Where should a tick be referred? - briefly
A tick should be submitted to a certified medical laboratory for species identification and pathogen testing. It may also be turned in to a public health agency or university entomology department for analysis.
Where should a tick be referred? - in detail
Ticks that have attached to a person must be directed to appropriate medical evaluation rather than left unattended. The first step is immediate removal with fine‑point tweezers, grasping the mouthparts as close to the skin as possible and pulling steadily upward. After removal, the site should be cleaned with antiseptic and the tick placed in a sealed container for identification, if needed. Documentation of the encounter—date, time, location of bite, tick species (if known), and duration of attachment—facilitates risk assessment.
Referral criteria include:
- Presence of erythema migrans or other rash suggestive of Lyme disease.
- Fever, headache, fatigue, joint pain, or neurological symptoms developing within weeks of the bite.
- Bite by a tick known to transmit Rocky Mountain spotted fever, anaplasmosis, babesiosis, or other region‑specific pathogens.
- Uncertainty about tick identification or removal technique.
- Immunocompromised status or pregnancy, which increase complication risk.
When any of these conditions are met, the patient should be sent to a primary‑care physician for initial evaluation and possible initiation of empiric antibiotic therapy. If the primary clinician suspects a specific tick‑borne illness, referral to an infectious‑disease specialist or a regional public health laboratory for serologic testing is warranted. In areas where mandatory reporting exists, the case must also be communicated to the local health department to trigger surveillance and vector‑control measures.
Follow‑up care involves monitoring for delayed symptoms, repeat serology if indicated, and patient education on prevention—use of repellents, wearing protective clothing, and regular tick checks after outdoor activities. By adhering to this protocol, the risk of severe disease transmission is minimized and appropriate treatment can be administered promptly.