What to do with a tick bite

Last update: 2022-05-11

2022-05-11

The course of action to be taken in the event of a tick bite can vary greatly depending on the specific circumstances of the incident. Sometimes it is enough to simply remove the parasite from the skin and throw it away, and in other cases you need to try to carefully remove it from the skin alive, place it in a hermetically sealed container, treat the wound at the site of the bite, and then rush to the medical facility along with the preserved parasite.

Such differences in actions are due to the fact that in different situations the danger of a tick bite is not the same. For example, in areas endemic for tick-borne encephalitis or Lyme borreliosis, people should do everything possible to minimize the risk of severe consequences from contracting the infection. Sometimes it can be quite troublesome, but any time spent in this case is justified.

Next, we will step by step consider the tactics that should be followed when a tick is found on the body. If you correctly and in time remove the parasite from yourself, as well as implement a number of preventive measures, then even in the most unfavorable situation, the chances of encountering serious complications after a tick bite will be minimal ...

Why tick bites are dangerous and why they require special attention

The main reason why bites ixodid ticks much more important than, for example, the bites of bedbugs, fleas or mosquitoes is attached to the ability of individual individuals of these parasites to infect humans with deadly diseases: tick-borne encephalitis, borreliosis, spotted fever and some others.

Tick-borne encephalitis (TBE) is considered the most formidable disease, since it leads to the development of disability (usually associated with mental disorders) and deaths much more often than all others. In addition, the causative agent of TBE is a viral infection, against which there are currently no specific drugs and which, because of this, is more difficult to treat.

Lyme borreliosis is known for its high prevalence throughout the world. If the rules of diagnosis and treatment are violated, it can also lead to disability and death, but with the right approach to combating it, it is treated quickly and successfully.

On a note

Other infections transmitted by ticks (at least in Eurasia) are much rarer, and cases of fatal outcomes during their development are rare. On the one hand, due to this, they are considered less significant, on the other hand, it is precisely in the fact that they are given less importance, and their cunning lies. With them, they rarely turn to doctors on time, medical errors often occur, resulting in a severe course of these diseases and, as a result, complications.

See also article How to distinguish an encephalitic tick from a common (non-infectious) parasite.

It is important to understand that in some cases, a person may die or become permanently disabled from the consequences of a tick bite., and in almost any region, even one in which tick-borne encephalitis is not noted - from the same borreliosis, for example.The chances of not getting infected at all or easily transferring the disease are high, however, even a small probability of a threat to life justifies the rather troublesome measures that must be taken after a tick bite.

The first step is to remove the tick immediately.

It must be understood that if the tick has not yet stuck, but is found only crawling over the body in search of a place of attachment, then it can simply be brushed off. It is not dangerous and is not fraught with infection. The danger is precisely the bite of the tick, that is, when the integrity of the human skin is violated, followed by bloodsucking.

It is also possible that a tick is detected immediately at the moment of cutting through the skin - when it has formally already bitten, but has not yet sucked. There is a short period during which the mouth apparatus of the parasite, although it is in the skin, does not yet secrete saliva into the wound. Therefore, the infection has not yet occurred.

However, in practice, it is impossible to understand whether the tick has already managed to secrete infected saliva into the wound, and it is pointless to make any guesses in such a situation. Therefore, it is recommended to consider that if the tick has already pierced the skin, then it could well transmit the infection.

On a note

Some experts believe that the risk of infection is less likely if the encephalitic mite is removed within the first 24 hours after being bitten, and greatly increases if the parasite has survived in the skin for more than 48 hours. Such data are not devoid of logic, since the intensity of nutrition and fluid exchange between the parasite and the host increases precisely by the middle of the attachment period.

If the tick has already stuck, it is not so easy to remove it without some skill. Certain difficulties are associated with several factors:

Ticks are able to hold onto the host's skin very tightly (see more details). how a tick bites and what happens). The parasite bursts the skin at the site of the bite with its jaws, and in many species around the proboscis (having many notches) a cement case is formed from hardened saliva, which fixes the parasite very rigidly. As a result, tearing the tick's body is often easier than tearing its mouthparts off the skin. However, such a development of events should not be allowed - the parasite should be taken out entirely;
At tick extraction you can not squeeze his body, pierce or stretch, because with all such manipulations, the parasite secretes additional portions of saliva (possibly infected) into the wound.

