Tick tock, it’s ‘tick o’clock’
The fall is officially upon us! Don’t let the fear of ticks and Lyme disease stand in the way of enjoying the colorful Pennsylvania outdoors!
Simple steps to
prevent tick bites
First, dress for the occasion!
Ticks are easier to spot if you are wearing light-colors. Choose long-sleeved shirts and long pants. Tuck you pants into your socks or boots and your shirt into your pants to cover any exposed skin. Consider wearing permethrin-treated clothing. You can buy commercially treated clothing or treat your clothes yourself. Just remember that permethrin should never be used on skin but on fabrics only!
For your skin, only use an EPA-registered repellent but remember to apply it only on exposed skin and not under clothes. Always read the safety label and follow the instructions.
While outdoors, avoid ticks’ habitats such as wooded, brushy areas with high grass and leaf litter. Keep to the center of trails.
After you come indoors, do a daily tick check, and take a shower: Showering within two hours of being outside has been shown to reduce your risk of getting Lyme disease.
Do not forget to examine gears such as backpacks as well as pets! Carefully look and feel for bumps and small dark spots. Adult deer ticks (also called blacklegged ticks) are roughly the size of a sesame seeds and nymphs are as small as a poppy seed!
Tumble dry clothes in a dryer on high heat for 10 minutes to kill ticks. If the clothes are damp, additional time may be needed. If the clothes require washing first, hot water is recommended as cold and medium temperature water will not kill ticks.
Why you should never squish a tick
We have all heard of peculiar home remedies and creative ways people use to remove attached ticks. While these can dislodge the tick, they may put you at higher risk of infection!
The bacteria responsible for Lyme disease is called Borrelia Burgdorferi and is carried by ticks in their guts. It usually takes as long as 36 to 48 hours for the bacteria to migrate from the gut into the salivary glands and be transmitted to the host through the bite.
In other words, if a blacklegged tick has been attached for less than 24 hours, your risk of Lyme infection is nil. On the other hand, if you squeeze, crush, twist, or jerk a tick, or upset the tick in any way, let’s say using nail polish remover, heat or whichever folklore remedy you might have heard of, the tick will immediately regurgitate and empty its stomach content through its mouth into the host. So, the best and safest method for tick removal is to use fine tipped tweezers.
Try to grab the tick as close to the skin surface as possible. If you grab too high, you may squish it! Make sure you do not touch or get anywhere near the main body of the tick and pull slowly and steadily straight up. Do not forget to clean the bite area.
Lastly, do not worry if you do not manage to remove the so-called “head.” The part of the tick that is buried under the skin is not the head but the mouth parts. Contrary to the popular belief, leaving the mouth parts in does not increase your risk of infection.
So, what can you do after a tick bite?
Early symptoms of Lyme usually develop a couple of weeks after the tick bite and can often be quite vague such as fatigue, fever, headache, muscle aches, joint pain or swelling. A typical feature of Lyme is a bull’s eye skin lesion called “erythema migrans.”
However, a skin lesion develops in only 60-80 percent of Lyme cases and only 19 percent of these display the typical bull’s eye’s appearance. The recommended blood test for Lyme disease is a two-step process, using one single blood sample.
If the first test comes back negative, you can usually rule out Lyme disease. If the first test comes positive, a second test will be carried to confirm the diagnosis. If the second test is negative, Lyme disease is ruled out.
This test can help make a diagnosis, but the timing is important. If testing too early, the result can be falsely negative and lead to false reassurance. On the other hand, once you have been infected by Lyme, these tests might keep being positive for months and years which make diagnosing a new infection more challenging if you get bitten by a tick again.
Your doctor will consider your story of tick exposure as well as your signs and symptoms to determine if you need a test and if you need a treatment. No treatment is ever warranted following a tick bite.
Always record the date of the bite, the kind of tick, the level of engorgement (taking a photo quickly before removing can be useful) or how long you think the tick might have been attached for. For the next 2 to 4 weeks, watch out for symptoms. If you develop any flu-like symptoms or a skin rash following a tick bite, contact your doctor.
To send or not to send the tick for identification and testing
Sending the tick or photos for identification can be useful since only blacklegged tick carry the bacteria responsible for Lyme disease. However, most people diagnosed with Lyme do not recall a tick bite. Remember that most ticks feed and then detached themselves before the person even notices! So, even if the tick you removed is not a blacklegged tick, that does not mean you have not been unknowingly bitten by another blacklegged tick. And while blacklegged tick are the only tick species that transmits Lyme, all tick species can transmit one or several other tickborne diseases. Knowing the kind of tick does provide useful information, but it is not enough on its own to make a diagnosis.
Similarly, you can send the tick for pathogen testing and determine if the tick was carrying the bacteria for Lyme or another pathogen.
However, if the results come back positive, showing that the tick was indeed infected, it does not mean that you have been infected. Remember that timely and safe tick removal can prevent the transmission of most tickborne diseases and that a blacklegged tick needs to be attached and feed for at least 24 hours to be able to transmit Lyme. For that reason, a positive test from a tick is not enough to make a diagnosis or warrant a treatment either.
Moreover, if you have been infected, you will probably develop symptoms before results of the tick test are available. For these reasons, the Center for Disease Control and Prevention (CDC) simply recommends disposing of the live tick. You can put it in alcohol and place it in a sealed bag or a container or flush it down the toilet.
If you want to learn more about ticks and tickborne diseases, please visit the Penn State Extension website extension.psu.edu and browse our articles, workshops, and webinars on the topic!
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Maria Luisa Tejda De Rivero Sawers MD MScPH is a Food, Families and Health educater with Penn State Extension. She can be reached by by calling 814-871-9131 or emailing email@example.com.