The following article was written by Lisa Menard-Manlove MD, FAAFP, MHM. She is board-certified in Family Medicine.
It’s summer! We are enjoying the great outdoors and so are the ticks!
There is an excellent resource from the University of Rhode Island: www.Tickencounter.org Use this resource first for any questions you may have about preventing tick bites, how to remove a tick, tick identification, and other common concerns.
Deer Ticks (Ixodes scapularis) need to be feeding and engorged to transmit Lyme disease. It takes about 24 hours for a tick to attach and start feeding. It takes 36-48 hours of feeding for a tick to transmit Lyme. The Lyme bacteria (Borrelia burgdorferi) sit dormant in the midgut of the tick and are activated by saliva. The tick must feed long enough to inject these back into a person for the tick to transmit Lyme. There is a 1-3% chance that an individual tick will transmit Lyme disease.
Tips to help prevent Lyme Disease:
- Daily tick checks. A tick that is crawling on the skin or has been attached less than 24 hours cannot transmit Lyme.
- Wear long pants, tuck pants into socks, wear light colors, wear long sleeves. This helps you to find a tick before it bites.
- Use DEET or Picaridin spray - apply to skin as directed
- Consider using Permethrin spray on clothing, this lasts several washes
There is some evidence that a single dose of the antibiotic doxycycline can decrease the risk of Lyme disease, however, there are very specific guidelines for its use. The tick must be swollen and on for at least 36 hours. If the tick is flat, it has not been feeding long enough to transmit Lyme. It must have been less than 72 hours since the tick was removed. Please call regarding possible preventive medication only if the above is true.
A rash called Erythema Migrans is the first sign of Lyme disease. This rash occurs in 80% of people who have Lyme. The Erythema Migrans rash is an expanding area of redness that is more than 3 inches and may have central clearing or “bulls eye”. It may occur up to a month after the tick bite. Please call for a video or in person appointment if you have this rash. Early Lyme is treated with a short course of antibiotics. The rash from a reaction to the tick bite is usually about the size of a dime and sometimes has a central dark spot. This is not an Erythema Migrans.
Testing for Lyme is not necessary after a tick bite with no symptoms. Often testing is not done even with the diagnosis of early Lyme, as testing does not become positive until 2-6 weeks later.
There are several other tick-borne illnesses that can be transmitted by deer ticks, dog ticks, and lone star ticks, all of which are found locally. Several species of ticks are expanding into the region that they are being found in, exacerbated by climate change.
If you have any other symptoms you are concerned about, please call for an appointment.
