fact not tickbite fever, he might initially only prescribe medicine that will work on the symptoms of the disease - the aches and pains, the fever and that agonizing headache.

Specific antibiotic medication designed to treat the disease itself is 'withheld’ for 48 to 72 hours to enable the body's immune system to react and eliminate the parasite itself.

There is a school of thought, however, that feels the immune system has had all the chance it needs to assert itself by the time the patient starts to feel ill, and they therefore prescribe antibiotics immediately. This would normally be tetracycline for an adult. Younger children would be given some other form of antibiotic such as erythromycin, which has no effect on teeth (unlike tetracycline).

These medicines would be taken until the fever has subsided for at least 48 hours - and some doctors wait for five days before withdrawing the drug. Normally patients respond to these specific treatments rather quickly and will be up and about in five to seven days. Long-term complications are usually rare, but for about six weeks the victim will experience fitness problems and become tired easily. This is known as a post viral syndrome. It is not advisable to perform strenuous and taxing exercise during the recovery period.

Although the human immunology system responds to the infection and this response helps eradicate the infection, it would seem that long-term immunity does not occur and that tickbite fever can reoccur if a tick carrying the germ bites one later. Tickbite fever is not the only infection one can pick up from ticks. The insects can pass on diseases such as typhus and trench fever. However, cases of these diseases from this source are fortunately rare.

If these diseases are caught you will probably already be under medical care and the relevant specialists can be called in time to restore your health.

Any fever that is accompanied by bleeding should be taken seriously. If that happens, go to your doctor as soon as possible. If you have been in the bush recently, tell the doctor as this may help with his diagnosis.

One problem that does occur occasionally is when a tourist on a five or six day trip presents the symptoms of the disease halfway through the trip. If this happens, the ill tourist must be taken to the nearest doctor. If he is too weak to walk, help should be brought to the patient as soon as possible.

A Johannesburg doctor, who is also a 4x4 enthusiast, told me that the patient should be dosed with drugs to bring down the temperature and to kill the pain. He said that drugs such as Panado and Aspro would not be at all helpful.

Because of this, tourists should find out if the area they intend visiting is a recognized tickbite fever area. If the route falls within one of the areas, stronger painkiller and tetracycline or erythromycin must be carried in the first aid kit. Should someone fall ill with tickbite fever, treatment should be started immediately.

Should the patient be left while others go for help, he must drink plenty of liquids as the fever will cause sweating and the moisture lost this way will need replacing. Tickbite fever should be treated seriously and can, especially in the very young or the elderly, prove to be fatal if not treated properly and in time.

Prevention: The old truism that Prevention is better than cure applies equally to tickbite fever. There is no doubt that taking a few preventative measures before you embark on your trip is far better than catching the disease.

Do not take drugs such as tetracycline or erythromycin before doing on a hike in the hopes that this will prevent tickbite fever. Medical tests have shown that they will not stop you getting the disease.

Lf the grass is short and the vegetation is sparse, the dancer of ticks hitching a ride on your legs is minimal. However, if the grass is long and there are wetlands close by, you stand a good chance of picking up ticks. And this does not only apply to the bush, there have been a number of cases of people catching the disease from ticks living in open ground in the middle of urban areas.

It is mainly in the summer months that South Africans pick tip these pests that dangle from grass and leaves. The best way - if somewhat uncomfortable in summer - of avoiding ticks is to wear long trousers tucked into socks or boots. Although this is reliable, another method to adopt if you insist on wearing shorts is to stop the ticks getting on board by using an insect repellant on the legs in rings. Spray above the socks, above and below the knees and just below the shorts and groin area. Anti-mosquito sprays and lotions can be applied to the ankles and legs, but ticks show a remarkable resilience to chemical deterrents.

Avoid sitting in long grass, and at the end of the day inspect your body, especially the groin area, for ticks.

Ticks are most numerous and active at the beginning of the spring rains. Where cattle and game are plentiful, so too are ticks. If you find a tick that has burrowed under the skin, remove it carefully with a sharp object such as a knife or a needle. The wound should then be washed with soap and water and then an antiseptic ointment should be applied. A Povidone-type ointment is generally recommended.

If you have a bit of time to spare, you can remove the smaller ticks that have attached themselves to you by suffocating them with a blob of Vaseline or antiseptic ointment.

There is an argument that if one pulls a tick off your body it will leave its head behind, which will cause an infection. The counter-theory is that the bite would probably have become septic anyway.

There are two main types of ticks. There are 'hard' ticks, or tampans, known to entomologists as Ixodidae. These are the more active kind and remain with their heads buried under the skin for far longer periods than the second variety, the 'soft-bodied' ticks known as Argasidae.

To avoid the bumps and sores that normally accompany insect bites, try not to scratch. There are preparations in pharmacies that will help ease the itch.