By Doug MacQueen, MD
The most common infection carried by the deer tick in this region is Lyme disease. Winter weather is usually cold and snowy enough for a long enough period of time to keep deer ticks inactive. However this particular winter has been mild so we can expect to see cases of Lyme disease earlier in the spring and throughout the summer and fall months. Ticks are active any time the temperature is above 40 degrees and there is not dense snow cover.
What steps can I take to avoid tick bites?
After you have been hiking in brushy areas or in the woods on a mild winter day with no snow (and into the warmer months), check yourself and family for ticks. Look in all the nooks and crannies, including your armpits and in your hair. Adult deer ticks are hard to find; nymphal deer ticks are even smaller and look like freckles with legs.
What do I do if I find a tick on my body?
Use tweezers to grasp the tick at its head where it is embedded in the skin, pull with gentle, steady pressure then flush it down the toilet. Clean that spot with soap and water. If the tick is not full of blood when you remove it, this means it has not had enough time to transmit Lyme disease to you: in order to pass on Lyme disease, the tick must be attached to you for about 48 hours. Only about 30 percent of deer ticks in this region carry the Lyme bacteria, so most tick bites here will not give you Lyme if you are bitten.
What should I do after getting a tick bite?
Monitor the area of the bite. If you have redness and itching soon after you remove the tick, it is an allergic reaction to the tick saliva. Seven to 14 days later, if you develop a round red rash that expands, it could be a Lyme disease rash and you should see your doctor.
Should I see my doctor right after a tick bite for preventive antibiotics?
Most deer tick bites will not transmit Lyme. If the tick is fully engorged you have two options. One is to monitor the area of the bite to see if the round rash develops. The other is to take a one-time dose of antibiotic, which may decrease the chance of getting Lyme disease. My recommendation is to limit antibiotic exposure and monitor for symptoms. Testing for Lyme is not helpful at that point as any blood test for Lyme disease will be negative because you have not had time to develop antibodies that indicate the infection is present.
What are symptoms of Lyme disease?
In addition to the round red rash, some people experience fever, aches, sweats, and low energy. Lyme tests are also negative at this point and should be avoided; antibiotics should be prescribed, based on the appearance of the rash. If the illness remains untreated for a few weeks, it may cause multiple red rashes and fever. At this stage a blood test will be positive for Lyme, though the appearance of the rash is classic enough to make the diagnosis and start antibiotics. Untreated Lyme can eventually cause infections in the heart tissue, spinal fluid, and joints. However, even at these later stages, Lyme is completely curable with antibiotics.
If untreated, do I run the risk of developing chronic Lyme disease?
Chronic, incurable Lyme infection is not an entity. Some people may have prolonged fatigue or aches after Lyme infection, but this is not due to ongoing infection and does not respond to antibiotics. As with any serious infection, it can take time to recover from Lyme disease. Unfortunately, the notion of Lyme as an incurable infection has gained traction. This is because doctors claiming to be Lyme experts label patients with prolonged non-Lyme symptoms as having “chronic” Lyme disease. They give them long courses of antibiotics, even though randomized control trials show they do not help. In truth, these patients have been misdiagnosed with Lyme in the first place. Lyme disease is curable at any stage and is not permanent.
Dr. MacQueen is board certified in internal medicine and infectious diseases. He is on the medical staff of Cayuga Medical Center and can be reached at the Cayuga Center for Infectious Diseases at (607) 241-1118.