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(right). Multiple bites from larval Paralysis ticks. Over 20 larval ticks were removed from this patient.
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• The Paralysis tick is the most commonly encountered tick attaching to humans in Australia, and occurs along the east coast. • Bites from the larvae are especially frequent, particularly during mid- to late summer and early autumn (February to May). • Possible adverse effects from the bite include allergic reactions (even anaphylaxis), paralysis a...
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Citations
... Tick go through four development stages; eggs, larvae, nymphs, and adults (male/female). After hatching from eggs, they evolve into six-legged nymphs and then eight-legged adults (Doggett 2004). In recent years, tick-borne zoonosis has become more common due to climatic change and the transportation or migration of tick-infested animals across the border. ...
... Worldwide, ticks are important vectors in the transmission of a range of pathogenic microorganisms, including protozoa, rickettsiae, bacteria and viruses, to their host animals and to humans [1,2]. In Australia, Ixodes holocyclus, commonly known as the Australian paralysis tick, is the most common species that bite humans and is the main species responsible for inducing tick-related morbidity in humans and pets [3,4]. Not only is the species capable of transmitting rickettsia such as Rickettsia australis Philip (etiological agent of Queensland tick typhus) [3], the bite of the tick can cause potentially life-threatening toxicosis, tick paralysis, and induce a range of allergic reactions, such as α-Gal syndrome (mammalian meat allergy) [5,6]. ...
... In Australia, Ixodes holocyclus, commonly known as the Australian paralysis tick, is the most common species that bite humans and is the main species responsible for inducing tick-related morbidity in humans and pets [3,4]. Not only is the species capable of transmitting rickettsia such as Rickettsia australis Philip (etiological agent of Queensland tick typhus) [3], the bite of the tick can cause potentially life-threatening toxicosis, tick paralysis, and induce a range of allergic reactions, such as α-Gal syndrome (mammalian meat allergy) [5,6]. With the controversy surrounding the existence (but unproven) presence of Lyme disease in Australia [7,8], much of the contemporary research on I. holocyclus has focused on potential pathogens the tick may carry. ...
Ultrasonic pest repellers are often promoted as a means of protecting people and pets from
the bites of hematophagous arthropods, such as ticks. However, to date, there has been no published
research on the effectiveness of these devices against the Australian paralysis tick, Ixodes holocyclus
Neumann. The purpose of this study was to test the effectiveness of nine ultrasonic devices against
female I. holocyclus. Two arenas were constructed, one for the test (with the ultrasonic device) and
one for the control (no device). Each arena had a test and an escape chamber, connected by a corridor.
Twenty ticks were placed in each test chamber. After the ultrasonic device was operated for 1 h, the
number of ticks in both chambers was recorded. Ten replicates were conducted for each device. The
average number of ticks that moved from the test to the escape chamber was greater in all the test
arenas, with three devices being statistically different from the control. However, the highest percent
of ticks that escaped was only 19.5%. This amount is insufficient to offer adequate protection against
tick bites and this study adds further weight to previous investigations that ultrasonic devices should
not be employed in pest management.
... Among these six species, 97% of tick bites in humans are caused by the Australian paralysis tick, Ixodes holocyclus (Taylor et al. 2019;Geary et al. 2020). This tick is considered the most medically significant species in Australia because of its ability to induce paralysis, trigger a variety of allergic reactions, and for the transmission of infectious diseases (Doggett 2004). The species is involved in inducing mammalian meat allergy and the spread of tick-borne diseases such as Australian tick typhus, Rickettsia australis (van Nunen et al. 2007;Graves & Stenos 2017;van Nunen 2018). ...
Permethrin is a pyrethroid insecticide that has been widely used for the impregnation of fabrics to prevent the bites from arthropods such as mosquitoes and ticks. There are two types of permethrin impregnation: Do-It-Yourself (DIY) packs and pre-impregnated fabrics. Both forms have been on sale for many years in Australia, however to date, no data are available regarding their efficacy against Ixodes holocyclus. The aims of this study were to test and compare the contact toxicity of a DIY product versus two pre-impregnated fabrics (shirt and trousers) against I. holocyclus, and to test the efficacy of the fabrics after repeated laundering. All treated and untreated fabrics were tested before laundering (0 washes) and after 10, 30 and 50 washes. Five ticks were placed onto each test fabric for 2 min, with four replicates for a total of 20 ticks per test. Both knockdown and mortality of I. holocyclus ticks were recorded at 60 min and 24 h, respectively. Logistic regression analysis was used to assess the relationship between knockdown and mortality in ticks exposed to each fabric product, before and after laundering. All of the unwashed treated fabrics were effective in causing 100% knockdown. With 10 washes, the percentage of knockdown with the pre-impregnated shirt and trousers was 95% and 90%, respectively. The DIY product was less effective with only 15% knockdown. The levels of knockdown with the pre-impregnated shirt and trousers further decreased with 30 washes to 70% and 20%, respectively, and then further declined to 45% and 20% with 50 washes. For the DIY product, knockdown was only 10% and 5% with 30 and 50 washes, respectively. There was minimal mortality recorded at 24 h even with the unwashed fabrics. This study indicated that the pre-impregnated product was more effective in repelling I. holocyclus ticks than the DIY impregnation pack and the efficacy of this product degrades notably after 10 washes.
