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During tick season in the United States, which runs from April to September, people spend more time outdoors, and the tiny, hard-to-spot tick nymphs are active, so your chances of encountering one are higher. Finding a tick on your skin is always alarming because it only takes one bite and a small amount of saliva to transmit a disease-causing pathogen (such as Lyme disease) to its host.
If you see a tick on yourself or a loved one, remove it immediately. “The longer a tick is attached, the more opportunity it has to transmit an infectious dose of germs, and it’s important to remove it as soon as possible,” said Thomas Mather, professor of public health entomology and director of public health entomology at the University of Rhode Island.
Here’s everything else experts recommend for dealing with a tick bite quickly and safely, including what to do with the tick after you’ve removed it and when to contact your doctor.
First, take a good look at the tick
Take a closer look: is it definitely a tick? And is it attached? “If it’s moving, it’s trying to find a bite to feed on blood,” said Michelle Shamun-Pour, co-director of the Binghamton University Tick-Borne Disease Center. But the on-the-move tick hasn’t bitten you yet, so there’s no chance of it infecting you, he assured.
The attached tick is another story. If it’s attached, see how attractive or plump it is. A recently fed tick can be the size of a poppy seed (in the tiny nymph stage) or a sesame seed (as an adult), “and then it gets bigger and bigger, and when it’s full of blood it can look like a little raisin,” said Brian Fallon, director of the Lyme and Tick-Borne Diseases Research Center.
While some tick-borne diseases can be transmitted in a short time frame, many, including Lyme, require a tick to feed for at least 12 to 24 hours. “Especially black-legged ticks, they’re carriers of Lyme disease, they don’t attach and feed for more than a day until they can transmit an infectious dose,” Mather said.
Then, “try to think about when and where you were, where you got it,” said microbiologist James Ossey of the Center for Vector Biology at Rutgers University. If you’re sure the tick couldn’t have been attached for more than a few hours — say, because you saw it after a hike and it didn’t look attractive — you don’t need to be as concerned as someone who finds a large, heavily stuffed tick, Fallon said.
Remove it quickly and carefully
If a tick is attached to you, remove it immediately. It’s most effective to do it yourself—waiting to make an appointment with your provider allows the tick to continue feeding, increasing the chance of developing a tick-borne illness. The sooner you get it out, the safer you are, Occi said.
Pointy, fine-tipped tweezers are best for tick removal (you can find some designed specifically for ticks), followed by regular tweezers. You can use your fingers to pinch, but they don’t have a precise grip, so you’re more likely to break the tick’s head when you remove it, Shamun-Por said. “It doesn’t help, because if there are pathogens, they will be in the tick’s salivary glands,” he said. Scratching your skin can also harbor bacteria, increasing the risk of infection.
With tweezers, hold the tick close to your skin, focusing on “putting it under the tick’s belly and lifting it up,” Fallon said. Try not to squeeze the tick’s stomach: “This can, in some cases, act like a syringe, pushing the contents of the stomach into the bloodstream,” he added. If any part of the tick’s mouth remains, gently remove it with tweezers.
After you’ve isolated the tick, clean the area (you can use rubbing alcohol or hydrogen peroxide, Fallon said) and wash your hands with soap and water or hand sanitizer. Now is a good time to thoroughly check the rest of your body for ticks.
Tick removal methods to skip? Some people try applying heat to the attached tick, but “it’s not very successful,” said Peter Krause, a senior research scientist in the Department of Epidemiology and Public Health at the Yale School of Public Health. Nor is covering it in Vaseline to “fix” it, he added.
Take a photo or put it in a sealed bag
Experts suggest photographing the tick or popping it into a sealed plastic bag or container. This allows you to determine its species, which helps the healthcare provider figure out which pathogens you may be at risk of contracting. The best way to capture its identifying features is to place the tick against a light-toned background after you’ve removed it, and take a photo with the tick’s face in the foreground, Mather said.
While Lyme is the most common tick-borne disease in the U.S., black-legged ticks also transmit the bugs that cause anaplasmosis and babesiosis., and Different species can transmit other diseases such as Rocky Mountain spotted fever (spread by American dog ticks and brown dog ticks) and alpha-gal syndrome (red meat allergy caused by Lone Star ticks). Many of these diseases can make you very sick and require immediate treatment.
Mather and his team at the University of Rhode Island run a program called TickSpotters, where anyone can submit a photo and receive a free tick identification and risk assessment, often within 24 hours. You can show your medical provider the tick (or a photo of it) or even show images of the ticks online.
Experts do not recommend sending ticks to testing companies, which are not clinical diagnostic laboratories. These labs cannot tell for sure if you have the infection. “The fact that the tick is positive, it doesn’t necessarily mean that you will catch the disease 100 percent of the time,” Shamun-Poor noted.
To dispose of the tick, the Centers for Disease Control and Prevention recommends placing it in a sealed container or wrapping it in tape before throwing it in the garbage. Or, flush it down the toilet. Do not crush the tick with your finger, as this can spread the germs.
Give your doctor a heads up
It’s a good idea to keep in touch with your provider after the tick has been removed. Guidelines from major expert groups recommend prophylactic antibiotic treatment, usually a single dose of oral doxycycline taken within 72 hours, for adults and children who identify tick bites considered high risk for Lyme disease.
If you live in a Lyme-prone area and suspect you’ve been bitten by a blacklegged tick, “you can ask your doctor if they think it makes sense to get prophylaxis,” Krause said.
If they think you may or may be at risk of developing a different tick-borne disease, they can suggest the best treatment protocol for you.
Always seek medical attention if you notice symptoms. For some tick-borne diseases, including Lyme, you can develop rashes “that expand and get bigger,” said Jacob Lemieux, MD, an infectious-disease physician in the multidisciplinary Lyme Disease Program at Massachusetts General Hospital. Sometimes the rash has that typical bull’s-eye pattern, but not always, and other times it can appear dark red or purplish blue. If you don’t develop a rash (and 30 percent of people don’t), you may experience flu-like symptoms such as fever, headache, muscle aches and joint pains — many of which are common in tick-borne illnesses.
Most people will develop symptoms of a tick-borne illness (such as fever) within a month of being bitten. But symptoms of Lyme disease can develop weeks or even months later, such as uncomfortable swelling in one or more joints (usually the knee), called Lyme arthritis, and appear on average more than six months after the initial infection, Fallon said.
“And if a rash or viral-like symptoms appear in the next few weeks,” she added, “definitely consult your provider, because there may be another attached tick that you missed.”
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