How to remove a tick / Tick diseases

The proper steps for removing a tick, according to the CDC:

Using a pair of fine-tipped tweezers, grasp the tick as close to the skin as possible. 

Pull straight up with steady, even pressure. "Press down on the skin on either side of the tick so that the skin doesn’t pull up when you pull the tick off. This lessens any pinching sensation you may feel."

Thoroughly clean the bite (and your hands) with rubbing alcohol or soap and water.

The CDC discourages "folklore remedies" like nail polish, petroleum jelly (Vaseline), and heat that lift the tick away from the skin, since they rely on waiting for a tick to detach, which takes longer. "Anything that delays removing a tick is a bad idea," says Robert B. Kimsey, Ph.D, an entomologist with the University of California, Davis specializing in ticks.

"Suffocating a tick is not very effective," Dr. Kardos says. "Covering a tick with petroleum jelly or nail polish may even cause the tick to become slippery and more difficult to grasp. And don't try to burn a tick off — you’ll just burn your child’s skin."

What happens if you don't remove a tick?
Some species of ticks in certain parts of the country can transmit illnesses like Lyme disease, Rocky Mountain spotted fever (RMSF), and southern-tick associated rash illness (STARI), the CDC states. While not every tick carries pathogens, waiting too long to remove a tick can increase the likelihood of transmission.

"In general, it takes anywhere from a day and half to two days or so for a tick that's attached to you to transmit any pathogens it may have," Dr. Kimsey says. "Once that tick attaches to you, that sets a timer and you're best off getting it off just as quickly as you can."

How do you get a tick to let go?
The short answer: You can't. "Ticks, as an initial process of feeding on you, actually glue themselves in place," Dr. Kimsey explains. "The hard ticks that people are most concerned about can’t back out of their own volition."

So not only is it a bad idea to wait to grab peppermint oil, dish soap, Vaseline, or whatever fix the internet is currently prescribing for tick bites, but these home "remedies" may also not work the way you believe they do.

What happens if you squeeze a tick?
Those worries about whether squeezing a tick may cause it to regurgitate more pathogens into the bite may be misguided.

The redness and swelling you may see a few hours after a tick bite isn't necessarily a cause for concern, though. It shows that your body is recognizing the foreign proteins in the tick saliva and using an immune response to flush them out, just like with a mosquito bite. "In reality, that initial reaction to the tick saliva occurs long before any pathogens get transmitted," Dr. Kimsey says. "It’s just your immune system doing its job."

Tick Diseases

Lyme disease is caused by bacteria (Borrelia burgdorferi). Deer ticks need to be attached from 24-48 hours to transmit this disease. Initial symptoms usually begin 3 to 30 days after a person is bitten by an infected deer tick and may include an expanding rash at the site of the bite and/or flu-like symptoms. If left untreated, the bacteria can spread to almost any site in the body and can cause arthritis, neurologic difficulties, and/or heart problems. Cases of Lyme disease occur throughout Massachusetts. This is the most common tick transmitted disease in Massachusetts. Over the last decade, the number of cases has averaged over 3,000.

Anaplasmosis is caused by bacteria (Anaplasma phagocytophilum) that affect certain white blood cells called granulocytes. Deer ticks need to be attached from 12-24 hours to transmit this disease. Symptoms typically appear suddenly 7 to 14 days after being bitten by an infected deer tick and can include fever, headache, muscle aches, chills, sweating, nausea, and vomiting. Because symptoms may become life-threatening, immediate treatment is necessary. The elderly, people with diabetes or collagen vascular disease, and people without a healthy immune system are more likely to develop serious symptoms. In Massachusetts, cases occur most frequently on Cape Cod, Martha’s Vineyard, Nantucket, and in Berkshire County. The state has tracked this disease since 2008 when there were 41 confirmed cases. The number of human infections in Massachusetts has steadily risen to 677 in 2015.

Babesiosis is caused by a parasite that affects red blood cells. The two most common parasites in humans are Babesia microti and Babesia divergens. Most people who are infected will show no or only very mild signs of illness. Symptoms, when they do occur, begin gradually about 1 to 6 weeks after being bitten by an infected deer tick and can include fever, chills, headache, achy joints and muscles, fatigue, nausea, vomiting, abdominal pain, and dark urine. The elderly and people without a healthy spleen or immune system are more likely to develop serious symptoms. In Massachusetts, cases occur most frequently on Cape Cod, Martha’s Vineyard, and Nantucket. The state has tracked this disease since 2008 when there were 51 confirmed cases. The number of human infections steadily rose to 535 in 2014. There were 414 cases in Massachusetts in 2015.

Ehrlichiosis is a bacterial disease (Ehrlichia chaffeensis) that causes fever, headache, muscle aches and pain, anorexia, diarrhea, abdominal pain, and confusion. Symptoms occur 1-2 weeks after being bitten. Illness may be severe with rare fatalities. Transmitted by the lone star tick which has only been found in southeastern Massachusetts. Recently reported in Massachusetts. There were 20 cases in 2014 and 7 in 2015.

Powassan virus/deer tick virus are two closely related viruses spread by two different ticks. Powassan virus is spread by woodchuck ticks and deer tick virus is spread by deer ticks. Some evidence shows that ticks only need to be attached for 15 minutes to transmit these viruses. Symptoms of these diseases can include but are not limited to fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, and memory loss. About 10% of infections result in death. People that initially recover from these viruses may experience long term neurological problems. Although rare, these viruses are likely found throughout Massachussetts because their vectors are widespread. From 2013-2015 there have been 5 confirmed and 2 probable cases in the state.

Borrelia miyamotoi is a bacterial disease first identified in Japan in 1995. Onset of disease and symptoms are similar to lyme disease with which it is closely related. However, unlike lyme disease, no rash is associated with Borrelia miyamotoi. Deer ticks, which are common throughout Massachusetts, spread this disease. First reported in New England in 2001. There is evidence to suggest that at least 5% of lyme disease cases are actually Borrelia miyamotoi.

Rocky Mountain spotted fever (RMSF) is a rare bacterial disease (Rickettsia rickettsii) that usually presents as a high fever with severe headache and fatigue 3 to 14 days after being bitten by an infected dog tick. A rash that spreads to the palms of the hands and soles of the feet often appears 3 to 5 days after the fever begins. In Massachusetts, cases occur most frequently in the southeastern part of the state, on Cape Cod, and on Martha’s Vineyard.

Tularemia is caused by bacteria (Francisella tularensis) that can be spread to people in a number of ways, including through the bite of an infected dog tick. Symptoms vary depending on the way the germs are transmitted and usually begin between 3 to 5 days after an exposure, although it can take as long as 21 days. People infected by a tick bite typically have a slow healing skin sore (ulcer) and swollen glands (lymph nodes). In Massachusetts, cases occur most frequently on Cape Cod, Martha’s Vineyard, and Nantucket.

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