What are the symptoms of a tick bite? How should a tick bite be treated? What types of ticks can transmit diseases? Explore the answers to these pressing questions and more in our detailed guide.

Understanding Tick Bites

Ticks are small, blood-feeding arachnids that can transmit a variety of diseases to both humans and animals. While most tick bites are harmless and cause only minor symptoms, some ticks can carry and transmit bacteria, viruses, or parasites that can lead to serious illnesses. It’s important to be aware of the potential risks and take appropriate steps to prevent and treat tick bites.

Symptoms of Tick Bites

The majority of tick bites cause only minor signs and symptoms, such as redness, swelling, or a sore on the skin. However, some ticks can transmit diseases that may lead to more severe symptoms. These can include:

• Fever
• Chills
• Fatigue
• Muscle and joint pain
• Headache
• Bulls-eye rash (indicative of Lyme disease)

If you experience any of these symptoms after a tick bite, it’s important to contact your doctor as soon as possible.

Treating Tick Bites

The most important step in treating a tick bite is to remove the tick as soon as possible. Here’s how to do it properly:

1. Use fine-tipped tweezers to grasp the tick as close to the skin as possible.
2. Gently pull the tick straight out, using a slow and steady upward motion.
3. Avoid twisting or squeezing the tick, as this can cause the mouthparts to break off and remain in the skin.
4. Wash the bite site with warm water and soap, rubbing alcohol, or an iodine scrub.
5. If possible, seal the tick in a container and save it for your doctor to examine.

If you’re unable to remove the entire tick or if the bite site becomes infected, it’s important to seek medical attention.

Types of Ticks and the Diseases They Transmit

There are several different types of ticks that can transmit a variety of diseases. Some of the most common and concerning include:

• Deer ticks (Ixodes scapularis): These ticks can transmit Lyme disease, anaplasmosis, and babesiosis.
• American dog ticks (Dermacentor variabilis): These ticks can transmit Rocky Mountain spotted fever and tularemia.
• Lone star ticks (Amblyomma americanum): These ticks can transmit ehrlichiosis, Southern tick-associated rash illness (STARI), and alpha-gal syndrome.

It’s important to be aware of the types of ticks that are common in your area and the diseases they can transmit.

Preventing Tick Bites

There are several steps you can take to reduce your risk of tick bites and the diseases they can transmit:

• Avoid areas with high tick populations, such as wooded or grassy areas.
• Use insect repellent containing DEET, picaridin, or IR3535 when spending time outdoors.
• Wear long-sleeved shirts, long pants, and closed-toe shoes when in tick-infested areas.
• Conduct thorough tick checks after spending time outdoors, and promptly remove any ticks you find.

By taking these preventive measures and being vigilant about tick bites, you can significantly reduce your risk of contracting tick-borne illnesses.

Seeking Medical Attention for Tick Bites

If you’ve been bitten by a tick, it’s important to monitor the bite site and your overall health for any signs of illness. Contact your doctor if you experience any of the following:

• Inability to completely remove the tick
• Expansion of the rash or a bulls-eye pattern appearance
• Flu-like symptoms, such as fever, chills, fatigue, or headache
• Signs of infection at the bite site, such as redness or oozing

Your doctor may prescribe antibiotics or other treatments to prevent or address any potential tick-borne illnesses. It’s also a good idea to bring the tick with you to your appointment, as your doctor may want to examine it.

Conclusion

Tick bites can be a serious health concern, as they have the potential to transmit a range of harmful diseases. By understanding the symptoms, proper treatment, and preventive measures, you can help protect yourself and your loved ones from the risks associated with tick bites. Remember to remain vigilant, seek medical attention when necessary, and take steps to minimize your exposure to these arachnids.

Tick bites: First aid – Mayo Clinic

Most tick bites are painless and cause only minor signs and symptoms, such as redness, swelling or a sore on the skin. But some ticks transmit bacteria that cause illnesses, including Lyme disease and Rocky Mountain spotted fever. In general, to transmit Lyme disease a tick needs to be attached for at least 36 hours. Other infections can be transferred in a few hours or even a few minutes.

To take care of a tick bite

• Remove the tick promptly and carefully. Use fine-tipped forceps or tweezers to grasp the tick as close to your skin as possible. Gently pull out the tick using a slow and steady upward motion. Avoid twisting or squeezing the tick. Don’t handle the tick with bare hands. Experts don’t recommend using petroleum jelly, fingernail polish or a hot match to remove a tick.
• If possible, seal the tick in a container. Put the container in a freezer. Your doctor may want to see the tick if you develop new symptoms.
• Wash your hands and the bite site. Use warm water and soap, rubbing alcohol, or an iodine scrub.

When to seek emergency care

Call 911 or your local emergency number if you develop:

• A severe headache
• Difficulty breathing
• Paralysis
• Heart palpitations

When to contact your doctor

• You aren’t able to completely remove the tick. The longer the tick remains attached to your skin, the greater your risk of getting a disease from it.

• The rash gets bigger. A small red bump may appear at the site of the tick bite. This is normal. But if it develops into a larger rash, perhaps with a bull’s-eye pattern, it may indicate Lyme disease. The rash usually appears within three to 14 days.

  Also consult your doctor if signs and symptoms disappear because you may still be at risk of the disease. Your risk of contracting a disease from a tick bite depends on where you live or travel to, how much time you spend outside in woody and grassy areas, and how well you protect yourself.

• You develop flu-like signs and symptoms. Fever, chills, fatigue, muscle and joint pain, and a headache may accompany the rash.
• You think the bite site is infected. Signs and symptoms include redness or oozing.
• You think you were bitten by a deer tick. You may need antibiotics.

If possible, bring the tick with you to your doctor’s appointment.

Oct. 22, 2019

Show references

1. Tick bites. Merck Manual Professional Edition. https://www.merckmanuals.com/professional/injuries-poisoning/bites-and-stings/tick-bites. Accessed July 25, 2017.
2. Tick and Lyme diseases FAQ’s. Maine Center for Disease Control & Prevention, Division of Infectious Disease. http://www.maine.gov/dhhs/mecdc/infectious-disease/epi/vector-borne/lyme/lyme-faq.shtml#Q06. Accessed June 30, 2017.
3. Tick removal. Centers for Disease Control and Prevention. http://www.cdc.gov/ticks/removing_a_tick.html. Accessed July 25, 2017.
4. Symptoms of tickborne illness. Centers for Disease Control and Prevention. http://www.cdc.gov/ticks/symptoms.html. Accessed July 25, 2017.
5. Lyme disease: What you need to know. Centers for Disease Control and Prevention. https://www.cdc.gov/lyme/toolkit/index.html. Accessed June 30, 2017.
6. Goyal DD (expert opinion). Mayo Clinic, Rochester, Minn. June 21, 2017.
7. Tintinalli JE, et al. Zoonotic infections. In: Tintinalli’s Emergency Medicine: A Comprehensive Study Guide. 8th ed. New York, N.Y.: The McGraw Hill Companies; 2016. http://accessmedicine.mhmedical.com. Accessed July 25, 2017.
8. Hu, L. Evaluation of a tick bite for possible Lyme disease. https://www.uptodate.com/contents/search. Accessed May 9, 2018.
9. Pritt, BS (expert opinion). Mayo Clinic, Rochester, Minn. May 7, 2018.

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Tick Bites – Harvard Health

What Is It?

Ticks are tiny, biting arachnids that feed on the blood of warm-blooded animals, including humans. They burrow painlessly into the skin with their feeding parts, bite, draw blood and eventually drop off when they become engorged with blood. Only the feeding parts are inserted into the skin. The body, which is dark in color and ranges from the size of a poppy seed to a pencil eraser, remains visible on the skin surface or scalp. Ticks swell and turn bluish-gray when filled with blood. Most tick bites in the United States involve hard ticks (Ixodidae), which have been increasing in number since the middle 1900s.

Secretions from the tick’s feeding parts can cause skin reactions, such as raised areas, lumps and growths called granulomas. Fever and paralysis also may develop after tick bites, although paralysis is rare. In addition, ticks can be infected with bacteria, viruses or protozoa. These organisms can be transmitted from the tick to the host (the animal or person) as the tick feeds, causing disease.

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Tick bite | DermNet NZ

Author: Marie Hartley, Staff Writer, 2009. Updated by Vanessa Ngan, Staff writer, 1 February 2014.

What is a tick bite?

Ticks are blood-sucking parasites. When they take a blood meal, they can cause dermatologic disease directly by their bite, or indirectly as vectors of other diseases. Tick-borne diseases include:

• Bacterial infections including Lyme disease, relapsing fever, tularaemia, and babesiosis
• Rickettsial infections including Rocky Mountain spotted fever, other spotted fevers, ehrlichiosis and anaplasmosis, and Q fever
• Viral diseases including tick-borne encephalitis, Crimean-Congo haemorrhagic fever, Colorado tick fever, Powassan encephalitis, and others
• Tick bite-induced red meat allergy.

This page will focus on skin diseases that occur as a direct result of tick bites. Risk factors for tick exposure include outdoor activities such as camping, hiking, walking in long grass, or contact with animals. In endemic areas, infections can also be acquired during routine activities. Many cases of the tick-borne disease occur in the summer months when ticks are most active.

Ticks

What are the clinical features of a tick bite?

While tick bites can be painful, in many cases they can go unnoticed. Once the tick is full from its blood meal it falls off the skin.

Ticks can be categorised as either hard or soft ticks and this distinction determines some of the clinical features of the tick bite. Hard ticks feed for a few days to several weeks, while soft ticks feed quickly and leave their host rapidly.

Ticks cause acute and chronic skin diseases through physical trauma, salivary secretions, toxins, excretions, body parts, or by causing a host to scratch. Skin disease may occur away from the site of the bite, and tick bites can also cause disease in other parts of the body such as ‘flu-like symptoms, vomiting, paralysis and even anaphylaxis.

Tick bites

Acute or early skin manifestations of a tick bite

For both hard and soft tick bites, 0.5–2 cm red areas, papules (small bumps), or thin plaques may form at the site of attachment within 1 to 3 days. The lesion may feel hard and may be surrounded by redness. Mild swelling or blister formation can occur. The bite can be mild to severely itchy.

Necrotic (dead tissue) ulcers can form in severe cases; usually due to bites from soft ticks. Bites from soft ticks may be painful.

Specific tick species can also cause characteristic lesions such as bruising (purpura), urticaria, and ulceration.

Chronic or late skin manifestations of tick bites

Acute skin lesions can persist and become papules, nodules (larger solid lumps), or plaques. Over days to months, these lesions can form a tick bite granuloma; a 0.5 to 2 cm nodule made up of mixed inflammatory cells.

Tick bites can also rarely result in hair loss (alopecia), which may resolve within 1 to 3 months, or be permanent.

Tick bites can develop wound infection due to secondary infection by bacteria such as Staphylococcus aureus and Group A Streptococcus. Retained tick material and host scratching may increase the likelihood of this complication.

How is a tick bite diagnosed?

Diagnosis can be difficult, especially if the bite has gone unnoticed. Microscopic examination of skin biopsy specimens may assist diagnosis. Sometimes if a tick is still attached, it can be removed and identified. Additional tests may be done according to the tick identified and whether or not it is a vector for certain diseases.

What is the treatment for a tick bite?

Itch resulting from a tick bite may be relieved with topical steroids and oral antihistamines. Tick bite granulomas can be surgically removed.

Ticks still attached to the skin should be physically removed. Equipment necessary for tick removal includes gloves, isopropyl alcohol or other skin disinfectant, and fine-toothed forceps. The patient should be comfortably positioned so that the doctor can easily access the tick.