... Vector mosquito species occur in almost all locations of Australia, where they can transmit a range of these pathogens. Other vector-borne diseases are those transmitted by ticks and mites, including Queensland tick typhus Rickettsia australis and Flinders Island spotted fever Rickettsia honei (both transmitted by ticks; Doggett 2004), and scrub typhus Orientia tsutsugamushi, transmitted by mites . None of these three diseases are notifiable, which means that statistics on case numbers are not recorded by health departments; thus, the frequency of these conditions is unknown. ...
... Envenomation following injection with a toxin via a bite or sting occurs with numerous groups including spiders, ticks, Hymenoptera and several other arthropods, which are known to occasionally result in anaphylaxis and even death (Brown & Hamilton 1998;Doggett 2004;Mullins et al. 2016;Rappo et al. 2013;van Nunen 2015van Nunen , 2018. Affected patients may require administration of antihistamines and other supportive medical treatment, and those with known anaphylaxis may need to carry an EpiPen® with them at all times. ...
... This age class more than doubled that of the next most frequent, even when adjusted for population age data. This observation is in accord with past reports, e.g. of the 20 documented deaths due to tick paralysis, 70% were in children under 4 years of age (Doggett 2004). In some cases, the tick was attached to children in unusual locations on the body, such as on the conjunctiva of the eye (Teong et al. 2015). ...
Arthropods are the cause of considerable human morbidity. In spite of numerous text books and reviews published on arthropods of medical importance, this is the first paper in the world to present a comprehensive review of specimens sent to a medical entomology laboratory over an extended period. The Department of Medical Entomology at Westmead Hospital is the New South Wales reference laboratory for arthropods of medical importance. In the years 1988–2017, there were 5655 samples submitted for identification. Some 25 orders, 188 families and 177 different genera were recorded, with 170 unique species. The most common specimens included the Australian paralysis tick Ixodes holocyclus (708 specimens submitted), the bird mite Ornithonyssus bursa (506), bed bugs Cimex spp. (149), moth flies Clogmia spp. (135), head lice Pediculus capitis (105), pubic lice Pthirus pubis (91) and scabies Sarcoptes scabiei (57). In 1211 samples submitted, there was no evidence for any life stages of arthropods. For these common samples, data analysed included yearly and seasonal trends, female vs. male patient submissions and the age classes of the patients. Some species such as I. holocyclus, O. bursa, Cimex spp., Clogmia spp. and P. capitis demonstrated strong seasonal trends. In the case of the female vs. male patients, there were significant differences in submissions with O. bursa, P. capitis, P. pubis and with the samples containing no arthropod evidence. Of these, only with P. pubis did more males submit than females. Younger ages classes (<10 years) were more associated with I. holocyclus and P. capitis, older patients >70 years) with scabies, mature females (50–69 years) with samples containing no evidence of arthropods and middle‐aged adults (40–69) with the remainder of the common samples. Key diagnostic features are included for some of the more challenging arthropod species to distinguish and as well as case studies provided of situations involving unique or unusual infestations. The data provides useful information on the risks that arthropods of medical importance pose to the community and will refine educational programs.
... Tick bites and the transmission of tick-borne pathogens continue to be a global public health concern (Jongejan & Uilenberg 2004). The Australian paralysis tick, Ixodes holocyclus, is the species most commonly responsible for causing tick-related human morbidity in Australia (Doggett 2004). ...
... The tick is less active in the hot summer months where it over-summers as the egg stage (Eppleston et al. 2013;Barker & Walker 2014). As the common name suggests, the tick can induce paralysis, and some 20 human deaths occurred before the development of an effective anti-venene (Doggett 2004). The paralysis is induced by a toxin (known as 'holocyclotoxin') that occurs in the tick saliva that is injected during blood feeding. ...