The photographs below show a tick's proboscis, dotted with notches:

In many cases, another factor that complicates the extraction of a tick is the person's own fear of this procedure. In practice, many people, due to inexperience, can prepare for this action for half an hour, smear the parasite with oil, try to burn it with alcohol, etc. And all this time, the bloodsucker continues to secrete its saliva under the skin, possibly along with infectious agents.

Therefore, the first rule: efficiency is important when removing a tick. If the choice is between pulling out the tick in a second with tweezers, and smearing the parasite with kerosene, and then waiting two hours for it to finally suffocate and unhook itself (this, by the way, will not happen), then it’s better to just pull it out .

Actually, this is exactly what experienced tourists, fishermen and hunters do. Seeing a sucking tick, an experienced person immediately grabs it with his nails under the body, right next to the skin, and pulls it out.If at the same time the head remains in the skin, then it is immediately removed with a needle, like a splinter.

It takes 2-3 seconds to remove the tick, and another minute to remove the head from the skin. At the same time, the head itself remains in the skin very rarely - in one case out of several hundred bites, and if this happens, then it no longer poses an infectious danger, since all the glands that secrete infected fluids remain in the detached body of the parasite.

On a note

Partly because of the rarity of blown heads, many hunters find it impractical to buy and carry special tickeders. If an experienced person is bitten by 10-15 ticks in one season, then in a few years he may have a situation where the head of the parasite remains in the skin. Moreover, this situation is identical in danger to getting a splinter under the skin.

For a person who encounters a tick for the first or second time in his life, it is better to remove the stuck parasite with the help of special devices. Such devices are not intended for pulling out, but for twisting the parasite - it is during the rotation of the gnatosomes that the fixation of the oral organs in the cement case weakens, after which the bloodsucker does not even need to be pulled, since it falls off by itself.

These twisting devices include:

Hook extractors like Tick Twister, Trixie Tick Remover and similar. They are very simple, inexpensive and easy to use;
Pliers in the form of special tweezers;
Spoon extractor, on the “scoop” of which there is a small slot, which captures the tick for further twisting;
Special lasso handles, in which a loop of fishing line is thrown onto the tick, tightened, and then the parasite is twisted out with a rotational movement;
Handles with tweezers at the end, and the tweezers open when the cap is pressed, and when released, they are compressed. The tick is grasped with forceps and rotated;
Flat key wrenches, convenient to carry in a wallet, but less convenient to remove parasites than hooks.

Also, the simplest mite can be made independently - at home or in nature. For example, a flat wooden stick with a wedge-shaped slot at the end makes it possible to effectively unscrew the parasite, similar to commercially produced pincers.

It is also useful to read: How to unscrew the tick and in which direction it should be twisted

The actual removal of the tick occurs as follows:

The extractor is wound up with a cut under the tick and rests against it so that the edges of the cut are tightly pressed against the body of the parasite and fixed it;
The device begins to rotate in an arbitrary direction around the axis of the body of the parasite (it does not matter in which direction to unscrew the tick - clockwise or counterclockwise). As a result, the tick begins to rotate along with the twister;
After 2-3 revolutions, the parasite usually falls out on its own. If this does not happen, then you can make another 2-3 turns in the same direction and try to smoothly and easily pull the tool up. If the parasite is not removed, then the sequence is repeated again - scroll 2-3 full turns, then lightly pull.

On a note

Both at home and in nature, it is convenient to use an ordinary thread - a loop is made on it and pounces on the head of the tick under its body. Then it is tightened around the head at the point of contact of the body of the parasite with the skin. After that, the ends of the thread are twisted one around the other with rubbing movements of the fingers.At a certain moment, the body of the tick will begin to rotate along with them, which after a few revolutions will fall out of the skin.

If there are no devices at hand at all, then you can grab the bloodsucker with your nails under the torso, try to squeeze the head (without squeezing the body itself), make rotational movements in one direction and the other to loosen the grip of the proboscis, and then smoothly pull it out of the skin.

