By Dr. Kathryne Buege
As I mentioned in an earlier blog post, I live in Erie, PA. We have had an increased incidence of Lyme disease in recent years, and this past spring we have had twice as many ticks reported to the Erie County Department of Health. Why? Despite a cold spring, the ticks are hungry and looking to feed. Yes - the ticks are on a feeding frenzy. You and your pets are the targets, and I have written this in order to help protect you and provide some insight into the symptoms of Lyme disease.
What should you do?
- First, protect yourself when you go outdoors. Wear long pants and tuck them into your socks. (Not the most fashion forward, but worth the embarrassment compared to contracting Lyme disease!)
- Use bug spray that contains at least 20% deet.
- Do a thorough check for ticks when you return home.
- Take a shower immediately after walking trails or doing yard work. You should also wash and dry your clothes right away, as the the dryer is what kills any ticks.
If you have a tick, how do you remove it?
- Use fine, flat tweezers and grip the tick as close to the skin as possible.
- Pull backwards gently but firmly, using an even, steady pressure. Do not jerk or twist.
- Do not squeeze, crush or puncture the body of the tick, since its bodily fluids may contain infection-causing organisms.
- After removing the tick, wash the skin and hands thoroughly with soap and water.
- If any parts of the tick's mouth remain in the skin, these should be left alone - they will be expelled on their own. Attempts to remove these parts may result in significant skin trauma.
- DO NOT use a smoldering match, nail polish, petroleum jelly (e.g. Vaseline), liquid soap, or any other folk remedies, as they may irritate the tick and cause it to behave like a syringe, injecting bodily fluids deeper into the wound.
What are a tick's characteristics?
It is helpful when a patient can provide information about the size of the tick, whether it was actually attached to the skin, if it was engorged (full of blood) and how long it was attached.
- Deer ticks are brown and approximately the size of a poppy seed or pencil point. They may transmit Lyme disease
- Dog ticks are brown with a white collar and are about the size of a pencil eraser. These ticks DO NOT transmit Lyme disease.
- Lone star ticks aren't exclusive to Texas, as its name might imply. This type of tick is brown to black in color with a white spot on its back. They may be transmitters of STARI (southern tick-associated rash illness), which causes a rash similar to Lyme disease, but has no other similarities.
Only ticks that are attached and have finished feeding or are near the end of their meal can transmit Lyme disease. A tick that is not attached, easy to remove or just walking on the skin, and still flat, tiny, and not full of blood when removed could not have transmitted Lyme disease or any other infection, since it has not yet taken a blood meal.
When treatment is needed:
- If the attached tick is identified as a deer tick
- If the tick is estimated to have been attached for 36+ hours, based on how engorged the tick is and the amount of outdoor exposure
Treatment involves antibiotics, often administered within 72 hours of tick removal.
What are the symptoms of Lyme disease?
- In the days and weeks after a tick bite, you may experience:
- a red rash that may develop and expand, however some infected people may not develop a rash. This rash may be uniform in its coloring and is usually salmon in color, but can be an intense red. The rash tends to expand over the span of a few days or weeks, and can reach over 8 inches in diameter. As the rash expands, the center can become clear with concentric rings appearing around it, giving it a "bulls eye" appearance.
- flu-like symptoms, such as fatigue, chills, fever, stiff neck, body and head aches
- swollen lymph nodes
- additional rashes on the body
- swollen and painful joints
- neurological disorders, such as numbness or leg weakness
- loss of muscle tone in the face
- heart palpitations
- If a small bump or redness at the bite site goes away in 1-2 days, it most likely is not Lyme disease.
- Confirmed cases of Lyme disease are treated within 3-6 weeks with antibiotics, which may be given intravenously in more serious cases.
Don't get "ticked" off if you can't remove a tick or are unsure what to do. When in doubt, seek medical attention immediately at your local MASH Urgent Care or your primary care physician. Enjoy the outdoors this summer!