Tick bite and Lyme disease: what should be done? - briefly
Remove the attached tick promptly with fine tweezers, disinfect the bite site, and observe for rash or flu‑like symptoms; if the bite occurred in a Lyme‑endemic region or early signs develop, start a short course of doxycycline within 72 hours. Immediate medical evaluation is advised for severe reactions or atypical presentations.
Tick bite and Lyme disease: what should be done? - in detail
A tick attached to the skin can transmit Borrelia burgdorferi, the bacterium that causes Lyme disease. Immediate removal reduces the risk of infection. Use fine‑tipped tweezers, grasp the tick as close to the skin as possible, and pull upward with steady pressure. Do not twist or crush the body, as this may release infectious material. After extraction, clean the bite site with antiseptic and wash hands thoroughly.
Monitoring the bite area for several weeks is essential. Look for the characteristic expanding erythema called a “bull’s‑eye” rash, joint pain, fever, chills, fatigue, or neurological symptoms such as facial palsy. Document the date of the bite, the geographical region, and any observed changes in the lesion.
When certain criteria are met, a single dose of doxycycline (200 mg) within 72 hours of removal is recommended as prophylaxis. Indications include:
- Tick attached for ≥ 36 hours
- Exposure in an area where ≥ 20 % of ticks are infected
- No contraindications to doxycycline (e.g., pregnancy, allergy)
If the rash appears or systemic symptoms develop, initiate a full course of antibiotics. Doxycycline (100 mg twice daily for 10–21 days) is first‑line for adults; amoxicillin or cefuroxime are alternatives for children and pregnant individuals.
Prevention strategies focus on reducing tick encounters and limiting attachment time:
- Wear long sleeves and pants, tucking trousers into socks when walking in wooded or grassy environments.
- Apply EPA‑approved repellents containing DEET, picaridin, or IR3535 to skin and clothing.
- Perform full‑body tick checks within two hours of leaving the area; shower promptly to dislodge unattached ticks.
- Maintain lawns by mowing regularly, removing leaf litter, and creating a barrier of wood chips between forested zones and recreational spaces.
Education of at‑risk populations, including hikers, outdoor workers, and residents of endemic regions, enhances early detection and treatment, thereby lowering the incidence of chronic manifestations.