Tick Bite Care

What to do if you get a tick bite?  There are some myths, but there’s also good science busting them.

1. Tick attachment time is not always relevant.  Studies suggest any attachment longer than 6 hours can transmit infection with increasing risk beyond this length of time; however, this is still not a guarantee. If a tick has a high enough ‘infectious load’, Lyme organisms are in their saliva, and they can transmit the disease almost immediately.  If the tick is less infected, the Lyme bacteria have to migrate from their stomach to their mouth, and that takes longer.  But do you really want to count on how sick the tick is?  Don’t let anyone tell you that because the tick wasn’t attached for 24-36 hours you’re ok. If you have had Lyme before or suffer from any immune concerns, you should be treated preventatively. If you are in good health, you should test the tick and/or carefully monitor yourself for any signs of developing infection.
2. One double-dose of doxycycline is commonly prescribed but not sufficient to treat Lyme.  The guidelines on the government advisory website, guidelines.gov, advise 21 days of treatment.  No other federally endorsed Lyme guidelines exist. (The CDC is not in charge of treatment guidelines; the Institute of Medicine provides this information). The problem with the study of one single-dose of doxy is that it looked for the bull’s eye rash; it did not look to see if people became sick later.  It reduced the rash incidence by 87%. That’s something, but not enough. It tells us nothing about whether those without a rash eventually developed symptoms of tick-borne illness. There is no reason not to follow the government guidelines and to risk your health or that of your child because somebody only wants to give you one “double dose” of doxy.  There are mice studies of this treatment, and they look abysmal.
3. If you missed the tick bite and have the bull’s eye rash you are lucky inasmuch as you have clear evidence of being infected with Lyme. You HAVE Lyme and you need to seek appropriate treatment as soon as possible. The longer you wait the more difficult it can be to eradicate the Lyme bacteria as it can migrate into more difficult to treat areas like joints and the brain. You can find recommendations for treatment on the guidelines.gov website. Here’s a direct link to the Lyme Guidelines:  .  These are both ILADS (International Lyme and Associated Diseases Society) and government endorsed guidelines; the best we have at this point in time.
4. Tick-testing is controversial. Don’t rely solely on the results of a tick test to decide on whether you should get treated. If the tick was attached more than 6 hours, you develop any ‘flu-like’ symptoms or experience new or unusual symptoms 3-30 days after the bite, you should seek immediate treatment. While PCR testing a tick is reported to be highly sensitive, we actually have no idea how reliable it is to test the tick vs a human being.  If a tick is positive for a co-infection (something other than Lyme/Borrelia), you should also consider getting prophylactic treatment.  That’s your call, made with your doctor, but it’s a real consideration. So if you send the tick for testing, make sure the lab tests for co-infections, as well as several species of Lyme.   We currently recommend using the Tic-Kit by Pharmasan Animal Health because of its affordability and quick turn-around time, but I have also prepared a list of additional labs that do effective tick testing.
5. A prescription for a specific topical antibiotic from the compounding pharmacy, if applied within 72 hours of the bite, has been shown in research studies to effectively eradicate the Lyme bacteria before it can spread into your body. Scheduling a brief appointment with a Lyme-literate doctor at BCNC will allow you to get this prescription and ensure that any follow-up care or testing is addressed. While the studies on use of this topical antibiotic look incredibly promising for Lyme prophylaxis, it is still not a guarantee. Being vigilant, following the steps listed above and speaking with a properly trained physician will ensure you get the appropriate care to reduce your risk of getting Lyme disease.

Have a safe summer!