While wearing protective gloves, gently grasp the tick with tweezers as close as possible to the skin and slowly, gently pull it upwards and away. Do not twist or jerk the tick as this may cause the tick mouthparts to break off and remain in the skin. Also, do not squeeze or puncture the body of the tick as this may contain infectious organisms that cause disease.

How can tick bites be prevented?

• Avoid areas such as forests or fields where ticks are found.
• Use insect repellent containing DEET on the skin, and permethrin on the clothes.
• Wear long-sleeved clothing that fits tightly around the wrists, waist, and ankles.
• Check twice daily for attached ticks and remove immediately.
• Dry clothing at high heat in a tumble dryer.

Lyme disease symptoms & treatments – Illnesses & conditions

Lyme disease, or Lyme borreliosis, is a bacterial infection spread to humans by infected ticks.

Ticks are tiny spider-like creatures found in woodland and heath areas. They feed on the blood of birds and mammals, including humans. Ticks that carry the bacteria responsible for Lyme disease are found throughout the UK and in other parts of Europe and North America.

Lyme disease can often be treated effectively if it’s detected early on. But if it’s not treated or treatment is delayed, there’s a risk you could develop severe and long-lasting symptoms.

This page covers:

Signs and symptoms of Lyme disease

When to see your GP

How you get Lyme disease

Who’s at risk and where are ticks found?

Treating Lyme disease

Preventing Lyme disease

How to remove a tick

Chronic Lyme disease

Signs and symptoms of Lyme disease

Early symptoms

Many people with early-stage Lyme disease develop a distinctive circular rash at the site of the tick bite, usually around three to 30 days after being bitten. This is known as erythema migrans.

The rash is often described as looking like a bull’s-eye on a dart board. The affected area of skin will be red and the edges may feel slightly raised.

The size of the rash can vary significantly and it may expand over several days or weeks. Typically it’s around 15cm (6 inches) across, but it can be much larger or smaller than this. Some people may develop several rashes in different parts of their body.

However, around one in three people with Lyme disease won’t develop this rash.

Some people with Lyme disease also experience flu-like symptoms in the early stages, such as tiredness (fatigue), muscle pain, joint pain, headaches, a high temperature (fever), chills and neck stiffness.

Later symptoms

More serious symptoms may develop several weeks, months or even years later if Lyme disease is left untreated or is not treated early on. These can include:

• pain and swelling in the joints (inflammatory arthritis)
• problems affecting the nervous system – such as numbness and pain in your limbs, paralysis of your facial muscles, memory problems and difficulty concentrating
• heart problems – such as inflammation of the heart muscle (myocarditis) or sac surrounding the heart (pericarditis), heart block and heart failure
• inflammation of the membranes surrounding the brain and spinal cord (meningitis) – which can cause a severe headache, a stiff neck and increased sensitivity to light

Some of these problems will get better slowly with treatment, although they can persist if treatment is started late.

A few people with Lyme disease go on to develop long-term symptoms similar to those of fibromyalgia or chronic fatigue syndrome. This is known as post-infectious Lyme disease. It’s not clear exactly why this happens, but it’s likely to be related to overactivity of your immune system rather than persistent infection.

When to see your GP

You should see your GP if you develop any of the symptoms described above after being bitten by a tick, or if you think you may have been bitten. Make sure you let your GP know if you’ve spent time in woodland or heath areas where ticks are known to live.

Diagnosing Lyme disease is often difficult as many of the symptoms are similar to other conditions. A spreading rash some days after a known tick bite should be treated with appropriate antibiotics without waiting for the results of a blood test.

Blood tests can be carried out to confirm the diagnosis after a few weeks, but these can be negative in the early stages of the infection. You may need to be re-tested if Lyme disease is still suspected after a negative test result.

In the UK, two types of blood test are used to ensure Lyme disease is diagnosed accurately. This is because a single blood test can sometimes produce a positive result even when a person doesn’t have the infection.

If you have post-infectious Lyme disease or long-lasting symptoms, you may see a specialist in microbiology or infectious diseases. They can arrange for blood samples to be sent to the national reference laboratory run by Public Health England (PHE), where further tests for other tick-borne infections can be carried out.

How you get Lyme disease

If a tick bites an animal carrying the bacteria that cause Lyme disease (Borrelia burgdorferi), the tick can also become infected. The tick can then transfer the bacteria to a human by biting them.

Ticks can be found in any areas with deep or overgrown vegetation where they have access to animals to feed on.

They’re common in woodland and heath areas, but can also be found in gardens or parks.

Ticks don’t jump or fly, but climb on to your clothes or skin if you brush against something they’re on. They then bite into the skin and start to feed on your blood.

Generally, you’re more likely to become infected if the tick remains attached to your skin for more than 24 hours. But ticks are very small and their bites are not painful, so you may not realise you have one attached to your skin.

Who’s at risk and where are ticks found?

People who spend time in woodland or heath areas in the UK and parts of Europe or North America are most at risk of developing Lyme disease.

Most tick bites happen in late spring, early summer and autumn because these are the times of year when most people take part in outdoor activities, such as hiking and camping.

Cases of Lyme disease have been reported throughout the UK, but the Scottish highlands is known to have a particularly high population of ticks.

It’s thought only a small proportion of ticks carry the bacteria that cause Lyme disease, so being bitten doesn’t mean you’ll definitely be infected. However, it’s important to be aware of the risk and seek medical advice if you start to feel unwell.

Treating Lyme disease

If you develop symptoms of Lyme disease, you will normally be given a course of antibiotic tablets, capsules or liquid. Most people will require a two- to four-week course, depending on the stage of the condition.

If you are prescribed antibiotics, it’s important you finish the course even if you are feeling better, because this will help ensure all the bacteria are killed.

If your symptoms are particularly severe, you may be referred to a specialist to have antibiotic injections (intravenous antibiotics).

Some of the antibiotics used to treat Lyme disease can make your skin more sensitive to sunlight. In these cases, you should avoid prolonged exposure to the sun and not use sunbeds until after you have finished the treatment.

There’s currently no clear consensus on the best treatment for post-infectious Lyme disease because the underlying cause is not yet clear. Be wary of internet sites offering alternative diagnostic tests and treatments that may not be supported by scientific evidence.

Preventing Lyme disease

There is currently no vaccine available to prevent Lyme disease. The best way to prevent the condition is to be aware of the risks when you visit areas where ticks are found and to take sensible precautions.

You can reduce the risk of infection by:

• keeping to footpaths and avoiding long grass when out walking
• wearing appropriate clothing in tick-infested areas (a long-sleeved shirt and trousers tucked into your socks)
• wearing light-coloured fabrics that may help you spot a tick on your clothes
• using insect repellent on exposed skin
• inspecting your skin for ticks, particularly at the end of the day, including your head, neck and skin folds (armpits, groin, and waistband) – remove any ticks you find promptly
• checking your children’s head and neck areas, including their scalp
• making sure ticks are not brought home on your clothes
• checking that pets do not bring ticks into your home in their fur

How to remove a tick

If you find a tick on your or your child’s skin, remove it by gently gripping it as close to the skin as possible, preferably using fine-toothed tweezers. Pull steadily away from the skin without twisting or crushing the tick.

Wash your skin with water and soap afterwards, and apply an antiseptic cream to the skin around the bite.

Don’t use a lit cigarette end, a match head or substances such as alcohol or petroleum jelly to force the tick out.

Some veterinary surgeries and pet shops sell inexpensive tick removal devices, which may be useful if you frequently spend time in areas where there are ticks.

“Chronic Lyme disease”

There has recently been a lot of focus on Lyme disease in the media, with much attention on people who’ve been diagnosed with “chronic Lyme disease”.

This term has been used by some people to describe persistent symptoms such as tiredness, aches and pains, usually in the absence of a confirmed Lyme disease infection. It’s different to “post-infectious Lyme disease” (see above), which is used to describe persistent symptoms after a confirmed and treated infection.

It’s important to be aware that a diagnosis of chronic Lyme disease is controversial. Experts do not agree on whether the condition exists, or whether the symptoms are actually caused by a different, undiagnosed problem.

In either case, there’s no evidence to suggest people diagnosed with chronic Lyme disease can pass the condition on to others, and there’s little clear evidence about how best to treat it.

A Short Primer for Pain Practitioners

Recently, the Centers for Disease Control and Prevention (CDC) dramatically increased the estimate of the annual number of new cases of Lyme Disease (LD) in the United States from 30,000 to 300,000, with 14 states accounting for over 96% of cases reported.¹ In the United States, Lyme disease is most common in northeastern states, from Virginia to Maine; Upper Midwest states, mostly Wisconsin and Minnesota; and the West Coast, mainly in the northwest.

The number of new LD cases each year certainly qualifies this infection as an epidemic or at least a highly endemic disease. Consequently, pain practitioners must familiarize themselves with the signs and symptoms of LD. This article is a short primer on LD to give the pain practitioner some basic information and guidance. Given the magnitude of LD, Practical Pain Management will seek to expand on LD research in future issues.

Painful Sequelae

Many of patients with active or previously treated LD infection will develop painful sequelae.^2-7 In addition, many patients who are initially diagnosed with myopathies, neuropathies, or arthropathies later prove to have LD.^2-4 Many pain patients who have investigated LD on their own believe their pain may have resulted from an unrecognized LD infection. To complicate active disease, there is an autoimmune, painful condition called Post-Treatment Lyme Disease Syndrome (PTLDS) that may follow the eradication of an active infection.

Cause of LD

LD is caused by the spirochete bacteria Borrelia burgdorferi.^8-12 It is the most common vector-borne illness in the United States and is transmitted by a bite by an infected black-legged tick of the Ixodes family. The ticks pick up the bacteria, called Borrelia burgdorferi (B. burgdorferi) or Borrelia mayonii (B. mayonil) when they bite deer or mice that are infected. When infected ticks bite humans, they spread the bacteria. Ticks can attach themselves to any part of the human body, but are most commonly found in the groin, armpits and scalp.

Three Stages of Active Infection

Infection following a tick bite causes 3 stages of disease (Table 1). The early localized infection causes a rash called “erythema migrans,” commonly called a “bull’s-eye rash,” which eventually resolves, even without antibiotic treatment. Although diagnostic following a tick bite, the rash only occurs in about half of LD cases. In the early stages of infection, the spirochete can spread to other tissues and organs (eg, skin, nervous system, joints, and heart), causing more severe symptoms.⁸ LD has a predilection to attack the facial nerve and cause Bell’s palsy.^13-16 The disease also commonly affects the neck and cervical spine, causing pain, stiffness, headache, and possible radicular symptoms. Joint, muscle, and nerve pain begin to occur during active infection, with the knee being a favored site of joint pain.^4-6

The late, disseminated stage of infection is characterized by neurologic manifestations and severe arthritic pain in joints.^2-16 There may be shooting pains, myalgias, numbness or tingling in the hands or feet, insomnia, and problems with short-term memory. Tragically, the spirochete may have a predilection for the central nervous system (CNS).^13-16 Once infected, CNS LD may cause a number of symptoms that may mimic other neurologic diseases, including multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease. Many physicians refer to CNS infection by LD as “neuroborreliosis.”^6,10,13-16

Testing and Antibiotic Treatment

Diagnosis of LD usually is confirmed by serologic testing. Once LD is diagnosed, treatment of the infection requires antibiotics. There is some controversy surrounding diagnostic testing and antibiotic therapy. Ideally, antibiotic management of LD should be supervised by a physician with expertise or specialization in LD. Antibiotics commonly used for oral treatment include doxycycline (currently in short supply nationwide), amoxicillin, and cefuroxime axetil.¹⁷ Patients with certain neurologic or cardiac forms of illness may require intravenous treatment with drugs such as ceftriaxone or penicillin.¹⁷ [Editor’s Note: The specifics of antibiotic therapy will not be covered here]. If a specialist is not available and the treating pain clinician tests and treats, we recommend you consult “Clinical Practice Guidelines” or another up-to-date manual.¹⁷

Pain Treatment of Active Disease

Pain may be severe enough to require specific analgesic therapy at any stage of LD. The first line of pain treatment is anti-inflammatory agents, because inflammation is always present with LD.^4-6 The agents can be delivered topically (diclofenac; PennSaid, Voltaren, others) or systemically. Topical anesthetics such as lidocaine (Lidoderm, others) also are helpful for managing joint pain (Table 2). In addition to anti-inflammatory agents, standard, step-wise multimodal pain treatment is recommended—starting with agents such as acetaminophen, muscle relaxants (when needed), various neuropathic drugs, and complementary therapies. Opioid analgesics may be required for severe pain if non-opioid measures are ineffective. Hypnotic agents may be necessary for insomnia, and anxiolytics often are required as well.

