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Tickborne Disease

1. Can I get Lyme disease from any tick bite?

TERC Answer: First off, you can only get Lyme disease if a tick that is a carrier of the disease-causing microbe bites you. Second, Blacklegged (deer) ticks are the most common type of tick transmitting the Lyme disease bacterium from host to host. In most places in the Northeastern U.S., as many as 20% of Blacklegged tick nymphs and 50% of adult females are infected. If you are bitten by a tick, remove it right away, then identify it. You can have it tested for infection to better assess your risk. Blacklegged ticks attached for less than 24 hrs are not likely to have transmitted any infection.

2. I was bitten by a tick recently and now there is a big red spot. Should I be worried?

Answer: It depends on how recently. Within 3 days of being bitten by a tick, many people will develop a red spot that never expands to bigger than a dime. This is just an allergic reaction to the saliva that the tick is spitting into you. Watch the site, however. If the red spot grows in size over a period of a week or so, to bigger than two inches, then it is likely to be a sign that you are infected with the Lyme disease agent.

3. A couple of weeks ago I went to a walk-in clinic with a reddish round bruise on my ankle. The Dr. treated me with antibiotics as if it were a tick bite. The red mark began to fade the day I started taking the meds. Did I catch the disease in time? Could symptoms return? What should I be looking for? I saw the Dr. within 1-2 days of the "bite". (T.H. Coventry, RI)

TERC Answer: Tick bites can cause small papules up to the size of a nickel. These can be red, raised, and are sometimes itchy. This is in response to saliva that the tick injects while blood feeding, and can be felt as early as 18-24 hrs after the tick attaches. This reaction is not the so-called bulls-eye rash of Lyme disease. The Lyme rash grows larger than 5 cm (2 in) in diameter and does not usually appear before 5-7 days after the tick bite. The Lyme rash typically begins to fade a day or 2 after starting proper antibiotic treatment. If you took 3 weeks of an appropriate antibiotic, you should be fine, if this bruise even was a Lyme disease rash. To protect yourself in the future, consider using personal protection, like clothing only repellents, and if appropriate, treat your yard to reduce tick encounter risk.

Interview: Radio Boston with Dr. Thomas Mather

Meghna Chakrabarti of Radio Boston interviews Dr. Thomas Mather about Lyme disease, the role of deer and mice in tick-borne disease, tick habitat and life cycle, and finally TickSmart prevention strategies. Check out more interviews in our Resources > Interviews section.

Infection on Back

4. The attached picture is of my son's back. Although his pediatrician has diagnosed Lyme disease, do the numerous bullseye-like blotches mean that he was bitten by several ticks? If so, could the Lyme disease effects be worsened by this? M.A. Rhode Island

TERC Answer: Although presenting with numerous bullseye rashes (erythema migrans) like seen on your son is not the norm for Lyme disease, it is a good example of a systemic infection with the Lyme disease agent. The Lyme disease rash (EM) is an inflammatory manifestation of the bacteria spreading out from a central location under the skin usually centered on the tick-bite site. When multiple rashes occur, it is most likely that bacteria spread to multiple skin sites through the blood or lymphatic system, and not from multiple tick bites. Most likely, your son had just one initial tick bite. Systemic infection with the Lyme agent would likely occur a few weeks to even months after the initial tick bite, which may be why there is some cardiac involvement at this time. This may be a case of later-stage Lyme disease and symptoms could be worsened. You are wise to have pursued appropriate testing and treatment with his doctor.

5. Can I still get Lyme disease once there is frost? Patricia, Appleton, WI

TERC Answer: Most people think that bloodsuckers like mosquitoes and ticks disappear along with the risk for disease transmission once there is a frost and the weather turns cooler. That's true for mosquitoes; they either die, or some species go into a feeding diapause. Some ticks also go into a feeding diapause in the autumn, but not deer ticks (Ixodes scapularis) - they are a different type of bug! The adult stage deer tick actually begins its feeding activity about the time of first frost (or early October throughout its range), and it will latch onto any larger host (cat to human) any day that the temperature is near or above freezing.