... The paralysis is induced by a toxin (known as 'holocyclotoxin') that occurs in the tick saliva that is injected during blood feeding. As the adult female injects larger volumes of saliva, it is this stage that poses greatest risk of paralysis (Doggett 2004). Every year, more than 1000 companion animals are affected with paralysis caused by I. holocyclus (Hall-Mendelin et al. 2011;Eppleston et al. 2013;Mullins et al. 2016). ...
The Australian paralysis tick, Ixodes holocyclus, is the cause of significant human morbidity. Bites from the tick may result in paralysis, allergic reactions that can include anaphylaxis and death, mammalian meat allergies and the transmission of infectious agents. In recent years, there have been a number of papers published on the microbiome of the species, but to date, there is no published research on I. holocyclus management or personal protection options to prevent the bite from the species. The study herein focused on the latter; the use of repellents for the prevention of bites from I. holocyclus. Five personal repellents were tested along with coconut oil, and a citronella patch and wristband. These were all tested for repellency in a laboratory assay over the time intervals of 15 min, 1, 2, 3 and 4 h post application. The personal repellents included the active ingredients of picaridin (9.3%), DEET (11.5%), lemon eucalyptus (36.0%), a combined formulation of citronella and tea tree oil (28.4%) and an extract of Andrographis paniculata (30% w/v). The coconut oil was 30% v/v. The citronella patch contained 120 mg/patch, whereas the citronella wristband contained 750 mg/band. Two spatial repellents were also tested in the laboratory for repellency and toxicity against I. holocyclus and tested for toxicity in the field. These included OFF!® Clip‐On™ (metofluthrin 312 g/kg) and Thermacell® (allethrin 219.7 g/kg). For the personal repellents at 4 h, there was no statistical difference in repellency between the formulations of picaridin, DEET and lemon eucalyptus, with over 84% repellency recorded for all. Thus, these would be the personal repellents recommended for preventing tick bites. The citronella patch produced 100% repellency over 4 h; however, as this type of product is known to only provide protection close to the patch, it is not recommended for routine use. For the spatial repellents, both produced significant repellency and toxicity in the laboratory, but failed to produce any tick mortality in the field, and their use cannot be recommended. This is the first published study investigating personal and spatial repellents for the prevention of tick bite from I. holocyclus.
... Tick killing in situ to prevent allergic reaction in humans Table 1. Acute and delayed tick bite effects in Australia Acute effects Localised reactions Small local reaction Papules (small bumps) may form at the site of attachment within 1 to 3 days, not thought to be allergic response [11]. Large local reaction Localised erythema and oedema greater than 5-cm diameter, commencing 4 hours postbite and lasting up to 10 days [12]. ...
... Similarly unproven is the often-cited potential for retained or snapped-off mouthparts to increase pathogen transmission. Retained mouthparts generally slough off within a few days as the skin naturally sheds or can lead to harmless granuloma formation [11,12]. Nevertheless, most tick removal studies have focussed on avoiding retained mouthparts as a hypothetical proxy of reduced pathogen transmission [13][14][15][16][17][18]. ...
Background: Tick anaphylaxis is a potentially fatal outcome of improper tick removal and management.
Objective: To investigate whether killing ticks in-situ with ether-containing sprays or permethrin cream, before careful removal by the mouthparts could reduce this risk.
Methods: This was a prospective study at Mona Vale Hospital Emergency Department (ED) in Sydney, New South Wales, over a 6-month period during the peak tick season of 2016. Tick removal methods, allergic/anaphylactic reactions were recorded for patients presenting with ticks in situ or having already removed the ticks themselves. Primary endpoint was allergic/anaphylactic reaction after tick killing/removal.
Results: One hundred twenty-one patients met study inclusion criteria. Sixty-one patients (28 known tick-hypersensitive) had ticks killed with Wart-Off Freeze or Lyclear Scabies Cream (5% w/w permethrin) before removal with fine-tipped forceps or Tick Twister. Three patients (2 known tick-hypersensitive) had allergic reactions (5%), none anaphylactic. The 2 known hypersensitive patients suffered reactions during the killing process and the third patient had a particularly embedded tick meaning it could not be removed solely by mouthparts. Fifty patients presented to the ED post-tick removal by various methods, none using either fine-tipped forceps or Tick Twister, of which 43 (86%) experienced allergic reactions – 2 anaphylactic. Five patients suffered allergic reactions before presentation despite no attempt at kill or removal, but ticks had likely been disturbed by some other method. Five patients had live ticks removed in ED – 3 refused killing and had no reaction despite 1 having known hypersensitivity; 2 had ticks on eyelids contraindicating killing, 1 with known hypersensitivity but both had allergic reactions post removal.
