by Kim, SpiroChicks co-founder
Last week, I got this message from a friend on Facebook:
"Hey, we're on vacation and wife insisted that I send u a message. I pulled a deer tick out of my thigh 2 weeks ago. Big itchy spot at site now. no big ring. Kinda achy. How late is too late to be tested and start antibios if needed? So sorry to bother you with this, but wife worries a lot.”
There does seem to be a lot of confusion around what to do if you get a tick bite. And given my experience down the long, rutted, windy, washed out road of chronic Lyme, knowing that if I could change the past I would (i.e. eradicated the buggers before a deep set infection requiring YEARS of antibiotics set in), I wrote back: GO TO URGENT CARE AND GET ON ANTIBIOTICS ASAP. Then find an LLMD when you get home.
So for next time, you or I get a message like this, here's a post you can refer your friends and family to. The best resource out there is Dr. Burrascano's Advanced Topics in Lyme Disease from the International Lyme And Associated Diseases Society site. On page 19, He reccomends antibiotics for 28 days if you just get a tick bite, and six weeks if there's a rash. In the Appendix on page 32, is the rational for treating ANY tick bite:
RATIONALE FOR TREATING TICK BITES
Prophylactic antibiotic treatment upon a known tick bite is recommended for those who fit the following categories:
1. People at higher health risk bitten by an unknown type of tick or tick capable of transmitting Borrelia burgdorferi, e.g., pregnant women, babies and young children, people with serious health problems, and those who are immunodeficient.
2. Persons bitten in an area highly endemic for Lyme Borreliosis by an unidentified tick or tick capable of transmitting B. burgdorferi.
3. Persons bitten by a tick capable of transmitting B. burgdorferi, where the tick is engorged, or the attachment duration of the tick is greater than four hours, and/or the tick was improperly removed. This means when the body of the tick is squeezed upon removal, irritated with toxic chemicals in an effort to get it to back out, or disrupted in such a way that its contents were allowed to contact the bite wound. Such practices increase the risk of disease transmission.
4. A patient, when bitten by a known tick, clearly requests oral prophylaxis and understands the risks. This is a case-by-case decision.
The physician cannot rely on a laboratory test or clinical finding at the time of the bite to definitely rule in or rule out Lyme Disease infection, so must use clinical judgment as to whether to use antibiotic prophylaxis. Testing the tick itself for the presence of the spirochete, even with PCR technology, is helpful but not 100% reliable.
An established infection by B. burgdorferi can have serious, long-standing or permanent, and painful medical consequences, and be expensive to treat. Since the likelihood of harm arising from prophylactically applied anti-spirochetal antibiotics is low, and since treatment is inexpensive and painless, it follows that the risk- benefit ratio favors tick bite prophylaxis.