Supen Patel, MD

People who spend time outside gardening, hiking, walking the dog, or doing other activities in overgrown, grassy, and wooded areas can come into direct contact with ticks. Ticks are tiny blood-sucking parasites that can carry and spread diseases to humans, dogs, and other animals. While most ticks and tick bites are harmless, some diseases carried by ticks can have debilitating effects.

You will most likely not feel a tick bite. Although a tick bite can cause an itchy bump, like a mosquito bite, most people don’t notice unless an attached tick lingers and grows bigger.

The most common tick-borne disease in the United States is Lyme disease. This infection comes from the black-legged or deer tick, which can carry a spiral-shaped bacteria called Borrelia burgdorferi. Around 30,000 cases of Lyme disease are reported each year, but the disease is estimated to affect over 400,000 people annually.

The symptoms of Lyme disease vary and can overlap. Early symptoms occur in the first one to thirty days after a tick bite. The most common sign is a skin rash called erythema migrans, which begins as a red area on or near the tick bite. The rash doesn’t usually itch, can expand up to 12 inches in diameter, and often looks like a bulls-eye. Other early signs of infection include flu-like symptoms of fever, chills, fatigue, muscle aches and pain, joint or neck stiffness, headaches, and lymph node swelling.

Symptoms progress and become more widespread in the three to ten weeks after a bite. Arthritis can develop in large joints such as knees and ankles, with warmth and tenderness, swelling, and decreased range of motion. Other symptoms can include more skin rashes, brain fog, back and leg pain, numbness and pain in the hands and feet, eye inflammation called conjunctivitis, heart palpitations, muscle weakness in the face, and in rare cases, meningitis.

Lyme disease can be a challenge to diagnose and is called “the great imitator,” as symptoms can mimic other medical conditions. A blood test can indicate Lyme disease a few weeks after a tick bite, but other blood tests may be recommended to rule out other medical conditions such as rheumatoid arthritis, multiple sclerosis, fibromyalgia, or chronic fatigue syndrome. Tests may also include analyzing fluid for infection from a large swollen joint, an EKG for diagnosing arrhythmias, and a spinal tap if meningitis is suspected.

A health care provider can start oral antibiotics, pending lab results, if Lyme disease is suspected. Once a diagnosis of Lyme disease is confirmed, the treatment is typically oral antibiotics and can involve IV antibiotics for neurologic issues or joint infection. Medications for other symptoms may also be indicated. The sooner treatment is started, the more effectively it can alleviate symptoms and decrease the risk of long-term complications.

The high-risk areas for Lyme disease in the United States are the Northeast,

mid-Atlantic, and North Central areas. However, tick-borne diseases are on the rise. Climate change and a warmer environment expands the geographical areas for ticks carrying Lyme disease. In South Carolina, the risk is low, but there are also ‘local’ ticks in our area that carry other diseases including the lone-star tick, Gulf Coast tick, brown dog tick, and the American dog tick. Knowing how to deal with ticks can help decrease your risk of acquiring any type of tick-borne disease.

To avoid ticks and tick bites, keep your yard free of brush, mow regularly, and consider applying an insecticide at the beginning of spring. If visiting the woods or grassy, brushy areas, wear light-colored clothes, socks, close-toed shoes, long sleeves, and pants with pant legs tucked into socks. Spraying insect repellant on feet, ankles, and bare skin is another deterrent for ticks.

Take a shower within two hours of visiting areas populated by ticks. Complete a full body check and look for ticks on the underarms, between fingers and toes, behind the knees, on the neck, around the hairline and top of the head, behind the ears, and inside the belly button. Visually check all other areas of the body, and run fingers gently over the skin. Make sure to check kids and pets too! Transmission of disease does not occur until 24 hours or more of the tick being attached, so showering and doing thorough skin checks after being outdoors are first-line defenses to prevent disease.

If a tick is attached to the skin, stay calm, don’t touch it, and use tweezers to remove the tick. Take the tweezers and grab the tick by the head, close to the skin. Firmly, pull the tick straight out, without twisting or squeezing. Avoid using petroleum jelly, solvents, or a lit match to kill the tick. Either save the tick in a plastic bag for testing or take a clear picture of the tick and then flush it in the toilet. Wash the area with soap and water and apply an antibiotic cream to the area. Contact your health care provider for instructions and call immediately if any symptoms present themselves.

Contacting your health care provider with any tick-related issues can provide early treatment and improved outcomes. Take the time to develop a solid plan for dealing with ticks to decrease the risk of tick bites and transmission of tick-borne diseases for yourself, your family, and your pets.