Typically, the Lyme disease spirochete infection rate in adult female deer ticks is 40-60% in the eastern and mid-western portion of this tick's range. However, these ticks need to be attached for at least 48 hrs before they begin transmitting any infection through their saliva. So, even in the fall it is important to check yourself and your pets daily for any attached ticks, and continue to take precautions like using clothing repellents on you and topical products on your pets.

6. While working in the woods yesterday, myself, my partner and my dog all seemed to have run through a tick nest. I immediately came home and bathed, then showered and my clothes were dumped into the washing machine. My partner did the same. We gave the dog a bath later that evening when we realized we were still finding ticks on us. Then I showered AGAIN. After all that I still found a tick crawling up my inner thigh. I'm sure I've missed some despite thorough checks and multiple showers, is there any other way to get these ticks off? I fear I will never find them in my hairline because I have thick, dark hair and these are tiny, tiny ticks. Should I go through a round of antibiotics for lyme, just in case? SB - Reston, VA

TERC Answer: It sounds like you encountered an egg-batch worth of larval stage Lone Star ticks, sometimes referred to as seed ticks. These larvae hatch from egg masses containing 3,000 or more eggs that all hatch at about the same time. Look closely to see if these tiny ticks have 6 legs or 8. All larval ticks hatch from eggs with just 6 legs, and after a blood meal and molting, the nymph stage emerges with 8 legs.

De-ticking clothes is best done by throwing everything into a hot dryer for 15 minutes, even before washing. The ticks will dessicate. Washing clothes first does not kill them but drying does. To get the larvae off of you and the dog before they bite, we recommend using sticky duct tape as soon as you notice the ticks latched on. If you don't find them until they're already biting, they may not come off as easily and you may need a fine-pointed tweezer to pluck them off. The good news is that larval Lone stars present little risk for pathogen transmission – they hatch from eggs as pathogen-free ticks. Lone Star ticks don't usually transmit Lyme disease anyway, so a round of antibiotics without a disease diagnosis would seem inappropriate.

BTW, this time of year when both larval Lone Stars and larval deer ticks are out, we always have sticky duct tape ready for just such an encounter.

7. Today I pulled out a dog tick out of my scalp. It was relatively easy to pull out as I only used my fingers to slide it out of my hair. At first, I did not know what that is, of course. After looking at it and comparing it to pictures and descriptions I determined it is a dog tick possibly adult, but fairly flat. Can this type of tick transfer any disease? If yes, how long does it need to feed in order to infect a person? Like I said, the tick I pulled out does not appear to had been feeding very long. Aneta, North Aurora, IL

TERC Answer: American dog ticks can be infected with Rocky Mtn Spotted Fever rickettsia, other less pathogenic rickettsia, Colorado Tick Fever virus, and rarely, with the agent of tularemia. However, in your geographic area, the dog tick infection rate is quite low for Rocky Mtn Spotted Fever and the other pathogens are not known to circulate there either. Hopefully, the only concern is a bit of a tick bite.

8. I found an engorged tick on the back of my 3 yr olds scalp. It was identified as an adult fully engorged female dog tick. I'm very concerned because it must have been there for at least a few days. My daughter has a lot of hair. I wash her hair every night, she never complained and I never saw it or felt it when doing her hair. My question is...because I'm told it was probably there for 3-6 days, does that mean she is more likely to contract a disease? I'm reading about Rocky mountain spotted fever & tularemia and wondering how high her risk may be to contract something like this? I don't even know where she may have picked this up. We've only been in our backyard, which is always landscaped. We don't have a dog or cat. She was around my brother's dog a week ago, he lives in a very woodsy area. Please if you can back to me w/ as much info. as possible, I would greatly appreciate...very concerned! Thank You! Jennifer M., Pearl River, NY

TERC Answer: It's true that American Dog ticks can transmit the agents causing Rocky Mtn Spotted Fever and Tularemia, but the incidence of these infections in NY are rare and the tick infection rates are extremely low. While 1 in 4 nymphal deer ticks can infect you with some kind of agent if they feed for more than 36 hrs, typically only about 1 in 1000 dog ticks are carriers of disease-causing pathogens. So, while we cannot say that the risk for infection doesn't exist, it certainly is low.