What not to do when removing a tick:

It is impossible to squeeze the body of a stuck parasite with either tools or fingers. With pressure on it, additional portions of saliva are squeezed into the wound, which is undesirable;
You can not leave a tick in the skin for a long time - the longer the parasite sucks blood, the higher the risk of human infection;
You can not fill the tick with oil, cauterize it, put lotions with kerosene or repellent on it, in the expectation that it will detach itself. It will not detach: it will either be completely saturated in a few days and only then detach itself, or it will die right in the skin. In the latter case, it will still have to be deleted, only already dead.

If, nevertheless, during extraction, the mouth organs of the bloodsucker remained in the skin (they look like a small black dot in the center of the wound), it is quite easy to remove them with a simple needle or nail scissors - just like a splinter is removed.

What to do with the parasite immediately after removal

After removing the tick from the skin, further actions are based on the risk of developing a tick infection:

If the area is known not to be endemic for tick-borne encephalitis and Lyme borreliosis, the tick is usually discarded;
If an area is endemic for TBE, but the bitten person has tick-borne encephalitis vaccine, then the tick is again thrown away.If there is no vaccination, then the parasite is kept for later analysis.

First of all, the risk of infection with tick-borne encephalitis is taken into account. The study of a tick for infection with its borreliosis is not always carried out (although it is useful to do this) - emergency prevention of borreliosis is not carried out, and the disease itself, if it develops, is relatively easy to treat (it is only important to monitor your well-being in order to recognize the alarming symptoms in time, which will be discussed a little below).

On a note

It is possible to hand over a tick for analysis of infection with its causative agents of borreliosis for complacency - if the pathogen is not detected, then there will be no reason for concern.

If the tick needs to be preserved, then it is placed in any hermetically sealed container, a moist cotton wool is placed there and carefully corked. It is desirable that the parasite be alive and unharmed, but even if it was crushed or torn apart during extraction, its remains should also be preserved - they are quite suitable for analysis.

Then, as quickly as possible, the tick must be delivered to the laboratory for research. They will be able to determine whether the parasite is infected with an infection.

The next step is competent disinfection of the wound.

Immediately after removing the tick, the bite site must be treated with an antiseptic solution - for example, an alcoholic solution of iodine, "brilliant green", hydrogen peroxide, miramistin or chlorhesidin (in extreme cases, just alcohol or vodka). This will not prevent tick-borne infection, but it will protect against secondary infection by bacteria that may be on the skin and enter the wound.

It is not necessary to apply bandages and seal the bite with a plaster.The wound almost never bleeds, but it can be very itchy and itchy. If the tick has had time to get enough, unhook and crawl away on its own, the wound in the form of a dot at the site of the skin puncture will have a characteristic appearance, which will make it easy to distinguish a tick bite, for example, from a mosquito bite.

You should not try to squeeze ichor or blood out of the wound - this will not help to remove the infection if it got there, but will only contribute to the accelerated spread of pathogens to nearby tissues. Also, do not cauterize the bite site or pick it open to pour antiseptic inside.

If a red spot appears at the site of the bite, which is very painful or itchy, painkillers are usually used (Menovazan, Lidocaine, Fenistil-gel). When a rash and signs of allergy appear, the skin is treated with Advantan, Suprastin is given to the victim (in rare cases, hospitalization may be required, especially if the child has signs of urticaria).

Thus, first aid for a tick bite does not involve taking any powerful antiviral agents or antibiotics. After the PMP, no special wound care is required: you can wash yourself, you can wet the bite site with water and keep it in the sun - this will not have any effect on the condition of the victim.

Tick analysis for infection

It may be advisable to test a tick for infection, if only in order to completely remove concerns about the risk of infection in the event of a negative result. However, even if the tick was infected, this does not mean at all that the bitten person will certainly get sick - that is, a positive test result is not a basis for starting treatment.

Tick analysis for tick-borne encephalitis virus infection is carried out in microbiological laboratories at various hospitals and clinics, as well as in commercial laboratories. In each city, in the help desk or by calling the ambulance number, you can find out the address of such a laboratory.

The study of a tick usually lasts 2-3 days and costs about 500-700 rubles. The analysis is carried out if the tick was delivered for testing no later than the third day after the bite.

Before analysis, the tick does not need to be frozen, alcoholized and tried to be fed with something. It is enough to place it in a hermetically sealed container with a piece of damp cotton wool.

