Summertime is one of my favorite seasons. Warm weather, endless outdoor activities, and extra hours of daylight bring the color back to our cheeks after a long winter.
Last weekend, I attended a barbeque in one of Boston’s picturesque suburbs. Guests mingled on a patio adjacent to a well manicured backyard. Deep blue skies, great company, and lemonade combined to make this a perfect summer day, until one guest spotted a tick crawling along her arm. Not long afterwards, another guest discovered a tick traipsing across his neck. These little critters quickly reminded us that the arrival of summer also heralds the arrival of peak tick activity in New England.
Starting in the spring and continuing throughout the fall, I field numerous phone calls from patients reporting of tick bites. Many express concern about their risk for developing Lyme disease.
Lyme disease is the most common tick-borne illness in the United States, and is caused by the bacterium Borrelia burgdorferi. In the northeastern United States, Borrelia burgdorferi is transmitted to humans by the deer tick, Ixodes scapularis.
Deer ticks often reside on tall grasses and shrubbery. They may attach to any part of the human body, but are commonly found in difficult-to-see areas such as the scalp, behind the ears, underneath the armpits, inside the bellybutton, around the waistline, between the legs, and behind the knees.
Measures to prevent tick bites include:
- Avoid walking in tall grasses, brush, or other areas where ticks are abundant.
- Wear protective clothing including long pants and long sleeves when entering wooded areas.
- Apply a repellant containing DEET to skin and clothing.
- Perform routine, full-body tick checks with a mirror after outdoor activities.
- Bathe or shower within 2 hours following exposure to tick environments.
Generally speaking, a tick must be attached for 48 hours or longer to transmit Lyme disease. If you find a tick attached to your skin, do not panic. You have time to ensure proper removal. I recommend the following steps for removal:
- Locate a pair of fine-tipped tweezers or small forceps.
- Grasp the tick as close to the skin as possible.
- Pull straight upwards with firm but steady pressure.
- Do not twist or jerk sideways. This may cause part of the tick to break off and remain in the skin. If this happens, do not worry. Leave it alone and your body will eventually expel the remaining tick part.
- Cleanse the area afterwards with soap and water.
Please call your physician if you discover a tick that may have been attached for 48 hours or longer. They may prescribe a prophylactic dose of antibiotics to reduce your chance of developing Lyme disease.
Note that it is common for some people to develop a small, raised, red rash at the location of the tick bite that is about the size of a penny. This is not Lyme disease, and usually resolves on its own within a few days.
After removing the tick, I recommend observation for the following symptoms and signs:
- Erythema migrans (EM) is an enlarging red rash at the site of the tick bite. An EM rash may become quite large and may develop central clearing, creating a bulls-eye appearance.
- Fever, chills, fatigue, muscle aches and pains, headache, or enlarged lymph nodes.
- EM rashes located elsewhere on the body, joint swelling (such as the knee), Bell’s palsy, or palpitations.
Please call your physician if any of these symptoms develop.
Wishing you a happy and healthy summer,
Brad Weiner, MD
This blog is for informational purposes only. It does not replace medical care from a licensed physician. Please contact your doctor if you have any questions or concerns.