We've never heard of any tick bite prophylaxis for dog ticks and RMSF or tularemia. We suggest that your most prudent course of action would be to alert your physician regarding the tick bite, become familiar with the symptoms of RMSF and tularemia, and be watchful for signs of disease in your daughter, making sure that you contact your dr if you begin to notice any of the signs of disease. Generally, those 2 bacterial infections will present with acute symptoms in 5 days to 2 weeks.

Dog ticks are making a major come-back after a decade or more of very low population abundance--most likely due to 2 factors: effective spot on treatments of dogs and a decade long decimation of the raccoon populations along the eastern US as a result of a raccoon rabies epizootic. The rabies is still there but it has burned through the most susceptible animals now. Raccoons are the principle natural reproductive host for Am dog ticks.

9. I would love to know the dangers of disease and how to detect them. The tick i removed this morning was there for a long time, not sure how long. It was large and I have a mild headache. Julia I., Woodstock NY

TERC Answer: Your risk for infection with a tick-transmitted disease depends on the species and life-stage of tick, on whether the tick was infected, and on how long it was feeding before you removed it. Do you know what type of tick bit you? In your area of NY, the likely ticks biting now [May, June] are nymphal deer ticks, adult American dog ticks, and possibly a few stragglers of adult deer ticks. The size difference of an engorged nymph and engorged adult tick is striking, even though identifying the species of engorged ticks can be a little more challenging when comparing pictures. The disease risk from a nymph deer tick biting for 2 days is pretty high; about 1 in 4 of these ticks carries some agent that can make you sick--mostly the Lyme disease bacteria. American dog ticks, in contrast, are rarely infected with disease-causing rickettsia; about 1 in 100 or even 1 in 1,000. The first step in risk assessment following a tick bite is correctly identifying the tick. Your current headache is likely unrelated to your current tick bite.

10. I am desperately searching for RI Doctors who can diagnose and treat Lyme and co-infections. Please send me names and locations of specialist in this area.

TERC Answer: South County Hospital has a Lyme Disease Clinic : http://www.schospital.com/OurServices/LymeDiseaseClinic/tabid/322/Default.aspx

The South County Hospital Lyme Disease Clinic treats adults who have experienced chronic Lyme disease symptoms and for whom treatment has not been successful. To be seen at the Lyme Disease Clinic, you must have a referral from a doctor.

The clinic is staffed by Frederic Silverblatt, MD and Jeffrey Bandola, MD. The clinic is part of the Hospital's Infection Prevention and Control Department, headed by Lee Ann Quinn, RN.

11. I was bitten by a tick ten days ago and after removal sent the tick in for testing to the public health lab in the county where I encountered the tick. Today the lab informed me that the tick is the type that can carry lyme disease. However they did not find lyme disease bacteria in the body of the tick. They said that this is not a certain sign that it did not transmit lyme disease to me. They said the tick could have disgorged all the bacterium into my body. I think the tick was in me for about 17 hours, but I can't be certain. I found it in the next morning after being outside in the garden in the late afternoon. I wonder if I should take antibiotics prophylactically. Or is it almost impossible for a tick to bacteria free if it has the bacterium to start with. Thanks for your help. My physician does not know much about the transmittal of this disease. Barbara T., Berkeley, CA

TERC Answer: This doesn't sound quite right to us. We test a lot of ticks for a lot of different pathogens here but have never seen or heard that a negative tick test might result because the tick disgorged all of the bacteria into your body. First, in CA, the most likely tick involved in transmitting Lyme is a western blacklegged tick (Ixodes pacificus). These ticks naturally have a very low infection rate for Borrelia –usually less than 1 in 20. Also, it generally takes these ticks more than 24-36 hours to transmit an infection if they are infected. We can't make the decision about prophylactic treatment for you, but please discuss your likely risk factors with your doctor and decide on your course of action.

Disclaimer: TickEncounter Resource Center FAQ answers come from a variety of expert sources, including Dr. Mather’s nearly 30 years of active tick research and study of tick-borne disease prevention. Our mission is to engage, educate and empower people to take tick bite protection and disease prevention actions. TERC staff are not medical doctors and do not diagnose tick-borne disease or make treatment recommendations. If you are experiencing disease symptoms, please consult a knowledgeable medical doctor to determine treatment methods best for your situation.