Post-Treatment LD Syndrome

Approximately 10% to 20% of patients with LD have symptoms that may last months to years after treatment with antibiotics.^2,3,7,9,12 These symptoms can include muscle and joint pain, cognitive defects, sleep disturbances, and fatigue. The cause of these symptoms is not precisely known, since there is no evidence that there is ongoing infection with the spirochete. As noted, this condition is referred to as PTLDS. It is apparently an autoimmune disorder in which a person’s immune system continues to respond, doing damage to the body’s tissues even after the infection has been cleared. Further antibiotic therapy is not helpful.

PTLDS appears to be similar to other infections that produce an autoimmune condition after the active infection has resolved. Included here are Campylobacter jejuni (polyneuropathy, Guillain-Barre Syndrome), chlamydia (reactive arthritis, Reiter’s Syndrome), Streptococcus (glomerulonephritis), and Epstein-Barr virus (infectious mononucleosis) (Table 3). These post-infectious syndromes are of great importance to pain practitioners because they may produce severe pain in joints, nerves, and muscles that require potent analgesics. Also, many patients who are given a diagnosis of fibromyalgia, myofacial pain syndrome, or degenerative joint disease may, in fact, have PTLDS.

Pain therapy for these individuals may require a vigorous analgesic program, because autoimmune processes tend to be progressive and cause tissue destruction. Electromagnetic measures (eg, acupuncture, ultrasound, radio wave, infrared, laser) may help muscles, tendons, and joints stay flexible and mobile. Range of motion and stretching exercises are necessary to keep joints mobile and prevent contractures. Water therapy is very comforting. Corticosteroid injections or topical applications may be essential for treatment, especially if joint swelling is present and patients have limited mobility.

The Patient Who Suspects Chronic Lyme Infection

LD is so prevalent and well known that the public is well aware of its symptoms. Many patients, particularly those who have been diagnosed with fibromyalgia, degenerative arthritis, or neuropathies of unknown origin, believe they may have had unrecognized and undiagnosed LD. They may request recurrent LD testing and even antibiotic therapy, despite negative Lyme serologic tests.

In reality, some of these patients may be correct. The authors have encountered several patients who presented with a chronic pain syndrome such as fibromyalgia who were later found to have disseminated LD or PTLDS. At this juncture, we are not prepared to set out any specific diagnostic or treatment protocols. We do, however, believe that pain practitioners must consider LD as an underlying cause of pain in patients who present without a clear event or cause of chronic muscle, nerve, or joint pain. In addition to diffuse musculoskeletal and joint pathologies, cranial neuropathy (particularly facial palsy), and radiculoneuritis (motor or sensory or both) are 2 of the most common presentations of acute, early neurologic LD. Given what appears to be an epidemic of LD, we will carefully monitor the situation and bring you updates through Practical Pain Management.

Summary

There are approximately 300,000 new LD cases reported each year. The disease is reaching near epidemic proportions, especially in the Northeast and upper Midwest, where LD cases appear to cluster. It is unknown, however, whether this rate of new cases signals a true increase in infection or instead is a reflection of enlightened awareness and new testing technology. It is clear, however, that patients with suspected (or diagnosed) LD are showing up in pain practices in increasing numbers. These patients tend to fall into 4 categories (Table 4). The first category encompasses patients who have pain and documented LD by virtue of serologic test results. The second category is composed of patients with pain without an identifiable, obvious cause, in whom serologic testing later documents the presence of disseminate LD. The third category includes patients who investigated LD on their own and determined they may have it based on symptoms that are compatible with disseminated LD (unconfirmed). The fourth category encompasses pain patients with PTLDS, which presents as an autoimmune disorder that progressively destroys tissue, such as joint cartilage.

Pain treatment of LD generally follows the step-up regimen of multimodal analgesic therapy with oral and topical agents. A chronic infectious or autoimmune disorder always is accompanied by inflammation, making NSAIDs essential. Clinicians are reminded to incorporate physical and complementary modalities to improve function, diminish pain, and enhance patient well-
being. All pain practitioners should educate themselves about LD and its treatment, and stay abreast of future clinical recommendations.

Editor’s Note: Online version updated July 2019.

Last updated on: July 30, 2019

What to do when you have a tick bite

By Heather Lesage-Horton, MD

So you have a tick bite, what type of tick is it?

Lyme disease is spread through the bites of nymph or adult Deer ticks, also known as “Black legged ticks.”   If a tick is found on a host (a human or pet), it is important to identify the type of tick to know if a person or pet is at risk for Lyme disease.  If it is determined to be a black legged tick, your health care provider will want to know if it has been attached to the person and for how long.

How long has the tick been attached?

It can be difficult to determine how long a tick has been attached.  To help with this, think about times when you may have been in an area where there are ticks.  Think about walks in the woods or playing in or around tall grass.

Lyme disease is rarely passed on during the first 48 hours (first two days) a tick is attached.  To pass on Lyme disease, the tick will typically be engorged (swollen), which means the tick has had a blood meal. Ticks need to eat to pass on Lyme disease.

So it’s a deer tick, now what?

Remove the tick by using tweezers or a tick tool to grab the tick as close to the bitten skin as possible.  Pull straight up with steady pressure (or follow tick tool directions).  Do not squeeze, crush, or injure the body of the tick.  Clean the person’s skin after the tick has been removed.  If parts of the tick’s mouth remains attached, do not go after it – the human body will naturally get rid of it with time.

When you see or talk with your health care provider about a tick bite, they will need to know how long it has been since the tick was removed.  If it has been 72 hours (three days) or less, the tick is a black legged tick, and it has been attached for 36 hours or more (some people may use 24 hr. or more) we may recommend antibiotic prophylaxis.  This means we think about giving an antibiotic to try to prevent the bitten person from developing Lyme disease.  We think about this because here in the Northeast more than 20% of ticks (more than 1 in 5) are infected with the germ (Borrelia burgdorferi) that causes Lyme disease.  We do not test ticks to see if they have Lyme disease because even if the tick has Lyme disease, we do not know if it passed the disease on to the person it bit.

So I meet criteria for antibiotic prophylaxis, what does that mean?

This is where it gets a little more complicated.  If the bitten person is eight years or older, has had a black legged tick on them for 36 hours or more, and it has been 72 hours or less since the tick has been removed, we can prescribe a one-time dose of Doxycycline.

We do not routinely recommend doxycycline in children less than eight years old due to the risk of staining of teeth.  However, we may consider a one-time dose of doxycycline for that child if the parents are willing to accept this risk.  We may also consider doxycycline if future tick bites happen.  We do not have recommendations for antibiotic prophylaxis if a patient has an allergy to doxycycline.

So I’ve been bitten by a black legged tick. How do I know if I have Lyme disease?

Whether you received Lyme disease preventative antibiotics or not, it is important to know and watch for signs of Lyme disease.  Watch the area of the tick bite; at first redness may be noted. This is a reaction/response of the body at the site of the tick bite and is typically the size of a quarter or smaller.  Over the first month after the tick bite, watch for spreading redness or a bull’s eye rash as this could be a sign of Lyme disease.   The rash usually does not hurt, but some patients report burning or itching.  If this develops, most people will have one bull’s eye rash but some people may have more than one on different parts of the body. Some people may also experience a decrease in energy, mild headache, muscle or joint pain, and/or swollen lymph nodes in the area of the tick bite.  In rare cases, if Lyme disease is not diagnosed early, patients may develop more severe illness weeks to months after the tick bite.  If you are worried about late symptoms of Lyme disease, please talk with your health care provider.

How do I prevent Lyme disease?

Wear shoes and keep your skin covered with clothing when you go outside.  Wear light colors so you can more easily spot ticks. Use bug spray to keep ticks off of you (consider 20% DEET or permethrin treated clothing).  Shower/take a bath after being outdoors.  Do tick checks everyday – especially check under the arms, in and around ears, inside the belly button, around the waist and on the hairline and scalp.

Resources

Heather Lesage-Horton, MD, is a board-certified pediatrician at Just So Pediatrics, a department of Brattleboro Memorial Hospital. Just So Pediatrics is located at 19 Belmont Avenue, Brattleboro, VT. In addition to regular hours evening hours are available on most Tuesdays and Wednesdays until 8 PM.  Just So Pediatrics can be reached at 802-251-8626.

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Diseases, symptoms, and risk factors

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A tick is a small parasite from the same family as spiders. Ticks need blood to complete their life cycle, and they may bite humans. Some transmit diseases.

Ticks are common in many parts of the world, including the United States. Some tick-borne diseases can have severe complications, so people should always avoid tick bites when possible.

This article explores how to recognize when a tick bite needs attention and when to see a doctor.

Tick bites are not always harmful, but some can transmit certain diseases. These can lead to severe complications, but timely treatment with antibiotics will often resolve the problem.

A wide range of tick-borne diseases can occur in the U.S., including:

Ticks can be red, brown, or black. They range from around 0.5–3.0 millimeters (mm) in length, depending on the type of tick and stage in its life cycle. After feeding, the largest ticks may expand to 11 mm, which is around half an inch. They have eight legs.

Unlike other bugs, a tick may stay attached to the skin for several days. Most people notice a tick bite when they find the tick still attached.

If a rash or other symptoms appear after a tick bite, this may indicate that the tick has transmitted an infection. It is worth noting that a person may receive a bite without realizing it. People who are in areas with ticks should check for them on their clothes and body daily.

Here, learn to identify some different types of ticks.

What bit me? Learn here about different types of bites.

Many tick bites are harmless, but some transmit infections that need medical attention.

A person should seek advice if they develop symptoms that may indicate a tick-borne disease.

The symptoms will depend on the disease, but here are some common symptoms:

• body and muscle aches
• joint pain
• fever
• headaches
• fatigue
• a rash
• a stiff neck
• facial paralysis

If a person has symptoms of a tick-borne illness, a doctor will provide treatment as necessary. Often, this is with antibiotics.

If Lyme disease is common in the area, the doctor may recommend prophylactic antibiotic treatment. In other words, if a person knows a tick has bitten them, the doctor may give them antibiotics just in case, to prevent an infection. However, experts do not recommend prophylaxis for all tick-borne diseases.

There are many types of tick, and not all of them bite people. Ticks live in most regions in the U.S., but the type depends on the region.

Ticks usually live outdoors, in trees, grass, and shrubs. They can also be present in yards and even be found inside the house if they travel inside on pets or humans.

Ticks do not fly or jump onto people. They wait on leaves or bushes for a person or animal to brush by and climb on them as they pass.