Moreover, if the bite occurred in an endemic region, and the medical facility has drugs for emergency prevention of tick-borne encephalitis, then the victim will most likely be given it right away - in case the tick still turns out to be encephalitic.

On a note

Emergency prevention of tick-borne encephalitis by the introduction of immunoglobulin is effective only in the first 4 days after the bite. After this time, the procedure no longer makes sense.

If the tick, according to the results of the study, turned out to be a carrier of the tick-borne encephalitis virus, then it is necessary to carefully monitor the condition of the victim for at least a month. In addition, 2 weeks after the bite, you should donate blood to determine antibodies to the tick-borne encephalitis virus. It is pointless to take tests earlier than 10 days, since the result will certainly be negative (antibodies will not yet have time to form in sufficient concentration).

It is also useful to read: Dangerous consequences of a tick bite

Emergency prevention of tick-borne encephalitis

Emergency prevention of tick-borne encephalitis consists in the introduction into the body of the victim of serum with antibodies to the virus-causative agent of the disease. These antibodies (immunoglobulins, otherwise gamma globulins) bind viral particles and prevent them from spreading and replicating in the body. If such prophylaxis is carried out before the start of active reproduction of viruses, then the disease will not develop.

On a note

However, it should be noted that the effectiveness of such preventive measures has not been proven by the methods of modern evidence-based medicine in the West. Accordingly, neither in Europe nor in the USA such TBE prophylaxis is carried out. In Russia, immunoglobulin preparations against tick-borne encephalitis are considered effective, and the method of emergency prophylaxis is used in all regions endemic for this disease.

The main requirement for such prevention is to carry it out in the first 4 days after the bite. It is believed that in the first 2 days its effectiveness is maximum, on the 3rd-4th day it is already much lower, and starting from the 5th day it is pointless to do it.

All preparations of immunoglobulins for emergency prophylaxis of TBE are produced in Russia, the most common serum is produced by Microgen. Its packaging costs approximately 6500-7000 rubles for 10 ampoules of 1 ml. The amount of the drug is calculated according to the body weight of a person: for every 10 kg of body weight, 1 ml of the drug. Accordingly, it is possible to calculate the approximate cost of an injection (the procedures themselves, excluding the cost of immunoglobulin, are either free in polyclinics or cost symbolic money).

Injections of immunoglobulin against TBE are not carried out during pregnancy and lactation.

A few words about the means for self-prevention of tick-borne encephalitis

Contrary to popular belief, self-prevention of tick-borne encephalitis with pills or traditional medicine after a bite is impossible. This is due to the fact that today there are no effective means for such protection, and those that are commercially available are either dummies or drugs with unproven effectiveness.

An example of a useless drug is Anaferon, a well-known homeopathic remedy that does not contain components that could somehow affect the development of an infection.

Drugs with unproven efficacy are Jodantipyrine and Remantadine. Their ability to suppress the development of tick-borne encephalitis has not been confirmed by evidence-based medicine (which, however, does not prevent a large number of doctors from prescribing these drugs as preventive measures).

Other drugs marketed as antiviral or immunomodulatory (for example, Reaferon-Lipint, Cycloferon) also do not have any effect on the development of the disease.

On a note

Similarly, independent prevention of borreliosis is not carried out. Borreliosis itself is successfully treated with relatively inexpensive, accessible and safe antibiotics (the first-line drug of choice is doxycycline). Theoretically, prophylaxis could also be carried out with antibiotics, but in practice, almost all those bitten would need to use them because of the wide range of Borrelia themselves, despite the fact that the actual frequency of infection is low and approximately comparable to the frequency of side effects from the antibiotic itself. In other words, it is easier and safer not to carry out drug prophylaxis, but to treat borreliosis itself already during its development (which is revealed by the results of a blood test for borreliosis).

Monitoring the condition of the victim after a bite: what to look for

Regardless of the fact of carrying out emergency prevention of tick-borne encephalitis, as well as on the region in which the person was bitten and whether he had an anti-encephalitis vaccination, after a tick bite, you should carefully monitor the condition of the victim for at least a month, and if symptoms of the disease appear, immediately contact doctor.

On a note

The tick can infect a person with various infections, so having a tick-borne encephalitis vaccine is not a complete protection.

