I got bit by a deer tick yesterday

[Undisclosed]

I pulled a deer tick nymph out of me yesterday, awesome. I'm keeping a close eye in the bite and it's pretty red but no bullseye yet... however I know that's not there 100% of the time.

Is there anything I should be doing right away as precautionary measure?

http://www.aafp.org/afp/2012/0601/p1086.html

Removal of ticks within 24 hours of attachment can usually prevent acquisition of Lyme disease. Fine-tipped forceps are generally recommended for tick removal, with care taken to grasp the tick as close to the skin as possible without compressing the body.41 For engorged ticks or ticks that have been presumed to be attached for 36 hours or longer, antimicrobial prophylaxis with a single 200-mg dose of doxycycline is recommended for adults if it can be given within 72 hours of tick removal and there is at least a 20 percent rate of tick infection with B. burgdorferi in the area (e.g., any location within the top 12 endemic states).20,41Children eight years or older also may be given a single dose of 4 mg per kg of doxycycline (maximal dose of 200 mg) for prophylaxis.

Perhaps, a visit to your doctor would be the best thing at this point.

 

[brenda]

There is much dispute over what to do. One should not depend on one source of information. There is the official line which should always be regarded with suspicion especially when it concerns conditions that become very expensive to treat like Lyme and the line that experience shows is necessary. It is best to go onto forums that deal with Lyme alone in order to get a fuller picture and speak to a larger number of sufferers.

On them you will find that my advice is the general one, if it has not become more stringent that is.

 

[Undisclosed]

There is much dispute over what to do. One should not depend on one source of information. There is the official line which should always be regarded with suspicion especially when it concerns conditions that become very expensive to treat like Lyme and the line that experience shows is necessary. It is best to go onto forums that deal with Lyme alone in order to get a fuller picture and speak to a larger number of sufferers.

On them you will find that my advice is the general one, if it has not become more stringent that is.

(Mod note -- we do have a rule regarding diagnosing and prescribing).

We don't even know at this point if the tick even carried any infective organisms. If a person is bitten by a tick, it doesn't automatically mean they are infected, just like everyone bitten by a mosquito doesn't automatically get malaria. The tick, if it was infected, may not have infected aerose91. When one needs an answer to a medical problem, one can both see what others think on a forum and consult a physician/specialist to figure out the best course of action according to what they want to happen and considering their own unique health status.

If I were in this position because I am already chronically ill, I would go to my doctor and discuss doxy and tell her that I would like a course just in case because I am not willing to risk any further deterioration in my health. That would be my precaution to take. I am sure others might go a different route.

 

[brenda]

I never said not to consult a doctor, though they often are not very well informed on treating Lyme effectively and will only give a week or two of doxy at a lower dose than is needed. This is one of the reasons so many have chronic Lyme. People on here are mainly those who have found out later and are taking antibiotics which is why I say go to a Lyme forum to get a fuller picture and especially of those who tried the medical route that Kina is suggesting and later on find they still have it. Once they do that they are less likely to be hanging around here.

 

[adreno]

I am certainly no expert on the matter, but the two studies I could find both concluded 10 days of treatment to be sufficient:

Extending treatment with doxycycline from 10 to 20 days or adding one dose of ceftriaxone to the beginning of a 10-day course of doxycycline did not enhance therapeutic efficacy in patients with erythema migrans. Regardless of regimen, objective evidence of treatment failure was extremely rare.

Duration of antibiotic therapy for early Lyme disease. A randomized, double-blind, placebo-controlled trial.

Patients treated for 10 days with antibiotic therapy for early Lyme disease have long-term outcomes similar to those of patients treated with longer courses. Treatment failure after appropriately targeted short-course therapy, if it occurs, is exceedingly rare.

Antibiotic treatment duration and long-term outcomes of patients with early lyme disease from a lyme disease-hyperendemic area.


Anyone seen other data on this?

 

[duncan]

I think Kina and Brenda are both correct.

If it were a family member of mine, I'd say act proactively and start oral abx. It may be you have to nudge your doctor to do that.

The problem is prophylactic treatment is still the exception rather than the rule, at least in the U.S. Depending on where you live, most clinicians will sit tight and wait to see if you find a bulls-eye or develop other symptoms. You are in Europe - do you know if you are in an endemic area? This may matter, because the odds of whether a tick is carrying Borrelia - and accordingly possibly can pass on the infection to you - increase/decrease based on where you live. For instance, a tick from Texas is less likely to carry the agent of Lyme than a tick from, say, Hudson valley NY, where up to 50% of ticks recently tested positive for Lyme.

A problem for you, adreno, is that your current array of symptoms mimic many of Lyme's. So how will you know, if you fail to be lucky enough to get an EM? Acute Lyme, though, usually comes with a fever, and throwing up etc - it should be hard to miss. Not everyone who draws Lyme presents with acute symptoms, though.

So, long-winded way of saying odds are, you won't contract Lyme. But you may wish to consider talking to your doctor about treating prophylactically.

 

[valentinelynx]

That's not what I'm reading. Even if the tick is infected, the bacteria is usually not transfered, unless the tick is attached for at least 24 hours (which I don't think it was)

I ready recently that Powassan virus can be transmitted by deer ticks and can be transmitted in minutes. The "24" or "48" hours needed for attachment for transmission only applied to borrelia (Lyme) infection, not other tick borne diseases, e.g. babesia, bartonella, ehrlichia...

