Date: Fri, 24 Aug 2012 07:45:34 -0400
From: “Dr John R Dykers
Subject: Tick diseases – Support Beat the Bite 5K and 1 mile fun run/walk 14 October
Tick bites are good candidates for overtreatment, (Overtreatment is here defined as before diagnostic signs or symptoms or test results are present) but good prevention is even more practical. Keep the ticks off you in the first place, and there are many sprays and simple techniques like tucking pants legs into socks and wearing light colored clothes and long sleeves so you can see the tick, and check yourself carefully after coming from an outdoor excursion. Remember, simple ankle high grass will help ticks get on us, so cut a little closer than is good for the grass!. Guinea hens or Seven dust can greatly reduce the number of ticks around your house.
I used to freeze embedded ticks on patients who came to the office for tick removal, using ethyl chloride, and then careful removal with good tweezers BUT I have read that a cotton swab soaked in liquid soap may be applied to a tick on the skin and remove the tick very easily. PLEASE, anyone with actual experience with this method, post your experience on the Chatlist. The more prompt the removal the less the likelyhood of disease, not only Lyme, but also Ehrlichosis and Rocky Mountain Spotted Fever, this last of which I have nicknamed Jim Tatum Disease.
It was mainly because of Jim Tatum that I advocated overtreatment of tick bites even before Lyme disease was known. Jim Tatum was the famously successful football coach at Maryland who UNC lured to Chapel Hill in a long ago effort to revitalize Carolina football. Jim got sick and was admitted to UNC Hospital and the tick bite was known but the tests for RMSF are slow and non specific. The purists would not treat him without a definite diagnosis and by the time Jim had the diagnostic rash he was too sick to respond to treatment and died. $2.50 worth of tetracycline(this was before doxycycline) given early and he would have been well and back coaching in 24 hours.
Fortunately all three of these diseases respond to tetracycline or doxycycline and they both have few side effects, most of which can be aborted by stopping the medicine. It PROBABLY takes 24 hours after the initial bite of the tick for these infectious organisms to migrate from the carrier tick into the person bitten, BUT that time frame is not an absolute and when one finds a tick embedded, often by feeling the tick itself or the itch, one may not be reasonably certain of when the tick attached itself. IF YOU ARE REASONABLY CERTAIN as your possible exposure is documentedly recent, simply remove the tick quickly(we began by exploring the method of removal) if you can do so easily. Get help if needed to reduce the likelyhood of breaking off part of the tick. Don’t be surprised or alarmed if the bite is a little red and itches for even a few days. If the tick is crawling and has not bitten you, wash it or flick it off outdoors with its brothers and sisters and good riddance!
BUT. If you don’t discover the tick until your bath next day, or someone else finds it on you, or you find it on your child, and it is embedded, you are a bona fide emergency for prompt removal AND beg, if need be, for early treatment with doxycycline 100 mg twice a day for 10 days and RECOGNIZE that this may be overtreatment, but it is so cheap and easy compared with even a 1;10000 (I added an extra zero) chance of contracting any of these 3 diseases, that that is what I would do to myself, and in the absence of certainty, I always applied the Golden Rule to medical decisions. Treatment is a little more problematic in children with developing teeth that may be colored by the cycline, tetra or doxy. Early treatment when the innoculum is small is very unlikely to contribute to the development of antibiotic resistance in the wild infectious agent population. There is no vector for these organisms to interact; we are not treating the deer! Only treating the dear.
Do not be particularly concerned about the type of tick as the science of which species caries which infectious organisms is in flux and has been for 30 years. (but big old dog ticks seem to be the LEAST dangerous!) It is the little ones that drive you crazy and looking for the one so small you can’t find it!
John Dykers
Like many folks in Chatham, I had a number of tick bites this past spring and summer. One of them got quite infected and had what looked like a red bulls eye around it. It lasted that way for over a month. I had no other symptoms. I do not have medical benefits, but have heard so many horror stories, I decided to go to the public health clinic in Siler City. They did not offer any tests or antibiotics. They said that the flu like symptoms from tick borne diseases are very acute, and very obvious, since actual flu season is not in the summer. They said my bulls eye was just an infection from the bite. I have a strong immune system and am not prone to hysterics, but I am confused by so many mixed messages from professionals! Also, I tried the cotton ball soaked in soap method, that went viral on facebook several months ago. It did not work, all it did was give the tick a bath.
Just sign me,
Ticked off in Chatham