Average incubation period of tick-borne encephalitis and Lyme borreliosis is 1-2 weeks, but sometimes it can stretch up to several months. If at this time the victim's health worsens or the following symptoms appear, then this is an occasion to consult a doctor as soon as possible for an early diagnosis. Warning symptoms after a tick bite include:

Fever with an increase in temperature up to 38-39 ° C;
Pain in the head and muscles;
Convulsions, loss of consciousness, impaired coordination of movement (more often these are signs of encephalitis);
The appearance of erythema migrans - a large red, constantly expanding ring on the skin around the bite (this is the most characteristic sign of Lyme disease);
Nausea;
Extensive swelling of the tissues and (or) severe sudden pain at the site of the bite, even if there are no bite marks.

If any of these symptoms appear, you should contact an infectious disease specialist as soon as possible. It is the timely treatment started for all tick-borne infections that makes it possible to avoid the threat of developing serious consequences.

It should be borne in mind that if the bite site is swollen and reddened immediately after the tick is removed, this does not yet indicate infection with an infection, but is only associated with skin damage and the body's natural reaction to the parasite's saliva entering the tissues. One of the signs of infection is the persistence of the bump for more than 4 days with the development of generalized symptoms.

Similarly, if immediately (on the same day) after the bite, the head, arm or leg that was bitten by the parasite hurts, then this is unlikely to be associated with an infection. It takes at least a few days for its development and manifestation, and symptoms of the disease do not appear immediately.

Even if the analysis of the tick revealed that it was infected with an infection, the likelihood of developing the disease in humans is low. According to statistics, even when bitten by infected ticks, an average of 2-6% of those bitten fall ill.

However, the onset of the disease can be diagnosed even in the incubation period. To do this, you need to take a blood test for tick-borne encephalitis and borreliosis. Immunoassay in the blood reveals antibodies to the causative agents of the corresponding diseases.

As noted above, such an analysis will be indicative no earlier than 10 days after the bite. On the 14th day after the incident, it makes sense to donate blood for antibodies to the tick-borne encephalitis virus, and 20 days later - for antibodies to Borrelia. If this or that disease is confirmed, the doctor will prescribe treatment even before the onset of severe symptoms.

Prevention of tick bites

It is easier to prevent a tick bite than to run around hospitals and worry about possible infection. At the same time, all the difficulties of such protection against attacks by bloodsuckers are mainly organizational, not requiring any special knowledge and skills.

When going out into an area where ticks can be encountered, you need to dress in such a way that the maximum area of \u200b\u200bthe body is covered with clothing, albeit not tight (a tick cannot bite through clothing - even through thin tights). Socks must be on the feet, trousers must be tucked into them, and a shirt must be tucked into trousers. In this case, the parasite, clinging to the trouser leg, would have to crawl up to the throat in order to get under the clothes. The things themselves need to be chosen light, on which such a clinging "passenger" will be easy to notice and remove in time.

It is also useful to use repellents based on pyrethroids and DEET. Many of these products are also suitable for children.

In nature, in groups of people, participants need to examine each other every 2-3 hours and remove the detected ticks. In this case, special attention is paid to the places of the most frequent attachment of parasites - the abdomen, armpits, groin, chin, behind the ears.

On a note

If the tick has just begun to dig in, or is still crawling over the skin in search of a place for suction, it is hardly noticeable, as it has a small size. A sucking small larva is also not always easy to detect - it can look like a papilloma, and even with a close examination it can be “slip through” with a glance. Similarly, it can be difficult to find a tick in the hair if it has climbed onto the head.

When traveling to nature in a region endemic for tick-borne encephalitis, it is first necessary to be vaccinated against TBE. Then even a tick bite that occurs will be much less dangerous: a person will not get sick with encephalitis, and even if he does get sick (which happens extremely rarely with a vaccination), the disease will proceed easily and without complications.

However, vaccination cannot protect against Lyme borreliosis - a specific anti-borreliosis vaccine has not been developed.

Finally, some insurance companies now offer tick bite insurance. The insurance package for one person costs about 500-800 rubles, and the sum insured covers the analysis of the tick for encephalitis and borreliosis, blood tests of the bitten and the full treatment of the disease.