In the United States, tick bites are common during the spring and summer months. While most tick bites do not result in infection, these arthropods can transmit a variety of diseases, including Rocky Mountain spotted fever, Lyme disease, ehrlichiosis, tularemia, babesiosis, Colorado tick fever, and relapsing fever.
Some ticks carry more than one infectious agent and can transmit several diseases through a single bite. With most tick-borne diseases, the risk of transmission increases dramatically after 24 to 48 hours of tick attachment.
As temperatures warm and people (and their pets) once again venture outdoors, the incidence of tick-borne diseases increases. Unfortunately, even a short foray to mow the lawn—or a quick stroke of a dog’s fur—is enough to pick up a hitchhiking tick.
Tick bites are almost painless; indeed, many go unnoticed. Some ticks (e.g., Ixodes nymphs) are as small as the period at the end of a sentence; they can attach to their hosts for a few days, feed, and then drop away, leaving little evidence of their passing.
Since ticks can bite surreptitiously—and since several hours are usually required for disease transmission—prevention and early detection of tick attachment are necessary to reduce the likelihood of acquiring tick-borne illnesses.
Preventing Tick-Borne Diseases
The best way to prevent tick-borne illness is to prevent tick bites:
- Avoid wooded, brushy, or tall-grass areas where ticks are prevalent.
- Wear long-sleeved shirts, long pants, and long socks when outdoors.
- Tuck pant legs into socks.
- Use repellants that discourage tick attachment: N,N diethyl-m-toluamide (DEET) has proven most effective; it can be applied to clothing or directly to skin. Permethrin-containing repellants should only be applied to clothing. Herbal repellants have not been found to be particularly effective.
- Following all outdoor activities, thoroughly inspect entire skin surface for ticks. Pay particular attention to the scalp, armpits, groin, anal region, and scrotum.
- Inspect all pets that have ventured outdoors.
- Promptly remove any ticks that are attached.
How to Remove a Tick
Many popular methods of tick removal have proved to be unsatisfactory in controlled studies. In fact, some of these methods induce the tick to salivate and regurgitate infectious organisms into the host. (Gammons M, Salam G. Tick removal. Am Fam Phys 2002;66(4):643-45)
What NOT to do:
- Do NOT handle a tick with bare fingers
- Do NOT apply substances such as petroleum jelly (Vaseline), gasoline, lighter fluid, nail polish, lidocaine, etc., to a tick
- Do NOT crush, pinch, puncture, or squeeze the tick’s body
- Do NOT apply heat with a match, lighter, or hot pin or nail
- Do NOT apply a twisting or jerking motion when removing a tick
- Do NOT use sharp tweezers or forceps
The best method for tick removal is manual extraction using a blunt, medium-tipped, angled forceps. Commercially-available devices include Sawyer Tick Pliers (B&A Products), Pro-Tick Remedy (SCS Limited), and Ticked Off (Ticked Off, Inc.).
Grasp the tick as close to the skin as possible, and apply gentle, perpendicular traction (without twisting) until the tick detaches. Ideally, all mouth parts will be extracted simultaneously; if not, it is reasonable to attempt removal of those parts that can be easily extracted. However, leaving mouth parts in the wound will not increase the chances of disease transmission. (The Merck Manual, 18th Edition. 2006:2650-51)
Once a tick is removed, it can be placed in alcohol to kill it and to preserve it for identification, if necessary. Cleanse the skin around the tick bite with antiseptic solution. Watch for signs of infection or rash around the bite and for systemic signs of illness (i.e., flu-like symptoms or generalized rash).
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