I would err on the side of caution. A few weeks of doxycycline 20 years ago would likely have saved me 20 years of misery.

 

[adreno]

Doxy won't help if it's a virus, though. But I get your point.

I went to the doctor here and was told that lyme symptoms takes weeks to develop. She said it was probably an unrelated virus causing my symptoms. Come back after a few weeks if you get neuro symptoms (like paralysis, etc). Exactly what I want to avoid!

She also let me follow her pen with my eyes, and hammered on my knees to check reflexes. Then concluded everything was "fine". Took a CRP which was normal. I told her I had sore neck glands, which she kept referring to as a sore throat (=a virus).

 

[Valentijn]

@adreno - A precautionary course of antibiotics is pretty damned standard for tick bites these days, especially if there's any symptoms. Any chance you can get a different doctor who's less interested in gambling with your long-term health?

I'm also pretty sure she's wrong, in regards to Lyme symptoms taking weeks to develop. Some (neurological) might take a while, but others (immune reaction) should be happening pretty fast. Or does she think that the bulls' eye rash takes several weeks?

 

[adreno]

@adreno - A precautionary course of antibiotics is pretty damned standard for tick bites these days, especially if there's any symptoms. Any chance you can get a different doctor who's less interested in gambling with your long-term health?

I'm also pretty sure she's wrong, in regards to Lyme symptoms taking weeks to develop. Some (neurological) might take a while, but others (immune reaction) should be happening pretty fast. Or does she think that the bulls' eye rash takes several weeks?

Actually, I went and ordered some doxy online. Also, a member of the forum was so kind as to send me some by mail, so I can get started right away. What do we need doctors for, when we have PR?

 

[Sidereal]

Actually, I went and ordered some doxy online. Also, a member of the forum was so kind as to send me some by mail, so I can get started right away.

Excellent.

 

[sianrecovery]

Knowing what I do now, I would certainly be proactive - in exactly the way you describe. This is an emergent strand of disease, woefully unstudied and bogged down in politics. Antibiotics are no means a cost-free option - cost in terms of physical effects - but had I been given the choice, I would certainly have taken a course rather than try to eradicate the bugs years on.
Meanwhile - anyone reading this - wear light-coloured clothes so ticks are easy to spot, use a repellent you can live with, and keep your socks tucked into your trousers and have long sleeves. Don't make it easy for the blighters to get a free blood meal.

 

[Aerose91]

Actually, I went and ordered some doxy online. Also, a member of the forum was so kind as to send me some by mail, so I can get started right away. What do we need doctors for, when we have PR?

I'm glad u got the meds. I was about to offer to send u a prescription of doxy that I just got myself. Let me know if u may need it in the future

 

[adreno]

An update :

I had the tick tested, and it was infected with rickettsia, but not borrelia. Also tested negative for erlichia and babesia.

Any dose recommendations for rickettsia? Standard dosing seems to be 100mg doxy BID for 7 days:

The recommended dosage of doxycycline is 100 mg orally or intravenously twice a day for adults, and 2.2 mg per kg orally or intravenously twice a day for children who weigh less than 100 lb (45.4 kg). Although the optimal duration of therapy has not been established, a five- to seven-day course is recommended for RMSF and HME after the fever subsides. A 10- to 14-day course is recommended for HGA.

http://www.aafp.org/afp/2007/0701/p137.html

 

[adreno]

ILADS recommends 100-200mg BID for 20 days (for lyme prophylaxis):

Clinicians should promptly offer antibiotic prophylaxis for known Ixodes tick bites in which there is evidence of tick feeding, regardless of the degree of tick engorgement or the infection rate in the local tick population. The preferred regimen is 100–200 mg of doxycycline, twice daily for 20 days. Other treatment options may be appropriate on an individualized basis (Recommendation, very low-quality evidence).

Read More: http://informahealthcare.com/doi/full/10.1586/14787210.2014.940900

 

[brenda]

For myself, l would not take any lab test to be 100% as they make errors quite often, and with something as horrendous as chronic lyme l would be stuffing that doxy down at the recommended dose for Lyme.

 

[Aerose91]

For myself, l would not take any lab test to be 100% as they make errors quite often, and with something as horrendous as chronic lyme l would be stuffing that doxy down at the recommended dose for Lyme.

Is the testing of the tick itself as inaccurate as the tests for infections in a human?

 

[brenda]

Is the testing of the tick itself as inaccurate as the tests for infections in a human?

I do not know anything about the testing of ticks, but false negative tests are very possible I would say as in humans.

 

[Valentijn]

I do not know anything about the testing of ticks, but false negative tests are very possible I would say as in humans.

Actually I'm pretty sure that testing the tick is the most accurate option. It shouldn't be missing pathogens, aside from the ones which aren't tested for.

 

[adreno]

The PCR tests are extremely accurate:

Under laboratory conditions, these tests are better than 99.9% accurate at detecting as few as three copies of the targeted molecule.

https://ag.umass.edu/services/tick-borne-disease-diagnostics

I'm more worried about the pathogens they don't test for (or are unknown).