Indianapolis, In. — State health officials are urging Hoosiers to protect themselves from ticks as cases of tick-borne disease continue to rise in the state. More than 100 cases of tick-borne disease have been reported so far in 2018, including one death due to ehrlichiosis in an elderly patient. Deaths from ehrlichiosis are rare in Indiana, with only four deaths reported in the last five years.Ticks are small, insect-like creatures that are found throughout Indiana in grassy and wooded areas. They tend to be most active during the late spring and early summer. Ticks can transmit a variety of diseases, such as Lyme disease, ehrlichiosis and Rocky Mountain spotted fever. In 2017, Indiana reported more than 250 cases of tick-borne illness.“Cases of tick-borne disease tend to peak in July,” said Jennifer Brown, D.V.M., M.P.H., state public health veterinarian at the Indiana State Department of Health (ISDH). “You should take precautions to prevent tick bites whenever you spend time outdoors. Call your healthcare provider right away if you develop a flu-like illness or a rash during the summer months.”Symptoms of tick-borne disease can include a rash near the bite site and flu-like illness, including headache, muscle or joint pain and fever.Hoosiers can reduce their risk of tick bites by:Wearing a long-sleeved shirt and light-colored pants, with the shirt tucked in at the waist and the pants tucked into socks, if they will be in grassy or wooded areas.Treating clothing and outdoor gear with 0.5% permethrin, an insect repellent commonly used for this purpose. Note that permethrin should NOT be used on bare skin.Using EPA-registered insect repellents with active ingredients such as DEET, picaridin, IR3535, oil of lemon eucalyptus (OLE), para-menthane-diol (PMD) or 2-undecanone.Treating pets for ticks.Prompt removal of ticks can help prevent disease transmission. Once indoors, people should thoroughly check for ticks on clothing, gear, pets and skin and then shower to help remove any unattached ticks. Tumbling clothes in the dryer on high heat for 30 minutes will kill any ticks on clothing.To safely remove a tick, use tweezers to grasp the tick close to the skin and then pull outward with steady and even pressure. After the tick is removed, wash the area thoroughly. The tick should be discarded by submerging it in alcohol, placing it in a sealed bag or container, wrapping it tightly in tape or flushing it down the toilet. Ticks should never be crushed with the fingernails.Anyone who becomes ill after spending time outdoors should see a health care provider immediately and inform the provider about any possible tick exposure. Most tick-borne diseases can be successfully treated with antibiotics, and prompt diagnosis can help prevent complications from tick-borne infections.