Ticks are present all year, but they are most active from April to September, when the weather is warmer. People should check for likely activity in areas where they live or are planning to travel.

Avoiding areas where ticks live can be difficult, but there are ways to prevent bites.

Before they go outside here are some steps people can take to reduce the risk:

• Finding out where ticks are likely to be and take precautions.
• Wearing enclosed shoes, long-sleeved shirts, and tucking pants into socks.
• Tying up long hair.
• Avoiding sitting directly on the ground.
• Wearing light-colored clothing to make ticks easier to spot.

Insect repellent

Before going into an area where ticks may be present, people can apply insect repellents containing the following to skin and clothing:

• DEET
• picaridin
• ethyl butyl acetylamino propionate
• oil of lemon eucalyptus (OLE)
• para-menthane-diol (PMD)

Special considerations for children include:

• avoiding the use of OLE and PMD before the age of 3 years
• not using insect repellents before the age of 2 months
• avoiding products containing more than 30% DEET

Insect repellents are available for purchase in drugstores and online.

When back indoors, people should check for ticks on all of their clothing, as well as on any gear and pets. People should also shower and check their body thoroughly.

When looking for ticks on the body, be careful to check:

• the hair
• the ears
• the armpits
• the belly button
• the waist
• behind the knees
• between the legs

It is essential to remove a tick from the skin as soon as possible. Here are some tips for how to do that:

• Use a fine-tipped tweezer.
• Grasp the tick as close to the surface of the skin as possible.
• Applying even pressure, pull upward away from the skin. Avoid bending the tick as this can separate the mouth, which may remain in the skin.
• If it is not possible to remove the tick’s mouthpart, clean the area and leave it to heal.
• Clean the bite area and hands with rubbing alcohol or soap and water.
• Place a live tick in a sealed bag, put it in alcohol, wrap it in tape, or flush it down a toilet. Never crush a tick with the fingers.
• In some areas, doctors advise keeping the tick, and they will send it to a laboratory for testing. Check the recommendations for the area. Alternately, a person may want to take a picture of the tick, which can help their doctor identify the type of tick and determine their risk of a tick-borne disease

Ticks are common in many parts of the U.S.

Not all ticks are harmful, but some can transmit diseases, including Lyme disease, Colorado tick fever, and Rocky Mountain spotted fever. Some of these diseases can lead to severe complications.

Treatment for tick-borne diseases usually involves antibiotic medication. Tick bites can be hard to prevent, but people can take precautions to reduce the risk.

Here, get some more tips on staying healthy outdoors.

Tick bite

The greatest threat to health is the bite of a tick of the Ixodidae family. They are called ixodid ticks. The family includes many species. In our country, the following are most common:

1. Ixodes persulcatus – taiga ticks, live in the Far East, the Urals and Siberia (the habitat corresponds to their name).
2. Ixodes ricinus, the second name is dog ticks, which, despite their names, attack humans. This is an inhabitant of the European part of Russia.

Photo ixodid tick

These insects can be a source of very dangerous diseases. They rarely live high (usually no higher than 1 m). The parasites live on shrubs or tall grass. Ticks choose places with high humidity. Most often these are forest glades, hollows and ravines, the banks of reservoirs. They feel great in their summer cottages and garden plots.

These parasites are most active during the spring-summer period. Most of the requests are received from May to July.Further, the activity of parasites decreases. This is due to their vital activity and breeding period.

Rospotrebnadzor on its official website publishes a list of regions of the Russian Federation in which the probability of getting diseases from a parasite bite is highest. You can also find there which risk category your region belongs to.

Moscow has a favorable status for tick-borne encephalitis. But another serious illness – Lyme disease (tick-borne borreliosis) is common throughout Russia.In Moscow alone, 519 cases were registered in 2017.

How a tick bite occurs.

Ticks hiding wait for their prey on bushes, grass, trees. The insect can sense the approach of a potential host 10 meters away. This is due to the senses on the front legs. They sense carbon dioxide, ammonia, hydrogen sulfide and other substances that a person or animal emit. That is why ticks unmistakably find the places of accumulation of their victims.

When a person (or animal) enters the reach zone, the tick crawls onto it, clinging to clothing or hair. Sometimes the parasite can even chase the victim, crawling behind it for a certain distance. Then, with the help of its tenacious paws, it moves in search of a naked part of the body. Having found it, the insect sticks to its host.

The choice of the bite site is not accidental, the tick finds the most hidden and inaccessible places. He hides so that he cannot be seen.
Most often these are armpits, head under hair, neck, groin area, ears, etc.The tick bite itself is painless, the parasite injects anesthetics into the body of its host. Therefore, a person can detect a tick many hours, and sometimes even days after the bite.

What a tick bite looks like on the body.

Photo of the site of the tick bite

If you have been in the habitat of ticks, it is very important to conduct a thorough examination for the presence of possible parasites at least once an hour and upon arrival home. The site of a tick bite looks like a small dark dot surrounded by reddened skin with swelling.
Various local reactions to the bite are possible – a feeling of pain, severe itching, tissue swelling, pain at the site of contact. Sometimes a serious allergic reaction to insect saliva develops. In this case, in addition to a local reaction, a general one may also occur. It is expressed in the appearance of urticaria, dizziness, up to fainting, laryngeal edema and even anaphylactic shock. In this case, the person needs emergency medical attention.

The male tick is on the body of its victim for a short time – until 6 o’clock.That is how much he needs to saturate, and then falls off. At the same time, its size does not change significantly. This makes the male harder to spot.

The female needs much more time – up to several days. At the same time, it changes greatly in size, its length reaches 10 mm with full saturation with blood. Therefore, the likelihood of spotting a female parasite is higher. But, regardless of the sex of the tick, with any bite, a person can get infected with dangerous diseases.

Tick borne diseases.

The bite of a parasite can cause dangerous diseases in humans or animals. The most dangerous among them are viral encephalitis and tick-borne systemic borreliosis.

Tick-borne viral encephalitis (meningoencephalitis). This is a complex viral disease. It can lead to inflammation of the brain and spinal cord. The prodermal period is 7-21 days. More often not more than 14 days. At the same time, the virus has already infected the body, but there are no specific symptoms yet. The main signs of the disease:

• body temperature rises sharply (up to 40C)
• muscle pain, severe headache
• nausea, vomiting, weakness.

In case of untimely treatment of the disease, the consequences are dire. A person gets irreparable mental and neurological disorders or death occurs. If treatment is started on time, the prognosis is more positive. To prevent the development of the disease, the victim must be injected with immunoglobulin no later than 96 hours after the bite.

According to statistics, only 6% of ticks are carriers of the encephalitis virus, with a bite from 2 to 6% of people get sick. In order not to fall into this sad statistics, in the event of a bite, it is necessary to urgently seek medical attention.

Tick-borne borreliosis or Lyme disease is a bacterial infection that can be caused by several types of pathogens. The prodermal period is 7-14 days. There are several stages of the disease:

1. At the first stage, a fever appears (the temperature is rarely higher than 37.90 C), body aches, weakness, nausea, there may be catarrhal symptoms (sore throat, cough, runny nose). One of the hallmarks of Lyme disease is the presence of annular redness with a white center at the site of the bite (erythema migrans).If at this stage a person is treated with antibiotics, then in most cases, recovery occurs.
2. At the second stage, neurological symptoms appear. Signs of meningitis may appear. Basically, there is weakness of the facial muscles, malaise, a person quickly gets tired, a headache of a pulsating nature, photophobia. Fever is often absent.
3. If there was no timely adequate treatment, the disease can become chronic. The person can become disabled or even die.It is much more difficult to treat a chronic form with borreliosis; treatment can last more than 6 months.

What to do in case of a tick bite.

There are specialized medical institutions in all regions to seek qualified medical care. In Moscow, for example, these are:

1. Research Institute of Emergency Medicine named after V.I. N.V. Sklifosovsky (B. Sukharevskaya square, 3, metro “Prospect Mira”). The medical institution operates around the clock. Adult patients will be accepted here.
2. If a child has received a tick bite, then it is necessary to contact the Children’s City Clinical Hospital №13 named. N.F. Filatov (Sadovo-Kudrinskaya st., 15, metro “Barrikadnaya”, “Mayakovskaya”).

If medical assistance is not possible at the moment, you must remove the tick yourself. There are the following methods:

• can be pulled out with tweezers or by hand (wrap them in a clean bandage). Hold the tweezers or fingers perpendicularly.Do not jerk the insect or make sudden movements. It is necessary to slowly twist the tick around the axis, carefully removing it from the skin.
• you can make a loop of thread, grab the tick as close as possible to the place of its penetration. We tighten the knot and carefully, without sudden movements, pull the parasite up and remove it.
• very often, when pulling out an insect, a head remains in the body. It is also advisable to remove it, having previously treated the bite area with alcohol. In this case, you can use a needle.After removing the head, the wound must be treated with alcohol or iodine. If it is not possible to remove the head, it will come out naturally over time.
• there is another option to block the breathing of the parasite by lubricating it with oil, in which case it will come off by itself. This method is bad in that it complicates the study of the tick for the carrier of the diseases described.

When self-extracting, you must not:

• Do not squeeze the tick, as this can lead to infection of the wound due to squeezing the pathogen together with the insect’s insides.
• the tick must not be torn apart, this can lead to purulent inflammation of the wound with the remains of the parasite.
• Do not try to remove the insect with your teeth, as there is a high probability of oral infection.

After removing the tick, the wound must be treated with alcohol or iodine, the person in contact with the insect should wash his hands with detergents to prevent the spread of infection.

What to do with the extracted parasite.

The best option after removing a tick from human skin is to transfer it for examination.This will make it possible to understand whether the insect is a reservoir for an infectious disease (encephalitis or borreliosis). There are specialized laboratories for this. For Moscow and the Moscow Region, this can be done in the following medical institutions:

• Department of Particularly Dangerous Infections of the Microbiological Laboratory, FGUZ “Center for Hygiene and Epidemiology in Moscow”, located at Grafsky Lane, 4/9, 2nd floor, telephone ( 495) 687-40-47. (Opening hours from Monday to Friday from 9:00 to 15:30, delivery of results – from 15:00 to 18:00.When contacting you, they will specify the exact time, date and where the tick bite occurred.
• Laboratory of especially dangerous infections of the Federal Center for Hygiene and Epidemiology, located at Varshavskoe shosse, 19-a, telephone (495) 952-40-98.
• Laboratory of Highly Dangerous Infections FGUZ “Center for Hygiene and Epidemiology in the Moscow Region”, located at Moscow Region, Mytishchi, st. Semashko, 2,1 floor, contact phone (495) 582-96-56 (Working hours from Monday to Friday from 9:00 to 15:30)

Providing ticks for research is carried out according to certain rules:

• The insect must be placed in a clean container.Since the mites need a moist environment, a cotton pad soaked in water should be placed on the bottom of the container.
• No more than 48 hours have elapsed since the tick is removed.
• Do not treat the tick with any substances (alcohol, oil, etc.).

If it is impossible to conduct a study of the parasite or if a carrier is found in it, it is necessary to donate the blood of the person who has been bitten. The presence of antibodies in the blood will help diagnose the disease in a timely manner without waiting for the onset of symptoms.

Blood can be donated at the laboratory of the FGUZ “Center for Hygiene and Epidemiology” in Moscow (Grafsky per., 4/9, office building, 2nd floor). You can also contact private laboratories, most of which provide such a service on a commercial basis.

Similar laboratories also exist in other regions, please contact them for help. This will save time, and most importantly, nerves. And in case of infection, early diagnosis can improve the chances of salvation.

