As we all enjoy going outside in good weather, we need to be aware of these small, round, eight-legged bugs called ticks and the diseases they spread. Ticks are sneaky, hiding in places you cannot find, like tiny ninjas. They bury their head into your skin and can look like a mole.

Ticks lie in wait in tall grass, shrubs, and leaf litter, or rub off from pets onto you. Tuck your pants into your socks or boots and your shirt into your pants, use repellents, and shower within two hours after being where ticks live to find and wash them off you before they bite. A friend can help you search. The ones that get missed are often found in your hair, belly buttons, and back side.

There is a special way to remove ticks once they have latched that helps prevent disease. Step 1) use clean, fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible. Step 2) pull gently but firmly, do not jerk or twist. Step 3) Do not squeeze, crush or puncture the body of the tick as its fluids may contain disease. Step 4) wash the bite with soap and water. Do not damage your skin removing left behind parts. Do not wait for the tick to let go or use heat to force the tick off.

The most well-known tickborne disease may be Lyme disease: spread by the deer tick, which is not found in Arkansas, according to the Arkansas Department of Health. In fact, there was not a single case of Lyme disease found in Arkansas in 2018, according to the CDC. Arkansas, however, does have many other tickborne diseases that are potentially life-threatening, should be recognized, and immediately treated.

The Lone Star tick, which is brown with a white spot, spreads the diseases I have seen the most in the hospital: ehrlichiosis, tularemia, STARI and alpha-gal. Though many of these diseases have a distinctive rash, fever/chills and body aches may be the only symptom you see.

Ehrlichiosis has a rash that is not itchy and spreads along the palms and soles of your feet. If not treated right away, it can lead to more severe illness involving multiple organ failure and respiratory failure.

Tularemia has symptoms that range anywhere from skins ulcers, to unexplained, persistent fever, pneumonia, and pink eye. Its rash occurs at the bite. You also get painful lumps or bumps and is also life- threatening if left untreated.

Alpha-Gal is a disease where seven hours after eating meat, you develop allergy-like symptoms such as swelling and anaphylaxis, preventing breathing. The only treatment is to give up meat, except poultry and fish.

Other ticks of Arkansas carry diseases like Rocky Mountain Spotted Fever (RMSF) and Anaplasmosis. RMSF shows symptoms within days of the bite of fever and headache. The rash appears 2-4 days after fever, as small, flat, pink spots along wrists, forearms and ankles, sometimes the chest, palms and soles of feet. Treat early, before life-threatening multiorgan damage, confusion, necrosis leading to amputation, and respiratory failure set in. Children are especially at risk.

Not all tickborne illnesses develop a rash. Anaplasmosis occurs within days of the bite with fever, chills, body aches, stomach upset, but rash is rare. Please do not overlook these symptoms if you do not have a rash.

If you get a tick bite, watch for symptoms of fever, body aches, rash or stomach upset. Save the tick or take a picture of it, to help identify the disease. Go see your doctor as soon as symptoms begin.

Dr. Sara Whyte is a first-year Internal Medicine Resident at WRHS. She completed her medical training at the Medical College of Georgia at Augusta University.