Watch out for ticks

picture of a tick

Remember to cover up, check for ticks and remove them immediately.

Jeffrey Parsonnet, MD

Many northern New Englanders appreciate a mild winter. So do deer ticks, the tiny carriers of the bacteria that cause Lyme disease, and mice, which carry the ticks. “This winter was relatively mild, so people are anticipating that we’ll be seeing a lot of ticks, but it's very hard to predict,” says Jeffrey Parsonnet, MD, a physician in Infectious Disease and International Health at Dartmouth Hitchcock Medical Center and Dartmouth Hitchcock Clinics.

When a tick bites, it attaches itself to the body, draws blood and unless removed, becomes engorged. Tick bites don’t hurt, and they often go unnoticed but if the tick carries B. burgdorferi (the Lyme bacterium), Lyme disease may develop.

“The classic Lyme disease symptom is an expanding, flat rash that often looks like a bullseye,” says Parsonnet. “Other symptoms are flu-like—aches, stiffness, fatigue—and might develop five to seven days after receiving a bite. More advanced disease might cause swollen joints, infection of nerves responsible for heart rhythm regulation, or neurologic disorders like Bell’s Palsy (partial face paralysis), pain in limbs or rarely, brain infection.”

While Lyme disease can be very serious, it can be prevented and treated.

Prevention begins with keeping ticks off of your body. “When spending time outside, it’s best to wear long pants, socks and long sleeves,” says Parsonnet. “Gardeners should also wear gloves. And insect repellents like DEET really work.”

Tiny ticks might beat those defenses and should be followed by a careful tick check. “Ticks can attach anywhere, so check your entire body and be sure to check your kids,” says Parsonnet. “If you do find a tick, just remove it with a pair of tweezers. Try to remove every part of the tick but don’t worry if little bits are difficult to get. Your body will reject them like it would a splinter.”

Finding and removing ticks promptly can prevent the development of Lyme disease. “A tick needs about 36 hours to transmit the Lyme bacteria,” says Parsonnet. “If you find a tick that has been attached for more than 36 hours, a single, two-pill dose of the antibiotic doxycycline is highly effective at preventing Lyme disease.”

There are times when a patient doesn’t find a tick and never develops the tell-tale rash but experiences other Lyme disease symptoms. “In those cases, many physicians will treat for Lyme disease with a 14-to-21-day course of antibiotics,” says Parsonnet. “There is a diagnostic blood test for Lyme, but it only turns positive a month or so after infection so it's not a useful test in the acute setting."

This summer might be a good one for ticks, but it doesn’t have to be a bad one for people. “Remember to cover up, check for ticks and remove them immediately,” says Parsonnet. “And, if you do get Lyme disease, treatment is highly effective at preventing late complications."