By Josefa Paganuzzi, Thompson & Bender, for NewYork-Presbyterian Lawrence Hospital
Aug. 7, 2019: Tick season is upon us, and the threat of tick-borne disease is on the rise. According to the Centers for Disease Control and Prevention, between 2004 and 2017, the number of reported cases nearly tripled, and researchers discovered seven new tick-borne pathogens with the potential to infect people.
However, with common sense, simple precautions, and vigilance, you and your loved ones can still enjoy time outdoors this summer. Dr. David Goldberg, a board-certified internist and infectious disease specialist at NewYork-Presbyterian Medical Group Westchester and an assistant professor of medicine at Columbia University Medical Center, offers tips on how to keep you and your loved ones safe from tick bites and what to do in the event of a bite.
What should you do if you’ve been bitten by a tick?
Remove the tick by its head with a pair of tweezers. If you cannot remove all the body parts, you should see a doctor to complete the removal.
If the tick has been attached for under 24 hours, there is no need for any treatment. The tick must be attached for at least 24 hours (generally longer) to transmit the Lyme disease bacteria.
If it’s possible that the tick was attached for more than 24 hours, you should call your health care provider. In general, the treatment is one dose of doxycycline as a preemptive treatment (call your doctor for a prescription) (see below for more about treatment).
How can someone tell if they have Lyme disease?
The classic Lyme disease symptom is a gradually expanding red rash, usually flat or only slightly raised, with sharp margins and often (but not always) less redness in the center (the so-called “bullseye” rash). However, many people do not report the rash, either because they don’t have it or because it’s on a part of the body that they cannot see.
In many cases, people experience flu-like symptoms such as fever, headache, muscle aches, joint pains, and malaise. If these symptoms occur in the late spring or summer when the flu season has ended and the Lyme season has begun, you should see a physician for possible Lyme disease.
What precautions can people take to protect themselves from Lyme disease?
The most important way to prevent Lyme disease is to perform a thorough tick check, top to bottom and front to back, in the evening after a day outdoors. If the tick is removed the same day, it’s virtually impossible to get Lyme disease. You should be sure to have a good pair of tweezers on hand. You’ll need either a full-length mirror or the help of a relative or good friend in order to examine the parts of your body you are unable to see.
All children should be thoroughly examined for ticks after a day outdoors if they have spent it in an area where Lyme disease may occur.
You can also apply insect repellent to lower the risk of tick bites. If it isn’t too hot outside, you can wear long sleeves and long pants to protect yourself from tick bites. Ticks do not fly (they quest on the top of tall grasses), so you can also reduce your risk by not lying down in wooded areas.
How is Lyme disease treated?
Early Lyme disease can be successfully treated with an oral antibiotic, either doxycycline, amoxicillin, or cefuroxime. Doxycycline is usually the first choice since it also treats certain other bacteria transmitted by ticks such as Anaplasma and Ehrlichia. The antibiotic is generally given for 21 days, though there is evidence that a 10- or 14-day course of doxycycline may be as effective as a longer course.
If the oral antibiotic is started promptly, the risk of one of the late complications of Lyme disease is extremely low.
Most of the late complications of Lyme disease (with the notable exception of Bell’s palsy) are treated with an intravenous antibiotic, usually ceftriaxone. This is generally managed by a specialist with expertise in Lyme disease.
Pictured here: Dr. David Goldberg.
Photo courtesy NewYork-Presbyterian Lawrence Hospital
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