In order not to face the described problems, it is necessary to protect yourself and others as much as possible from tick bites and subsequent infection.

How to behave correctly in places where ticks accumulate.

The main thing is to follow the well-known and not complicated rules of behavior:

• try to avoid places of possible accumulation of ticks, try to find a place to rest with a small grass cover, or better without it.
• , you can clear a place to rest from bushes and grass, parasites will not sit in low grass, they cannot stand the hot sun.
• do not lie on the grass.
• Wear non-dark solid color clothing. Ticks are better visible on such things.
• The collar and cuffs of the shirt should fit snugly around the body, tuck the pants into the socks, and the shirt into the pants.
• try to cover your neck and head, it is better to give preference to clothes with a hood and overalls.
• do not bring home the branches you just plucked
• Inspect yourself and others for ticks.
• Be sure to shake your clothes in front of the door so as not to introduce parasites on them
• if there were pets in nature, examine them
• Pay great attention to the protection of children, they are more mobile and do not like to wrap themselves too much, the likelihood of a tick bite in children is higher.
• Use special protective equipment.

What protective equipment exist.

There are two main types of protective products – repellents and acaricides.

Repellents are protective ointments, sprays, gels based on diethyltoluamide. The protection time of the repellent is different, depending on the concentration of the active substance (most often it is 2 – 6 hours), and, as a rule, it is indicated on the package. But it should be remembered that with heat and sweat, the duration of action is reduced. Apply these funds to open skin areas. It is necessary to apply a sufficient amount of them, but do not be zealous, it will not bear fruit. These substances are relatively safe and can be used during pregnancy and lactation, as well as in children.

When using repellents, the following rules must be observed:

• Apply the substance only to an open part of the body.
• it is not necessary to apply too much repellent, it will not give any result, the protection will not get better.
• it is forbidden to apply them to damaged skin and mucous membranes.
• must be washed off thoroughly using soap. Do this as soon as you get home.
• if the repellant is in the form of an aerosol, it is necessary to remember the precautions – do not inhale, spray in a well-ventilated place avoiding fire
• when applying aerosol repellent to your face, first apply it to your hands and then to your face with your hands
• Take special care when applying the product to the skin of children.Do not smear your hands with them, as they can bring the protective agent into your mouth. Don’t let them apply the product themselves.

Acaricides are substances based on alphametrin or cypermethrin. Their action on nerve mites. They simply fall off the clothes as a result of paralysis. Acaricides should be applied exclusively to clothing.

There are also products consisting of a combination of repellents and acaricides. The most commonly used active ingredients are cypermethrin and diethyltoluamide.Combined remedies have a wider spectrum of action.

Whichever means of protection you choose, remember that you should always read the instructions before using so as not to harm anyone.

Vaccination as one of the effective means of protection.

If you know in advance about your trip to a high-risk area, you can get vaccinated. This is an effective method of prevention, it allows you to form immunity to viral encephalitis.The vaccine will help to avoid infection or reduce the consequences and make the course of the disease easier.

Vaccines for this virus are obtained by inactivation of the pathogen. Once in the human body, it promotes the production of antibodies, while forming specific immunity. In this case, infection with an inactivated virus is excluded. Vaccination must be done no later than 14 days before travel. The development of protection takes some time.

Today the following vaccines are used in Russia:

1. Tick-borne encephalitis vaccine, purified, concentrated, inactivated dry, (manufactured by FSUE “PIPVE im.M.P. Chumakov RAMS “). It is used by adults and children over three years old. After the first application of the vaccine, revaccination is done after 6 months (after 5-7 months).
2. Klesh-E-Vak (manufactured by FSUE “PIPVE named after MP Chumakov RAMS”). It is used for adults and children over one year old. After the first application of the vaccine, revaccination is done after 1-7 months.
3. EnceVir (produced by the Federal State Unitary Enterprise “NPO” Microgen “of the Ministry of Health of the Russian Federation). The vaccine is used only for adults (over 18 years old). After the first application of the vaccine, revaccination is performed after 6 months (after 5-7 months).

Previously, foreign vaccines were used, but they proved to be ineffective against the Far Eastern strain of the virus. Therefore, their further use was considered inappropriate.

Subsequent revaccinations are performed one year later, then every three years. Accelerated schemes are also provided (the second injection is given after 14 days). Vaccines have contraindications, which must be read in the instructions for the drugs. The vaccine is not given to people who are sick.

If there is no time for vaccination, a special human immunoglobulin can be administered. It can be used just before visiting a dangerous region. Immunoglobulin acts on average for a month.

Of course, vaccination is the most effective means of combating tick-borne encephalitis. Do not forget about other precautions. This issue must be taken seriously, as the consequences of diseases can be dire. Be healthy, take care of your health and the health of people close to you.

Tick bite: signs, symptoms, and consequences.

Tick bite: signs, symptoms, and consequences.

What does a tick bite look like in humans? The season of tick activity begins in spring, it is during this period that most people and animals are at risk of picking up the parasite. Tick ​​season runs from spring to autumn. The tick resembles a tiny bug, its body is only 4 mm long, has 4 pairs of legs, and is covered with a shell on top.Since the arthropod is very small, it is very difficult for a person to see its head and blood-sucking proboscis without special devices. Although the tick has no eyes, it can smell its prey at a distance of 10 meters, thanks to its well-developed sense of smell. The body of the male is smaller than that of the female. The female, having drunk blood, can reach up to 2 cm in size, she is able to drink blood 10 times its own weight. Many people fear that the tick may fall from the tree and dig into the scalp or neck, where it is very difficult to detect it instantly.It is a myth. The tick does not rise above 50 cm from the ground, so this possibility is excluded. Often he waits for a warm-blooded creature in the grass or on a bush, and when it comes closer, it grabs with its front paws and climbs quite quickly. The parasite travels through the body of the victim, choosing for itself the most tasty areas (most often the stomach, neck, ears, armpits). Then he digs into the skin, cutting it with his proboscis, and begins to suck blood. The mark from a tick bite on the human body remains in the form of a small red spot measuring 1 centimeter, unless there is a strong allergic reaction.

The victim’s condition depends on the number of bites and physique. The elderly, children and people with severe and allergic diseases are more difficult to tolerate. Possible signs of a human bite: Redness, itching. Increased body temperature. The appearance of a headache. Lowering blood pressure. Rapid heartbeat. The appearance of skin rashes. Swollen lymph nodes. Constant feeling of weakness. The consequences of an attack depend on whether the parasite is infected or not. The most dangerous for humans is the bite of an encephalitis tick.The consequences of such a bite are extremely serious (in case of infection and refusal of treatment): It paralyzes the body. Breathing problems occur. Deterioration of brain activity. Fatal outcome. If a person has suffered from a sterile tick, then the complications may not be as dangerous: The affected area rotts. An allergic reaction occurs. Edema appears, Quincke’s edema is possible. It is impossible to independently determine whether an infectious tick has stuck or not. Their appearance and color does not depend on whether they are infected or not. If bitten by an infected tick, timely treatment can save the victim’s life.How long does it take for the symptoms of a tick bite in humans to appear?

The first symptoms appear in 2-3 hours in the form of skin redness. After a week or later, the symptoms described above may appear. How is a tick bite different from other insect bites? How to find out which insect has bitten and left characteristic marks on the skin? There will be one speck, there will not be the same in the neighborhood, with every hour the redness will increase, an allergic reaction may be observed.Can a tick just bite a person without sucking its head under the skin? The answer is no. The tick bites only for the purpose of saturation, and for this it needs to catch on well, inject an anesthetic and immerse its proboscis together with its head under the victim’s skin. Males need less blood to saturate, so they can fall off within an hour, but females need a lot of blood, so they can parasitize for up to 6 days and increase in size many times over. Ticks drink blood in order to feed themselves and leave offspring.Females will not be able to lay eggs in a hungry state, she definitely needs blood.

How long can a tick suck blood? From several minutes to several hours, and females, as a rule, stay on the victim’s body longer. It should be borne in mind that most of the time the tick is on the skin of a person or animal in search of a place for sucking, so if the tick has not yet sucked, it must be brushed off as soon as possible (you do not need to press it on yourself like a mosquito, you can bring an infection under the skin) …On average, an adult sucks blood for 1-2 hours, after which it disappears. How much blood can a tick drink at one time? Hungry individuals of the ixodid tick weigh from 2 to 15 mg, and those who are fed from 200 to 1200 mg, which is many times their own weight. In one bite, a tick can pump out up to 1000 mg of human blood. The size of a hungry tick does not exceed 4 mm, and a full one can reach 3 cm, becoming similar in size to a corn seed. Does a tick die after being bitten? Some seriously think that the tick dies after it bites a person, but this is not at all the case.On the contrary, it only benefits from the bite, this is its nutrition, which contributes to further development and reproduction. A hungry tick will not be able to leave offspring, therefore, biting people and animals is a vital necessity for him. Why is a tick bite dangerous for humans?

A tick can serve as a carrier of a rather extensive list of diseases, therefore, having pulled out a tick, it is better to save it for tests to determine infections (encephalitis, borreliosis, called Lyme disease), this is done in a laboratory at an infectious diseases hospital.Scientists have proven that the chance of infection from a tick is unlikely, since 90% of ticks, according to research, are not infected. Although minimal, there is a chance.

First aid. If a tick crawls over you, shake it off immediately, and if it has already sucked, then remove it as soon as possible and save it in a jar with moistened cotton wool or grass blades to bring it alive to the laboratory for studying and diagnosing infections. Treat the wound with an antiseptic.If there are signs of allergy – severe redness and swelling of the bite site, immediately give the victim an antiallergic agent. …

How to remove a tick? An arthropod animal adheres to the human body very firmly, since the saliva of the parasite acts as a hardener. The proboscis digs deeply into the skin, so the tick must be removed very carefully. Step-by-step recommendations for removing the tick: With counterclockwise movements in a circle, as if unscrewing a self-tapping screw, pull it out of the skin with tweezers.Watch carefully so that the tick head does not come off. If you had to remove the bloodsucker in nature, and there were no tweezers nearby, an ordinary thread will help. With its help, the proboscis is tied around the very surface of the skin and is pulled out with light jerks. After removal, you need to make sure that the tick is intact, put it in an airtight container and take it to the sanitary and epidemiological station for analysis as soon as possible. Grease the surface near the bite with any antiseptic. People are often advised to treat the affected area with oil, kerosene, gasoline and other liquids so that the tick gets out on its own.This action is erroneous – the mite will try to sink even deeper under the skin. But if the insect comes out after that, its body will not be able to be examined in the laboratory. What to do if the head of the tick remains under the skin? The head of a tick can remain under the skin in the event of an inadvertent, overly abrupt extraction. It looks like a small splinter, so some treat its extraction with negligence, saying “the tick is dead, the blood no longer sucks, it will fall off by itself” or simply do not notice. But this is not recommended.Remaining under the skin, the tick proboscis will provoke inflammation and suppuration of the wound. Therefore, do not leave the head or proboscis of the tick under the skin, waiting for them to fall off on their own. Take a sharp needle disinfected in alcohol and pry out the remaining proboscis and remove it. After a bite, a small wound will remain on the skin, which will quickly heal if the tick was not infectious. Treat the bite with peroxide, then brilliant green or iodine. If the tick bite is very itchy, use Fenistil gel or a similar itch-relieving agent.Try not to scratch the inflamed area so that the healing process will take place faster. To prevent the head of the tick from remaining under the skin, cling it as close as possible to the place of suction. What disease can be contracted from a tick bite? Subsequently, a tick bite in a person develops various ailments – from ordinary irritation to a serious or fatal illness: Encephalitis: at first, the disease resembles a common cold. The incubation period can last up to a week. No analysis will give one hundred percent information about the infection if 10 days have not passed since the attack.For an accurate diagnosis, you need to bring a live and intact parasite for examination. Borreliosis (Lyme disease): This disease can be transmitted to humans if the tick contains borrelia bacteria. Symptoms do not appear immediately, after a while the lymph nodes increase, the body aches, a red ring appears on the skin.

