I’d like to discuss tick bite and signs and symptoms of Lyme disease.
Neither the tick’s body nor its head burrows into the skin. Instead, the tick attaches by its mouthparts. It is said (but not inconclusively proven) that an infected tick can transmit an infection only after it has been attached, taken blood from its host, and fed for 24 to 48 hours. If you find a tick on you that is unattached and non-engorged, it is also said to be unlikely to have transmitted an infection. Many people believe that a tick can transmit an infection no matter how long it has been attached. Look carefully for the immature nymphal ticks, which are the size of a sesame seed, they are the ones most likely to pass on the infection. It helps to shower after clearing brush or walking in wild lands to help clear off any non attached ticks from your body.
The proper method of removing a tick is to use a fine pair of tweezers and grasp the tick as close to the skin as possible. Pull it straight out, gently but firmly, without jerking or twisting. After removing the tick, wash your hands and the skin around the bite thoroughly with soap and water.
If, after removal, you see anything remaining in the skin, this represents tiny mouthparts of the tick. It is not the tick’s “head” and it cannot increase the risk of transmission of Lyme disease once the tick body is removed. If you are unable to remove the mouth parts easily, as you would a splinter, leave it alone and the skin should eventually heal. If you are concerned see your doctor.
Quite often, after an obvious tick bite, a red rash may develop at the site of the bite within the first 24 to 48 hours. A rash that develops this quickly after the bite is usually an allergic or sensitivity reaction to the saliva of the tick. It rarely grows beyond 2 inches, needs no treatment and disappears within a few days. This immediate type of rash is usually of no concern.
The actual Lyme’s rash, called erythema migrans, is reported to occur in at least 50 percent of infected tick bites. It is described as a red rash that is usually neither itchy nor painful. It develops a few days to a few weeks after a tick bite and is likely to be the first sign of Lyme disease. The rash most often continues to get larger over a period of time and will grow to be well over 2 inches, possibly 8 to 12 inches or more, and may last for several weeks. This rash may sometimes develop a pale appearance in the center, causing a bulls eye shape. Making this even more complicated is the fact that so many with early Lyme disease do not develop the tell tale rash and have to rely on symptoms only.
Either during the time of the rash or shortly thereafter, other symptoms of Lyme disease may appear, which resemble these common flu-like symptoms: fever and chills, malaise (achiness), headache, and achy joints.
The rash and/or the above flu-like symptoms may indicate early Lyme disease and you should see your doctor. When recognized during this early stage, most infections can be adequately treated.
If the above symptoms do not occur, are not recognized, or are not treated properly, then one might develop late Lyme disease which can more severely affect different parts of the body, such as the joints, the nervous system, and the heart, to mention a few. At this stage, months if not years of antibiotic treatment may be necessary.
It is also reported that greater than 50 percent of those with chronic Lyme disease have co- infections with other Lyme-like organisms, such as Babesia, which contribute to a more severe illness, more symptoms, and a longer recovery.
The bottom line is that whether you are aware of a recent tick bite or not, if you develop an unusual, unexplainable rash or if you develop flu-like symptoms (without respiratory symptoms), especially outside of the flu season, you should visit your doctor and discuss the possibility of Lyme disease.
- Terry Hollenbeck, M.D., is a retired urgent care physican at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view previous columns on his website, valleydoctor.wordpress.com, or e-mail th*************@gm***.com.
