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Ticks - Their Removal and Infection

The arrival of warm weather also means the arrival of ticks, which can spread diseases such as Lyme disease. Knowing the basics about ticks, their removal and infection is important.

There are three common species found in the United States that transmit infections, but only one transmits Lyme disease — the deer tick (Ixodes scapularis). About 50 percent of deer ticks in New Hampshire carry Lyme disease. However, Lyme disease is not instantaneously transmitted and takes at least 36 hours of attachment to transmit the disease. Therefore, it is important to check your kids and yourself daily for ticks. Start by just running your fingers through your child's hair and then do a quick head to toe inspection during bath or bed time.
 

How to Remove a Tick

If you find an attached tick it should be removed as soon as possible. A quick and easy way to remove a tick is with a fine pair of tweezers. Grasp the tick as close to the skin as possible without pinching the skin and pull straight out. The tick often will break and if this happens, repeat the process to remove the remaining piece. Do not dig down into the skin. Once you are able to remove as much of the tick as possible, clean the area with soap and water. Over the next few days you may notice a small bump where the tick was removed.

Lyme Disease Symptoms

If you or your child develops a "bull's eye" rash with a ring of redness, you should contact your physician immediately as this may be a sign of Lyme disease. Other symptoms of Lyme disease are sometimes vague and include fever, headache, muscle or joint aches and fatigue. Lyme disease is caused by the bacterium Borrelia burgdorferi. The diagnosis is often made by the physician just by looking at the bite site and asking questions about the tick bite. In some cases, a blood test is required to check for antibodies to Lyme disease. This test is not accurate in the first four weeks of infection, so testing too early may give a false negative result. Once you have had Lyme disease your blood may always have antibodies if you are tested again in the future.

Prevention of Lyme disease after a recognized tick bite

The Infectious Disease Society of America (IDSA) does not generally recommend treatment with antibiotics for prevention of Lyme disease after a recognized tick bite. However, in areas that are prevalent for Lyme disease, a single dose of doxycycline may be offered to adult patients (200 mg) who are not pregnant and to children older than 8 years of age (4 mg/kg up to a maximum dose of 200 mg) when ALL of the following circumstances exist:

  • The person can take doxycycline (eg, the person is not pregnant or breastfeeding or a child <8 years of age)
  • The attached tick can be identified as an adult or nymphal I. scapularis tick.
  • The estimated time of attachment is ≥36 hours based on the degree of engorgement of the tick with blood or likely time of exposure to the tick.
  • The antibiotic can be given within 72 hours of tick removal
  • Lyme disease is common in the county or state where the patient lives or has recently traveled, such as the New England area.

If the person cannot take doxycycline, the IDSA does not recommend preventive treatment with an alternate antibiotic for several reasons: there are no data to support a short course of another antibiotic, a longer course of antibiotics may have side effects, antibiotic treatment is highly effective if Lyme disease were to develop, and the risk of developing a serious complication of Lyme disease after a recognized bite is extremely low.

If you have any questions about ticks, tick bites or Lyme disease, please do not hesitate to contact your Primary Care Physician.

Additional Information
Ticks - CDC Center for Disease Control & Prevention
Lyme and Other Tickborne Diseases - DHHS NH Department of Health and Human Services


Ticks & Lyme Disease - Pediatrician, Elizabeth Melendy, MD