What is to be done? There is no need to panic, often an elevated body temperature and muscle pain can be a manifestation of a protective psychological response of the body after fear and anxiety.The onset of the disease goes through certain stages: An unreasonable and short chill, an increase in body temperature up to 40 degrees. According to the clinical signs of the formation of encephalitis, this period is more like a flu infection. After a while, the patient may develop symptoms: nausea and vomiting, attacks of severe headache. At this stage, all symptoms indicate an upset gastrointestinal tract. After a few days, the patient will suddenly show symptoms of arthritis or arthrosis. The pains in the head disappear, they are replaced by aches of the whole body.Patient’s movements are very difficult, breathing problems arise. The skin on the face and body turns red and becomes edematous, purulent abscesses appear at the site of the bite. Further, the symptomatology only worsens, because the infection enters the patient’s circulatory system and begins its destructive work. Delay can lead to death! If a tick has been found on the body, it should be removed immediately. This procedure can be carried out on your own or you can go to the hospital.Health workers can easily pull it out and carry out a series of tests. Only in laboratory conditions can it be accurately determined whether this tick is dangerous. If treatment is necessary, you must unconditionally follow the recommendations and prescriptions of the attending physician in order to maximize the effectiveness of the treatment.

Branch of the FBUZ “Center for Hygiene and Epidemiology in the Ryazan Region in the Shilovsky District” NADEZHDA KOLDAEVA

SYMPTOMS OF Tick-borne encephalitis and tick-borne borreliosis

Tick-borne borreliosis

Tick-borne borreliosis is caused by a bacterium that is found in the digestive canal of a tick.Studies carried out in Sweden have shown that up to 30% of ticks carry borreliosis bacteria. Despite this seemingly large percentage, the risk of getting sick after a tick bite is one in 100 cases. However, more than 1000 people in Estonia get sick with tick-borne borreliosis every year. Infection with borreliosis occurs, as a rule, only after two days or more, when the bacteria that have fixed on the skin are transmitted to a person.

How to recognize tick-borne borreliosis?

The most common symptom of borreliosis is Erythema migrans, which occurs at the site of the bite within 1–4 weeks.A typical picture is a red spot about two centimeters in diameter, which is constantly expanding. Sooner or later, the stain disappears. Less commonly, painful phenomena occur in the nervous system, joints, and in some cases in the heart. These symptoms are a sign of the spread of borreliosis infection in the body, and they are not always preceded by the typical reddening of the skin. Symptoms of disturbances in the nervous system may appear several weeks or a month after infection. They can be different: fatigue, headache, nausea, weight loss, mild fever, pain in the arms, legs, neck or back.Sometimes there is unilateral paralysis of the facial nerve, including in children. If the joints are also affected, it is most often expressed as bouts of pain or swelling in one or more joints. It usually involves the knee, ankle, elbow, or wrist joints. Sometimes, several years after the disease with borreliosis, a purple-colored skin lesion occurs, similar to an old frostbite site. It usually occurs on the hands or feet. In the area of ​​damage, pulsating pain occurs or sensitivity decreases.The diagnosis of tick-borne borreliosis is based on medical history and laboratory tests. Treatment is with antibiotics. If typical skin redness or other symptoms appear after a tick bite, you should see your doctor. After suffering borreliosis, unfortunately, immunity does not arise, and a person can become infected again. There is no vaccine against tick-borne borreliosis.

Tick-borne encephalitis

Acute viral disease affecting the central nervous system can cause long-term residual neurological effects.Even a lethal outcome is possible. Residual effects are associated with a deterioration in the quality of life and long-term costs for both the patient and society.
Tick-borne encephalitis is usually diagnosed in the second phase. Mortality from tick-borne encephalitis averages 1%. With age, the severity of the disease deepens: among patients aged 60 and over, the proportion of encephalitis and encephalomyelitis is 70% of cases, and the frequency of residual effects also increases. The mortality rate can be as high as 2.3%.
Vaccination can prevent tick-borne encephalitis.

How to recognize tick-borne encephalitis?

If a person contracted the tick-borne encephalitis virus, then after 1-2 weeks painful phenomena similar to the symptoms of influenza appear: a slight fever with headache and muscle pain. These ailments last up to one week, after which most people recover. However, in about a third of those infected, the virus can enter the brain and meninges, which in turn can cause inflammation of the meninges. The disease worsens, there is a high fever, severe headache, neck stiffness, vomiting, drowsiness and general ill health.If signs of illness appear, consult a doctor immediately!

90,000 signs, what it looks like, how to process it

It’s another matter when a tick transmits a particular virus to a person. There are many diseases they endure, but let’s dwell on the main ones:

Tick-borne encephalitis . It is an infectious viral disease that usually affects the central nervous system.

The incubation (latent) period of encephalitis lasts up to two weeks, but can extend to two months.The disease always begins acutely. The first symptoms of encephalitis: chills, headache, a sharp rise in temperature up to 39 degrees, nausea, vomiting, muscle pain.

Among the possible consequences of this ailment are neurological and psychiatric complications, paralysis and even death.

Borreliosis, or Lyme disease. Another infectious disease that affects the nervous system, heart and joints. The incubation period is usually 1–2 weeks, but can be shorter or longer.The first symptoms of the disease, like encephalitis, resemble the flu: headache, muscle pain, fever. Lyme disease is characterized by stiff neck muscles. Further – worse, sleep and memory disorders, meningitis, paralysis of the facial nerve, arthritis may begin.

If you do not treat borreliosis, you can become disabled, or even die altogether. And if you start to treat on time, then the prognosis is very favorable.

Ehrlichiosis is a bacterial infection that causes renal and respiratory failure.

Symptoms of infection are noticeable 1-3 weeks after the tick bite. Ehrlichiosis is characterized by headache, fever and chills, abdominal pain. If left untreated, the abdominal organs and nervous system will suffer. In severe cases, death is possible.

Anaplasmosis is a blood disease. It develops 3-21 days after the tick bite. The disease is characterized by an acute onset – severe fever, weakness, headache and muscle pain. In addition, blood pressure drops and heart rate drops.

Typhus is a disease that causes a rash on the skin and affects the lymph nodes.

Tularemia is a bacterial disease that affects internal organs.

Tick-borne encephalitis

Tick-borne encephalitis is a viral infection that affects the central nervous system. The disease causes persistent neurological, psychiatric complications and can lead to death. In nature, the tick-borne encephalitis virus is carried by ticks, its foci are recorded in Siberia, the Far East, the Urals, Belarus, and the central regions of Russia.Most often, outbreaks of the disease are observed from May to July, in some areas – additionally in August and September.

Symptoms
The tick-borne encephalitis virus enters the human body in natural conditions. There are two routes of infection – directly through the bite of an ixodid tick or through the consumption of raw milk from infected goats and cows. The tick-borne encephalitis virus is found in insect saliva. Therefore, in the case of the first type of infection, the virus is transmitted at the time of the bite.Even if a tick can be detected and removed immediately, the risk of infection remains, and if you crush the tick on the skin, the risk increases even more, since the virus can penetrate through the wounds. In different areas, the number of infected ticks is not the same, so not every tick bite is dangerous. Infection through goat and cow milk can be avoided altogether if the milk is boiled before use. The incubation period of the tick-borne encephalitis virus lasts 10 – 12 days. The course of the disease depends on the subtype of tick-borne encephalitis.

With the European tick subtype, the onset of the disease can be easily confused with a number of other diseases – the patient complains of malaise, muscle pain, headache, nausea and vomiting, and is disgusted with food. This period lasts 2 – 4 days, after which remission occurs for 8 days. Then, in 20 or 30% of patients, a second phase follows with clearly pronounced signs of damage to the nervous system. The patient goes into a fever, has a severe headache, his neck muscles harden. These symptoms can be supplemented by impaired consciousness, sensory disturbances, uncontrolled motor skills and paralysis.

The second subtype of tick-borne encephalitis – Far East – is more severe, often leading to deaths. The temperature rises to 38 – 39 ° C, there is a sharp headache, nausea, sleep disturbances. Literally after 3 – 5 days, symptoms of damage to the nervous system appear.

Forms of tick-borne encephalitis

In clinical practice, 4 forms of the disease are distinguished:

Feverish. Tick-borne encephalitis virus does not affect the central nervous system, only symptoms of fever appear, namely high fever, weakness and body aches, loss of appetite, headache and nausea. The fever can last up to 10 days. Cerebrospinal fluid does not change, symptoms of damage to the nervous system are absent. The forecast is most favorable.

Meningeal. Against the background of fever, headache, vomiting, photophobia, the muscles of the neck and occiput begin to harden.A lumbar puncture can detect signs of inflammation in the cerebrospinal fluid.

Meningoencephalitic. Characterized by damage to brain cells, which are characterized by impaired consciousness, mental disorders, convulsions, weakness in the limbs, paralysis.

Poliomyelitis. Characterized by damage to the neurons of the cervical spinal cord and outwardly resembles poliomyelitis. The patient has permanent paralysis of the muscles of the neck and arms, which leads to disability.

Diagnosis of tick-borne encephalitis

The difficulty in diagnosing tick-borne encephalitis lies in the fact that it is impossible to make a diagnosis based on external symptoms alone. Outwardly, the ailment resembles a tumor of the central nervous system, purulent processes in the brain, poliomyelitis, vascular pathology of the brain, meningoencephalitis, coma, influenza, hemorrhagic fever with renal syndrome. All these conditions require urgent and special treatment, so the doctor must conduct additional research.

Tick-borne encephalitis is indicated by epidemic data, for example, a visit to the forest. The most reliable results are given by a lumbar puncture, a study of cerebrospinal fluid – they show the presence and nature of damage to the central nervous system. To determine tick-borne encephalitis, tests for antibodies to tick-borne encephalitis, blood tests and cerebrospinal fluid by polymerase chain reactions (PCR) are required.

Treatment

The main method of treating tick-borne encephalitis remains symptomatic therapy and the fight against complications.The patient is prescribed bed rest, antipyretic drugs, corticosteroids, and supportive therapy.

In some cases, the victim is injected with an anti-mite immunoglobulin. But this cannot be considered a panacea: by the time the symptoms of tick-borne encephalitis are clearly visible, the body will already begin to produce its own immunoglobulin.

Prevention of tick-borne encephalitis

The only way to avoid getting sick is to create conditions under which the risk of infection will be reduced to zero.Under natural conditions, anti-epidemic measures are taken to clear the forest, aerial pollination of territories. Before visiting forests in a potentially dangerous period, mushroom pickers, forestry workers, participants in search parties use overalls, lubricate collars and cuffs with odorous substances, and after visiting the forest, they carefully examine their clothes and body in order to detect ticks in time. However, the best measure for the prevention of tick-borne encephalitis was and remains vaccination.

Vaccination against tick-borne encephalitis is shown to everyone, and those who live in epidemic foci or stay in them are required! Vaccination is carried out according to the main or emergency scheme.The main scheme of vaccination against tick-borne encephalitis is carried out with repeated vaccination after 1 – 3, 9 – 12 months and is repeated every 3 years. The first dose is administered in the fall, the second in the winter.

