When Should I Worry About a Tick Bite?

Reviewed on 9/16/2021

Ticks can transmit infection, but the risk of tick-borne illness is still rare. See a doctor, however, if you have symptoms within a few weeks such as fever, chills, headache, fatigue, muscle aches, joint pain (Lyme disease), rash, and flu-like symptoms.
Ticks can transmit infection, but the risk of tick-borne illness is still rare. See a doctor, however, if you have symptoms within a few weeks such as fever, chills, headache, fatigue, muscle aches, joint pain (Lyme disease), rash, and flu-like symptoms. 

Have you recently been bitten by a tick? Some types of ticks in the United States can transmit infections, however, the risk of acquiring a tick-borne infection is low, even if the tick has been attached, fed, and is actually carrying an infectious agent.

For example, the deer tick that transmits Lyme disease needs to feed for more than 36 hours before it transmits the spirochete that causes Lyme disease, which means the risk of acquiring Lyme disease from an observed tick bite is only about 1.2 to 1.4 percent, even in an area where the disease is common. 

When to See a Doctor

Different tickborne diseases may have similar signs and symptoms. See a doctor if you find a tick attached to you and you are concerned, or you get a tick bite and develop the symptoms of tick-related illnesses within a few weeks such as: 

How Is a Tick Bite Diagnosed?

  • Tick-borne illnesses caused by tick bites are diagnosed with a patient history that includes a known or suspected tick bite and a physical examination. It is helpful if the person is able to tell the doctor about the size and color of the tick, whether it was attached to the skin, if it was engorged with blood, and how long it was attached.
  • Blood tests are used to confirm a diagnosis of certain tick-borne diseases such as anaplasmosis, babesiosis, and Lyme disease. However, for Lyme disease, some people may have a negative result if they are tested soon after being infected and they have not yet developed the antibodies to the illness. 

What Is the Treatment for a Tick Bite?

Treatment for a tick bite starts with removing the tick. This can often be done at home. 

  • Use a set of fine tweezers and grasp the tick as close to the skin surface as possible
  • Pull backwards gently but firmly, using an even, steady pressure
  • Do not: 
    • Jerk or twist as you pull  
    • Squeeze, crush, or puncture the body of the tick, because its bodily fluids may contain infection-causing organisms
    • Use a smoldering match or cigarette, nail polish, petroleum jelly, liquid soap, or kerosene because they could irritate the tick and cause it to behave like a syringe, injecting its potentially infectious bodily fluids into the wound
  • After removing the tick
    • Wash the skin and hands thoroughly with soap and water
    • If any parts of the tick remain in the skin, leave them alone to be expelled on their own

The Infectious Diseases Society of America (IDSA) recommends preventive treatment for tick bites with the antibiotic doxycycline only in people who meet ALL the following criteria:

  • The attached tick is identified as an adult or nymphal Ixodes scapularis (deer) tick, the type of tick that spreads Lyme disease
  • The tick bite occurs in a highly endemic area, meaning an area in which Lyme disease is common
  • The tick is estimated to have been attached for at least 36 hours 
  • Doxycycline is able to be given within 72 hours of tick removal
  • The person is able to take doxycycline 

What Are Complications of a Tick Bite?

Complications of a tick bite include infection with tick-borne diseases, such as: 

  • Anaplasmosis 
  • Babesiosis 
  • Borrelia mayonii infection 
  • Borrelia miyamotoi infection 
  • Bourbon virus infection 
  • Colorado tick fever 
  • Ehrlichiosis 
  • Heartland virus 
  • Lyme disease 
  • Powassan disease 
  • Rickettsia parkeri rickettsiosis 
  • Rocky Mountain spotted fever (RMSF) 
  • STARI (Southern tick-associated rash illness) 
  • Tickborne relapsing fever (TBRF) 
  • Tularemia 
  • 364D rickettsiosis (Rickettsia phillipi, proposed) 

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Reviewed on 9/16/2021
References
https://www.cdc.gov/ticks/index.html

https://www.uptodate.com/contents/what-to-do-after-a-tick-bite-to-prevent-lyme-disease-beyond-the-basics/print