Posted on Jun 13, 2016 in Blog |

You do NOT need to have the classic EM rash to be diagnosed with Lyme. See a doctor ASAP if you find an embedded tick.

You do NOT need to have the classic EM rash to be diagnosed with Lyme. See a doctor ASAP if you find an embedded tick.

This is a good item to file away and hold onto so that when you find a tick embedded, you will know your options:
This article is by Kathy Meyer – I was asked to re-post this by a friend due to the numbers of people getting tick bites. It can also be found easily, thanks to Catherine Fox, at https://lifelovelyme.com/2016/03/28/guest-post-what-to-do-if-you-find-a-tick/ –Kathy Meyer

INFORMATION ON TICK BITES
“…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 [the bacteria that causes Lyme] 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 [taking antibiotics to kill potential infection] is low, and since treatment is inexpensive and painless, it follows that the risk benefit ratio favors tick bite prophylaxis.” -Dr. Joseph Burrascano, the longest-treating physician for Lyme in the U.S.
As the weather warms, there is justifiable panic in the question, “I just found a TICK on me, so what do I DO?!”
What I’ve concluded is that the only important question is, “Was the tick embedded and was it even a little puffy?”
If it is dug in and starting to exchange bodily fluids, just like unprotected sex and STDs, it may have given the patient a disease.
What to do next? I’m not qualified to give medical advice, but I’m grateful for the experienced Lyme specialists who have published their opinions. “I definitely advise treating tick bites. Waiting for symptoms is unwise,” says Dr. Steven Phillips in the Huffington Post this month. He says he starts treatment “within hours of the tick-bite.”

Treatment following a tick bite
As Dr. Burrascano notes above, a doctor can’t rely on testing or symptoms when it comes to a tick bite. There is no reliable test. He recommends the following:
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. Consider Doxycycline first in early Lyme due to concern for Ehrlichia co-infections. Doxycyline 200 mg bid with food
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. Amoxicillin 50 mg/kg/day divided into q8h doses.
See Dr. Burrascano’s complete guidelines for detailed information or see the treatment guidelines published by the International Lyme and Associated Diseases Society (ILADS) at the same link.
[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.]

Removing a tick
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 your bloodstream through mucous membranes and/or breaks in the skin.
DO NOT use petroleum jelly, a hot match, nail polish, or other products to try to get the tick to let go.
Grasp the tick as close to the skin surface as possible and pull upward with steady,even pressure.
DO NOT twist or jerk the tick; this may cause the mouthparts to break off and remain in the skin.
DO NOT squeeze, crush, or puncture the body of the tick because its fluids may contain infectious organisms.

Tick Keys are also effective for removing an embedded tick.

Tick Keys are also effective for removing an embedded tick.

After removing the tick, disinfect the bite site and wash your hands with soap and water
[Reference: Health Department, Fairfax County, Virginia: “Tick Removal”]

Seek medical help
If you find an embedded tick, suspect a Lyme rash (not everyone gets a rash, and it may not appear like a bull’s-eye), and/or have flu-like symptoms after tick exposure (especially in summer months), If you are not under the care of a Lyme-literate doctor (LLMD), go to your local Urgent Care or Emergency Room and request a full course of antibiotics.
Testing for Lyme is typically negative in the first weeks after a tick-bite. If your doctor requires a test for Lyme during the first weeks, the only one shown to be accurate in early weeks was developed by George Mason University. It is not covered by insurance, but a kit can be ordered at http://www.ceresnano.com/#!nanotrap-lyme-test/c64d
(Remember, ticks carry many diseases in addition to Lyme, some only recently identified and some not yet identified, and waiting for test results to start antibiotics can place you at risk.)
For persistent symptoms, most LLMDs have wait times that are too long for urgent care, so get started on antibiotics for tick bites, rash or early symptoms of Lyme immediately and get on a wait-list for an LLMD if needed.

Prevention
The best scenario of all is no tick bites.
Avoid direct contact. Keep out of 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. One resource: http://www.tickencounter.org/prevention/protect_your_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.
Check your wardrobe. 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. TickCheckChart
Use the chemical permethrin on your clothing. It is far more effective than just spraying repellents on your skin. Permethrin kills ticks and there are formulations to treat your clothes sold at sporting goods stores; follow the instructions given, and NEVER put on your skin, only on clothing and gear. Search online for permethrin-treated clothing, which is effective through as many as 70 washes. Here is one good site: http://www.bugbewear.com/
Check often 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. Dry clothes on high for 30 minutes BEFORE washing to kill any ticks you may not see.
Kathy Meyer
Parents of Children with Lyme Support Network
klizm@aol.com