Posted on Jun 8, 2015 in Blog |

***In Virginia, up to 50% of ticks can carry Lyme disease or other infections.

ADVICE ON TREATING TICK BITES (from Dr. Joseph Burrascano, the longest treating physician for Lyme in the U.S.):

“…The physician cannot rely on a laboratory test or clinical finding at the time of the bite to definitely rule in or rule out Lyme Disease infection, so must use clinical judgment as to whether to use antibiotic prophylaxis. Testing the tick itself for the presence of the spirochete, even with PCR technology, is helpful but not 100% reliable.

An established infection by B. burgdorferi can have serious, long-standing or permanent, and painful medical consequences, and be expensive to treat. Since the likelihood of harm arising from prophylactically applied anti-spirochetal antibiotics is low, and since treatment is inexpensive and painless, it follows that the risk benefit ratio favors tick bite prophylaxis.”

TREATMENT CATEGORIES

TICK BITES – Embedded Deer Tick With No Signs or Symptoms of Lyme. Decide to treat based on the type of tick, whether it came from an endemic area, how it was removed, and length of attachment (anecdotally, as little as four hours of attachment can transmit pathogens). The risk of transmission is greater if the tick is engorged, or of it was removed improperly allowing the tick’s contents to spill into the bite wound. High-risk bites are treated as follows (remember the possibility of co-infection!):

1) Adults: Oral therapy for 28 days.

2) Pregnancy: Amoxicillin 1000 mg q6h for 6 weeks. Test for Babesia, Bartonella and Ehrlichia. Alternative: Cefuroxime axetil 1000 mg q12h for 6 weeks.

3) Young Children: Oral therapy for 28 days.

Reference: ADVANCED TOPICS IN LYME DISEASE DIAGNOSTIC HINTS AND TREATMENT GUIDELINES FOR LYME AND OTHER TICK BORNE ILLNESSES, Sixteenth Edition, Copyright October, 2008, JOSEPH J. BURRASCANO JR., M.D. http://www.ilads.org/lyme/treatment-guideline.php

TO REMOVE ATTACHED TICKS:

  1. Use fine-tipped tweezers or shield your fingers with a tissue, paper towel, or rubber gloves, when removing the tick; otherwise infectious agents may enter through mucous membranes and breaks in the skin. DO NOT use petroleum jelly, a hot match, nail polish, or other products.
  2. Grasp the tick as close to the skin surface as possible and pull upward with steady, even pressure.
  3. DO NOT twist or jerk the tick; this may cause the mouthparts to break off and remain in the skin.
  4. DO NOT squeeze, crush, or puncture the body of the tick because its fluids may contain infectious organisms.
  5. After removing the tick, disinfect the bite site and wash your hands with soap and water.

Reference: http://www.fairfaxcounty.gov/hd/westnile/tickremoval.htm

URGENT CARE AFTER TICK BITES:

If you find an embedded tick or suspect a Lyme rash and/or have flu-like symptoms after tick exposure (especially in summer months), SPEED is critical ***. Remove ticks immediately. Consider one of the following clinics for Lyme-specialized urgent care.

· Dr. Andrew Heyman, MD, All ages. 39070 John Mosby Highway Aldie, VA 20105 Telephone: 703-327-2434 (Will fit in within 1-2 days. $165. Specify recent tick-bite.) Dr. Stone usually sees the urgent care patients.

· Dr. John Hart, MD, All ages. 305 Harrison Street, SE, Suite 200A , Leesburg, VA 20175, 703-724-9694. Will fit patient with tick-bite in on same day on Mon., Wed., Fri. in Leesburg or Tu., Th. in Fredericksburg. ($200 for ½ hour)

· Jemsek Specialty Clinic, 202-955-0003, Tara Fox will see newborn to age 18 with a recent tick attachment quickly. (NO ADULTS seen for early tick-bite/rash). Specify that a tick attachment occurred within weeks and no prior symptoms. (It’s a 1 hour limited consult at $375. Evaluations of children under age 2, with or without tick attachment, or under age 5 with tick attachment within previous YEAR can be done also.)

· Dr. Carolyn Walsh , MD, Adults only. 821 South King Street, Suite D, Leesburg, VA 20175, 703-723-7713 (Fit in quickly unless out-of-town. $350 for new patient with recent tick-bite, rash or early symptoms.)

· Internal Medicine of NOVA. 16 and older. Special instructions, see website at https://secure.intmednova.com/portal/urgent-new-patients/default.aspx New GMU test available ($500).

PREVENTION:

· Avoid direct contact with ticks. Avoid wooded and bushy areas with high grass and leaf litter and walk in the center of trails. Learn how to maintain a tick-free yard.

· Use a repellent containing DEET. Repellents with DEET can be applied to exposed skin to help repel ticks. Follow the label instructions. (**Consumer Reports has also identified Repel with lemon eucalyptus or Sawyer with 20% picaridin as acceptable repellents.)

· Wear long, loose-fitting, light-colored clothing. Wear long-sleeved shirts and long pants. Tuck your pants into your socks and your shirt into your pants so ticks don’t have easy access to your skin. It’s easier to see ticks when they are crawling on light-colored clothes.

· Use permethrin on clothing. Permethrin kills ticks and there are formulations to treat your clothes sold at sporting goods stores. Follow the instructions on the label. (Pre-treated clothing is available and is effective through 70 washes. www.bugbewear.com) **NOTE: Permethrin treated clothing is far more effective than just repellents on skin.

· Check for ticks. While outside, take breaks to check yourself for ticks. Bathe or shower as soon as possible after coming indoors (preferably within two hours) to wash off and more easily find ticks that are crawling on you. Do a thorough check at the end of the day; use a mirror or have someone help you check the hard-to-see places on your body.

· Examine gear and pets. Ticks can ride into the home on clothing and pets, then attach to a person later, so carefully examine animals, coats and backpacks.

· More info: http://www.fairfaxcounty.gov/hd/westnile/wnvpdf/dciguide.pdf

FOR FURTHER INFORMATION:
Kathy Meyer
Governor’s Task Force on Lyme Disease in VA 2010-13
Parents of Children with Lyme Support Network for DC Metro Area