According to the emergency scheme, tick-borne encephalitis vaccination includes two injections with a break of two weeks. The scheme is used for vaccination in the spring and summer. It is worth remembering that an emergency vaccination scheme against tick-borne encephalitis is effective only for one season, after 9 – 12 months it is necessary to give a third injection to the urgently vaccinated ones.

If you have been bitten by a tick

First aid for tick bites.

Due to the presence of analgesic and hemostatic substances in the mites’ saliva, tick bites are practically painless and invisible. The tick bites through the skin and sucks the victim’s blood. With a careful examination of the skin, you can find a small black dot – this is the abdomen of a sucked tick. When trying to tear off the tick from the wound, only the abdomen can come off and the head of the tick can remain deep in the wound.

The most common localization of tick bites:
– the scalp;
– auricles;
– neck;
– clavicle;
– armpits;
– chest;
– hands;
– back;
– groin.
It should be borne in mind that the likelihood of contracting tick-borne encephalitis, tick-borne borreliosis and other infections transmitted by ticks depends on the amount of virus that penetrates during the tick “bite” (that is, the time during which the tick was in a sucked state) – the earlier you remove the ingested parasite , all the better.

For tick bites, take the following measures:
Do not panic, do not try to shake off or pull out the tick with your hand, this can lead to its rupture, while part of the tick (head) will remain in the skin and it will be extremely problematic to pull it out.
The sucked tick must be removed immediately, and in no case should its head be allowed to come off and remain in the human body. Quickly removing a stuck tick can prevent transmission of the pathogen.
In order to remove the tick as best as possible, grab it with tweezers at the beginning of the head and only then pull.
Before trying to pull off a tick, you can moisten it with soapy water or alcohol.

How to remove a tick from a wound correctly?
There are two ways to remove stuck-on mites:

1. The first method: grasping the tick with tweezers or fingers wrapped in gauze (even better protected by rubber gloves), it is removed with slow, smooth twisting movements.It is convenient to remove ticks with curved tweezers or a surgical clamp, in principle any other tweezers will do. In this case, the tick must be grasped as close to the proboscis as possible, then it is carefully pulled up and at the same time rotated around its axis in a convenient direction. Usually, after 1-3 turns, the tick is removed entirely along with the proboscis. If you try to pull out the tick, then there is a high probability of its rupture.

2. The second method: if there are no tweezers or special devices for removing ticks at hand, then the tick can be removed using a thread.A strong thread is tied in a knot, as close as possible to the tick proboscis (between the base of the head and the human skin), the tick is removed by pulling it up. Sudden movements are unacceptable. There are special devices for removing ticks. These devices have an advantage over clamps or tweezers, since the body of the tick is not squeezed, squeezing the contents of the tick into the wound is excluded, this reduces the risk of contracting tick-borne infections. The Uniclean Tick Twister has proven itself well – this device for removing ticks can be purchased in Russia.
If the tick has sunk deeply and cannot be removed, then you can drop a drop of paraffin from the melting candle on the place where the tick is inserted (the paraffin will clog the outlet, block the air access to the tick, and the parasite will soon suffocate, fall off the tissues, and it can be easily removed whole wounds) or a drop of alcohol (alcohol vapors irritate the tick, it cannot suck and it is easier to remove it after that).
Removal of the tick must be done with caution, without squeezing its body, since it is possible to squeeze the contents of the tick together with pathogens into the wound.It is important not to rupture the tick when removing – the remaining part in the skin can cause inflammation and suppuration. It should be borne in mind that when the tick head is torn off, the infection process can continue, since there is a significant concentration of tick-borne encephalitis virus in the salivary glands and ducts.
The place of the tick bite must be treated with alcohol, iodine or brilliant green. Direct contact with the tick should be excluded due to the danger of transmission of infection (it is better to wear gloves before removing the tick).After removing the tick, wash your hands thoroughly with soap and water.
Even if the tick bite was short-lived, the risk of contracting tick-borne infections is not excluded.
A tick can be the source of a fairly large number of diseases, therefore, after removing a tick, save it for testing for tick-borne infections (tick-borne encephalitis, tick-borne borreliosis, if there is a possibility for other infections), usually this can be done in an infectious diseases hospital.
The tick should be placed in a small glass bottle along with a piece of cotton wool slightly moistened with water.Be sure to close the bottle with a tight cap and store it in the refrigerator.

Tick bite: what to do? (Sergiev Posad)

What should I do if bitten by a tick?

ATTENTION: Online medical consultations are available (more than 18 specialties).

A tick bite is an uncomfortable situation that can lead to significant health consequences in the form of deadly complications.

The activity of parasites in nature increases in the warm season, and they can invisibly harm humans.Arthropods live mainly in trees, but they can also be found on bushes and in grass – they are able to adapt to different conditions.

A rather long period of time usually elapses between the bite and the first symptoms of the lesion, and the causative agents of neuroinfections have time to penetrate the bloodstream, causing a number of irreversible changes.

The likelihood of interaction with these blood-sucking parasites makes people panic, but one should not worry without reason – a tick bite does not mean an obligatory infection.It is important to know the precautions, as well as the diagnostic algorithm for recognizing the bite and the order of emergency actions when a parasite is detected. Early detection of the tick and the timely initiation of treatment determine the success of therapeutic measures, while diagnosis in the later stages leads to difficulty in choosing a treatment, irreversible dysfunctions of the central nervous system or the transition to a chronic form. It is also necessary to assess the benefits of vaccination and determine the appropriateness of its implementation.

Why are ticks dangerous?

Tick-borne encephalitis and borreliosis (Lyme disease) are the main diseases that ticks can carry. This list also includes a number of other infections of the peripheral nervous system and the brain. Tick-borne encephalitis is a serious disease with damage to various parts of the nervous structures, which can lead to irreversible changes in the form of paralysis or even death. Borreliosis is also characterized by a complex disorder of the nervous, cardiovascular, and musculoskeletal systems.Parasites can become carriers of the causative agents of hemorrhagic vasculitis, an acute viral disease in which the circulatory system is affected, causing serious complications in the form of internal bleeding.

Signs of pathology after a bite

A careful examination reveals a suspicious area of ​​redness on the skin of exposed parts of the body – the arthropod is not able to get through the clothes. Initially, you may not notice the parasite, especially if it is in the hair.Local immunity initiates the appearance of hyperreactivity – a rounded spot up to 10-20 cm in diameter, which can increase. Also, a characteristic sign of infection with borreliosis is the formation of a well-defined red contour, which can eventually acquire a blue-white tint. A few weeks later, a crust with cicatricial changes forms at the site where the tick bitten.

Immediately after the detection of an arthropod on the skin, it is necessary to establish the stage of its development – the adult form is distinguished by the presence of four pairs of legs, and the nymph larva has only three pairs.It has been studied that a female needs more time to saturate with blood, and an adult can feed for several days.

Timely detection of the parasite at the suction stage avoids the bite, however, in the case of biting through the skin, it is necessary to definitely consult a doctor to monitor possible diseases during the incubation period. This period can take up to two months – the features of the human blood-brain barrier determine the rate of spread of pathogenic viruses or bacteria and the appearance of characteristic symptoms.

The effects of a tick bite and signs of infection vary depending on the form of the disease and the body’s response, but most often appear:

• characteristic swelling and bright redness at the point of contact with the tick;
• increase in body temperature;
• chills;
• general deterioration of health;
• lethargy, drowsiness;
• fast fatigability;
• attacks of nausea;
• photophobia – an unpleasant reaction to bright daylight or artificial light;
• various eruptions in the form of spots, nodules, abscesses;
• Difficulty breathing – shortness of breath on mild exertion;
• sensation of difficulty in movement and aching joints;
• mood changes, emotional instability;
• increased anxiety;
• possible changes in the perception of reality in the form of hallucinations.

Initially, the symptoms of a tick bite may be mild, the skin may look without visual changes, and the symptoms increase later. A vivid clinical picture is typical for children, elderly patients, as well as people with chronic diseases that negatively affect the function of the immune system.

Ordinary people may not feel the signs of a tick bite at first – neuroinfections that are carried by ticks develop rather slowly. Often, the progression of the disease is accompanied by an increase in temperature, increased heart rate, inflammation of the lymph nodes, a rash on the skin, itching in the place where the tick has bitten.

Also, often the bite of an arthropod causes a relatively harmless allergic reaction, which has nothing to do with a serious endemic disease. It is important to see a doctor for differential diagnosis of the conditions. An allergy to a tick bite is accompanied by a vivid local reaction on the skin, nasal congestion, watery eyes, and redness of the eyes.

Tick-borne encephalitis has a number of characteristic symptoms that are dangerous to health and even life. The onset of the disease can resemble the flu – there is a fever, chills, aching joints and muscles.Deterioration of the cardiovascular system leads to interruptions in the work of the heart, arrhythmias, shortness of breath. Patients often complain of changes in the work of the gastrointestinal tract – nausea and vomiting, lack of appetite, loose stools.

Neurological complaints may begin – episodes of changes in consciousness up to epileptic seizures. Despite the fact that different microorganisms become the causative agents of diseases, alarming symptoms in pathologies are similar.

Consequences of non-intervention

The lack of a timely response to a tick bite can lead to the progression of the disease – neuroinfection develops, which often leads to paralysis, meningitis, deadly complications and disabling consequences.It is important to know how dangerous a tick bite is for a person in order to respond to the problem in time.

Self-removal of mites

It is necessary to follow all the principles of the removal technique – it is necessary to remove the arthropod completely alive in order to preserve the possibility of diagnosing for the presence of a virus.

The classic version involves the use of tweezers as the main tool for removing the arthropod parasite. A full-fledged reliable girth of the body prevents the main complication of manipulation – the preservation of the tick head in the thickness of the human skin.Its body should be turned clockwise around the axis – this avoids sudden movements in order to safely remove the whole tick. There is also a method using a sewing thread – a knot is attached to a pincer, and twisting is done by rotating the thread.

Contrary to popular belief, the use of oil solutions only complicates the procedure, while making it impossible to analyze the parasite for the carriage of pathogenic viruses or bacteria.

If, after an attempt to remove, a mark in the form of a dark dot remains on the skin, this may indicate that the head of the arthropod was not removed.You should wipe the bite with alcohol, and then remove the remnants of the parasite.

You can also use iodine or another effective antiseptic to treat the skin. After completing the manipulations, the removed tick must be stored in a glass container with a cotton pad moistened with water. Preservation of the parasite will determine the danger of ticks to humans in this area.

However, it is better to entrust this task to specialists – experienced medical workers know how to quickly and correctly get rid of a tick, then immediately deliver the material for research to the laboratory.

Non-specific prophylaxis of tick bites

Preventive measures must be taken when traveling to endemic areas and disadvantaged forest-steppe regions with a high risk of contracting the parasite.

The main points to reduce the likelihood of tick bites:

• vaccination before traveling to forest-steppe zones;
• maximum cover of all parts of the body with clothing, hats, covered shoes;
• avoiding passage under trees and dense bushes;
• thorough examination of all family members for bites, including the scalp;
• treatment with special external insect repellent agents.

Vaccination against tick-borne encephalitis in the clinic “Paracelsus”

Doctors of the Paracelsus multidisciplinary medical clinic recommend vaccination against tick-borne encephalitis to all people at risk – people who live in endemic zones or are going to come to such territories are vaccinated. The Ministry of Health of Russia has determined a list of vaccines that are allowed for vaccination, some of them are produced by domestic companies, and several are supplied from other countries.

Vaccine administration schedule:

• consultation of a general practitioner and determination of the safety of vaccination;
• the first stage of vaccine administration on a specific day;
• revaccination – after 1-2 months according to the scheme;
• third vaccination – 12 months after the second stage of drug administration.

