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Site Safety and Health Plan 1 rerracon ±19.41 Acres Vacant Land ■ Manteca, California June 12, 2017 ■ Terracon Project No. N8177049 Tick borne diseases Lyme Disease, Ehrlichiosis, Tularemia, Southern Tick-Associated Rash Illness (STARI), and Rocky Mountain Spotted Fever (RMSF) are diseases transmitted by ticks and may occur throughout the United States during spring, summer, and fall. Lyme Disease is a potentially serious disease caused by the bacteria Borrelia burgdorferi. Humans can become infected following the bite of an infected deer tick also called the black legged tick(see figure below). Persons bitten by ticks carrying Lyme Disease may have symptoms such as a rash or a peculiar red spot (Bulls Eye) that expands outward in a circular manner (see photo below). Headaches, weakness, fever, a stiff neck, swelling and pain in the joints, and eventually, arthritis may also occur. The primary symptom of RMSF is the sudden appearance of a moderate to high fever. The fever may persist for two to three weeks. A severe headache, deep muscle pain and chills may also occur. A rash will appear on the hands and feet on about the third day and eventually spread to all parts of the body (see photo on the following page). RMSF may cause death if untreated. Ehrlichiosis refers to a disease caused by the bacteria Ehrlichia from the bite of the Lone Star Tick (see figure below). Symptoms of ehrlichiosis will generally include a sudden onset of fever, chills, headache, myalgia, and fatigue within 10 to 15 days following a tick bite. The symptoms of ehrlichiosis are similar to RMSF; however, a rash occurs less often. Other symptoms include nausea, vomiting, abdominal pain, and loss of appetite. Tularemia is a disease caused by the bacteria Francisella tuarensis. In Oklahomathe ticks commonly associated with Tularemia are the Dog Tick and the Lone Star Tick(see figures below). Symptoms of Tularemia are high fever, chills, fatigue, general body aches, headache, and nausea. Tularemia was once known as "Rabbit Fever". Southern Tick-Associated Rash Illness (START) is an illness that is indistinguishable from the early stages of Lyme Disease. These symptoms include the "bull's eye" rash commonly associated with Lyme Disease. The cause of the disease is not fully understood, but it appears to be associated with the bite of the Lone Star Tick. Lyme Disease is associated with the bite of the Deer Tick. Early diagnosis of tick borne diseases is essential to treatment of the disease. The following photographs show common symptoms one may develop. Insect repellent, containing diethyltoluamide (DEET), should be used in tick infested areas, and pants legs should be tucked into boots. Another option is to spray clothing with a repellent containing permethrin. Repellents containing permethrin should not be applied directly to exposed skin. Additionally, workers should search the entire body every three or four hours for attached ticks. Ticks should be removed promptly and carefully without crushing. A gentle and steady pulling action should be used to avoid leaving the head or mouth parts in the skin. Folklore remedies, such as the use of petroleum jelly or hot matches, do little to encourage a tick to detach from skin. In fact, they may make matters worse by irritating the tick and stimulating it 11