Conclusion: Results support killing ticks in-situ before careful removal by mouthparts to reduce allergic/anaphylactic reactions although further research is still required.
... In 1916, bed bugs were also suggested to be a cause of infantile paralysis in the far north coast of New South Wales, Australia (Anonymous, 1916). However, this incident occurred in an area endemic for the Australian paralysis tick, Ixodes holocyclus, a known cause of human paralysis (Doggett, 2004). Therefore, the authenticity of the arthropod identification must be questioned. ...
There is no question that the most painful aspect of the bed bug resurgence, aside from the itching bites, has been the financial devastation that these pests have brought to homes, businesses, and organizations that have attempted to control infestations while maintaining their reputation. It has been quite evident that since the start of the modern bed bug resurgence, the world’s economy has suffered billions of dollars of pest “damage” from a problem that had almost been in complete remission in the last 40 years of the 20th century. The failure of many businesses and organizations to respond proactively to bed bug infestations has resulted in increased bed bug numbers, loss of reputation, loss of clients, legal action, and an explosion in control costs. This chapter reviews the many ways in which bed bugs have had an economic impact on local, national, and international business organizations, and individuals, over the last two decades.
... In 1916, bed bugs were also suggested to be a cause of infantile paralysis in the far north coast of New South Wales, Australia (Anonymous, 1916). However, this incident occurred in an area endemic for the Australian paralysis tick, Ixodes holocyclus, a known cause of human paralysis (Doggett, 2004). Therefore, the authenticity of the arthropod identification must be questioned. ...
The most direct and obvious injurious effects of bed bugs are dermatological, due to allergic reactions from the bite. However, beyond mental health related issues, bed bugs have been reported as being responsible for a variety of miscellaneous health impacts. These can include factors relating to the presence of the bed bugs themselves, such as allergens triggering asthmatic reactions, severe blood loss from multiple bed bugs feeding, and the disturbance of sleep patterns. Other indirect health impacts may result from poorly implemented control programs. These can be associated with the methodologies employed by people desperate to rid themselves of a bed bug infestation, such as the dangerous mishandling of chemicals and insecticides, or as a result of the actions of inexperienced pest management professionals.
... In 1916, bed bugs were also suggested to be a cause of infantile paralysis in the far north coast of New South Wales, Australia (Anonymous, 1916). However, this incident occurred in an area endemic for the Australian paralysis tick, Ixodes holocyclus, a known cause of human paralysis (Doggett, 2004). Therefore, the authenticity of the arthropod identification must be questioned. ...
... The patient had given written consent for the release of medical information including photographs for the purpose of research and education. australis, the causative agent for Queensland tick typhus, and has been linked to the development of allergies in humans to the consumption of mammalian meats, and meat by-products (6,7). ...
... In the literature, tick-induced paralysis has been largely restricted to the field of veterinary medicine, with an estimated incidence of 10,000 to 100,000 reported animal cases per year, principally dogs (5,8). In humans, I. holocyclus has been linked to 20 human fatalities between 1904 and 1945 in Australia (6,8,9). ...
... Children are particularly susceptible to I. holocyclus tick paralysis, and child deaths, especially from bulbar or respiratory paralysis, are always a threat (10). Around 70% of all human deaths have been in children (6). Thankfully, such cases are now rare in the current age of modern medicine, but it still poses a risk in the travelling pediatric patient, although it is important to note that 30% of past deaths were in adults. ...
Background:
Ticks are blood-sucking arachnids that feed on all classes of vertebrates, including humans. Ixodes holocyclus, also known as the Australian Paralysis Tick, is capable of causing a myriad of clinical issues in humans and companion animals, including the transmission of infectious agents, toxin-mediated paralysis, allergic and inflammatory reactions, and mammalian meat allergies in humans. The Australian Paralysis Tick is endemic to Australia, and only two other exported cases have been reported in the literature.
Case report:
We report the third exported case of tick paralysis caused by I. holocyclus, which was imported on a patient into Singapore. We also discuss the clinical course of the patient, the salient points of management, and the proper removal of this tick species. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: With increasing air travel, emergency physicians need to be aware of and to identify imported cases of tick paralysis to institute proper management and advice to the patient. We also describe the tick identification features and proper method of removal of this tick species.