Vaccination can provide a reliable protective effect to prevent infection of the nervous system and the development of complications, so this method of prevention is necessary for everyone who is more susceptible to tick infection.

“Paracelsus” offers vaccination with the domestic vaccine “EnceVir”, effective against common strains of the virus carried by ticks. The Paracelsus team cares about the health of clients, therefore, before the vaccination, everyone needs to undergo an examination by a therapist and some additional diagnostic methods to assess the general state of health, possible contraindications and the risk of developing complications of vaccination.

Treatment in the center “Paracelsus”

A timely visit to a doctor is the key to preventing severe damage to the nervous system and internal organs, preventing serious complications and minimizing the risk of death.

Only in a medical institution can all conditions be provided for the quick and safe extraction of parasites with subsequent analysis of the tick, as well as comprehensive diagnosis of the victim for transmission of infections.

Medical Center “Paracelsus” is a complex clinic, where specialists from various fields of medicine are receiving appointments. Infectionists and parasitologists of our institution know how to remove a tick correctly, as well as handle the bite site. The study of the tick in order to determine the carriage of pathogens of neuroinfections is necessary for understanding the further tactics of managing the victim from the bite, since changes in his body that are noticeable during the diagnosis may not yet develop.

Further penetration of microorganisms into the human bloodstream causes the formation of specific antibodies, which can be detected by laboratory blood tests.

Even if a long period has passed after the moment of the bite, and complaints have appeared recently, it is better to consult a doctor to exclude dangerous diagnoses and pass the appropriate tests.

Also, a tick bite can cause allergic reactions, become inflamed and complicated by local infectious processes.In all such cases, a doctor’s examination is required with the further appointment of appropriate treatment. The use of antihistamines and topical ointments quickly restores quality of life.

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Tick bite | Mercy.ru

Summer has already declared its rights, which means that the insidious ticks have already woken up and began to actively attack the population.

What are tick borne diseases?

Borreliosis (Lyme disease) is the most common tick-borne infectious disease in the Northern Hemisphere. In Russia, it is found in the forest-steppe zone from Sakhalin to Kaliningrad.

The most common and noticeable symptom of borreliosis is redness at the site of the tick bite (erythema), which usually does not appear earlier than a week after the bite.Redness increases in size and can reach several tens of centimeters in diameter.

In this case, the center may lighten, and the redness may take the form of a ring. If redness occurs at the time of the bite, then this is most likely not a manifestation of borreliosis, but a reaction to a tick bite.

After the tick has been removed, this redness quickly disappears. Borreliosis erythema, on the contrary, increases.In some patients with borreliosis, the appearance of erythema is not accompanied by changes in well-being.

In other patients, on the contrary, the disease can take a non-erythema form and manifest itself exclusively by symptoms of general intoxication: fever, chills, headache, body aches, fatigue.

Symptoms may gradually fade away, however, this does not mean recovery: the causative agent of the disease, Borrelia, spreads throughout the body and can cause damage to the nervous system, joints, and heart.Borreliosis can take on a chronic form, lead to disability and even death.

At an early stage, the disease is easily amenable to antibiotic therapy, therefore, timely seeking medical help is crucial for recovery.

Tick-borne encephalitis is a viral infection characterized by fever, intoxication and damage to the brain and sometimes spinal cord.

The disease can lead to persistent neurological and psychiatric complications and even death of the patient.The traditional areas of the spread of tick-borne encephalitis are Siberia, the Urals, the Far East. At the same time, cases of infection are also found in central Russia, the North-West region, the Volga region.

In the European part of our country, the incidence ranges from 0.02 to 8 cases per 100 thousand population, in the Moscow region this figure is at the lower border. Infection occurs as a result of tick sucking, and sometimes through the ingestion of raw milk from an infected animal (goat or cow), but such cases are extremely rare.

The first symptoms of the disease appear on the 7th – 14th day after the bite: fever, malaise, muscle pain, headache, loss of appetite, nausea or vomiting. After that, relief comes, and for 8 days the patient is not worried about anything.

However, in 20-30% of patients, the second phase follows, accompanied by damage to the central nervous system in the form of meningitis (fever, severe headache, neck muscle stiffness), encephalitis (various disorders of consciousness, sensory disorders, motor disorders up to paralysis), or both.

The most effective prevention of infection after a tick bite is the introduction of anti-tick immunoglobulin (intramuscularly and once). In the presence of contraindications, the drug Anaferon is used, which increases the formation of interferons in the body.

If symptoms persist, seek medical attention immediately. Further treatment will be carried out in the hospital with the use of antiviral immunoglobulins, interferon and ribonuclease preparations. Strict bed rest, rational diet and vitamin therapy are required.

Tick-borne encephalitis is more dangerous than borreliosis, but the risk of contracting borreliosis after a tick bite is much higher than tick-borne encephalitis.

It is also important to know that even if you are bitten by a tick carrying the encephalitis virus, this does not mean that you will certainly get sick. A healthy immune system will fight the virus on its own and quickly. But no matter how confident you are about your immune system, there are simple precautions to take.

Ticks are most dangerous in early summer.Going during this period to the forest, on a camping trip, to the dacha, be sure to wear a hat, a long-sleeved shirt, long trousers, which it is advisable to tuck into socks. It is best to wear clothes made of dense and smooth fabrics: the tick will have nothing to catch on, and it will not be able to penetrate the skin through the dense fabric.

Exposed areas of the body and clothing can be treated with special chemical tick protection. They are divided into repellent (repelling ticks), acaricidal (killing them) and insecticidal-repellent (combined action drugs).

To repellents are “Medilis-mosquitoes”, “Biban”, “Defi-taiga”, “Off! Extreme ”,“ Gall-Rat ”,“ Gal-Rat-Kl ”,“ Deta-Vokko ”,“ Refamid Maximum ”. They are applied to clothing and exposed areas of the body in circular stripes around the knees, ankles and chest.

The tick, avoiding contact with the repellent, begins to crawl in the opposite direction. The protective properties of the processed clothes are preserved for up to five days.

The advantage of repellents is that they can be applied not only to clothing, but also to the skin.Treatment of clothes with acaricidal agents (“Reftamid taiga”, “Picnic-anti-tick”, “Gardeks aerosol extreme”, “Tornado-anti-tick”, “Fumitox-anti-tick”, “Gardex-anti-tick”) provides protection against ticks for up to 14 days, however, it should not be applied to the skin.

Clothes should be laid out and sprayed, wait until they dry, and only then put on. Insecticidal and repellent agents are produced in aerosol packages: Medilis-comfort, Kra-rep, Moskitol-spray. Special protection against ticks “,” Gardexxtrim, aerosol from ticks “,” Tick-kaput aerosol “.

As well as acaricidal, insecticidal-repellent agents are applied only to clothing. When using a product, be sure to read the instructions and follow their directions.

Do not forget to reapply the drug after the time indicated on the package. It must be remembered that rain, wind, heat, sweat, etc. reduce the duration of action of any chemical protective agent.

After returning from a country trip, carefully examine the clothes and body.

The tick bite is almost invisible, because the bloodsucker injects an anesthetic substance into the wound.

Most often, the tick bites into the scalp, neck, skin behind the ears, armpits, groin, but it can be found in any other place.

Never push or pull out the tick, as this may increase the risk of infection.

It is necessary to fill the tick and the skin around it with fat, oil or kerosene and wait a little. It is quite possible that after such processing, it will disappear by itself.If this does not happen, you need to try to remove the tick from the skin, preferably using tweezers with slow, smooth movements so that the head does not come off.

If the head does come off, it must be removed with a needle calcined on a fire (like a splinter). After removing the hand and the bite site, it is necessary to disinfect. Untreated hands should not touch the eyes, mucous membrane of the mouth and nose, take food with them, as in this case, infection with encephalitis can occur through the gastrointestinal tract.

The retrieved tick should be taken to the laboratory for analysis for Borrelia and Encephalitis Virus. It is important to remember that the most effective assistance to the victim is provided within the first 96 hours after the bite.

There is no vaccination against borreliosis, but for the prevention of tick-borne encephalitis, experts recommend vaccination, especially to those persons whose work is associated with staying in the forest and forest-steppe areas of the regions for which this disease is endemic.

As always, immunization against a disease requires a careful individual approach, assessing the balance of the possible benefits of vaccination and the risk of complications.

We have already written on several occasions that the patient himself should carefully read the information leaflet from the manufacturer, enclosed in the package with the doses of the vaccine, and make sure that the medical workers follow all instructions accurately. Why? Yes, here’s a relatively recent example.

Last year, in several cities at once – Chelyabinsk, Vologda, Tyumen – children developed severe malaise after being vaccinated against tick-borne encephalitis with the domestic drug EnceVir.

Children complained of fever, weakness and nausea.The head of Rospotrebnadzor Gennady Onishchenko ordered to suspend the use of this vaccine to immunize children. As a result of the check, it turned out that the quality of the vaccine meets the requirements of the standard, and the problem was that the schoolchildren were vaccinated with an adult dose of the vaccine.

Frankly speaking, the situation is strange: right away in three (!) Cities, nurses made the same mistake, mixing up the dosage. However, it was so or otherwise, and it does not hurt to carefully study the instructions for use, contraindications, data on drug compatibility, information about possible complications, and at the same time ask a question about the dosage administered to you or your child.

Currently, Russia has four vaccines for immunization against tick-borne encephalitis, two domestically produced and two imported.

All four vaccines were obtained by reproduction of the tick-borne encephalitis virus in the weighed primary structure of chicken embryo cells, and also contain aluminum hydroxide as an adjuvant.

This means that those who suffer from allergies and those with a history of neurological diseases should be treated with great caution.Other common contraindications are pregnancy, acute diseases, and chronic ones in an exacerbation stage.

The EnceVir vaccine, which was discussed above, is contraindicated for asthmatics, diabetics, patients with cardiovascular and endocrine diseases, diseases of the blood and connective tissues, rheumatism, epilepsy.

The Russian website dedicated to tick-borne encephalitis provides detailed information about both domestic and imported vaccines. However, it is alarming that there are some discrepancies between the original information leaflet of the FSME-immun inject / junior vaccine and the information contained on the Russian website.

For example, the original leaflet from the manufacturer does not contain the following passage: “According to the current state of scientific knowledge, vaccination is not a source of autoimmune diseases. There is no indication of an increase in the incidence of primary manifestations or exacerbation of autoimmune diseases after vaccination (eg, multiple sclerosis, iridocyclitis). ”

The manufacturer tells us to some extent the opposite: “As with other vaccines, it is impossible to exclude the deterioration in the condition of patients with autoimmune diseases (eg, multiple sclerosis, iridocyclitis) after the introduction of“ FSME Immune Junior ”, therefore, a careful assessment of the balance of the risk of infection is required and possible adverse effects of vaccination. “

The manufacturer’s leaflet also warns that special care is required when vaccinating children with cerebral diseases (eg, infantile cerebral palsy).

Apparently, the safest vaccine is Encepur, especially since a second generation drug is now available, developed on the basis of the previous one, registered in 1991 (children’s version – in 1994) in Germany, taking into account the adverse reactions caused by the first generation vaccine …

In any case, when deciding whether to vaccinate, compare the risk of a serious complication (1 in 100,000 or less) with the risk of developing encephalitis in your area.

Let me remind you that in the Moscow region it is 0.02 per 100,000. Perhaps, in this case, it will be enough to be careful, vigilant and prompt in contacting a doctor in case of a tick bite.

Sources:
Tick-borne borreliosis

Tick-borne encephalitis

Means of protection against ticks

Why are ticks dangerous

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