Got a tick bite? Don't panic – UConn Today

In Connecticut, the standard advice for preventing tick bites during spring, summer, and fall is: avoid areas where ticks are active when possible, wear long sleeves and long pants when appropriate, use insect repellent that contains DEET (at least 20% DEET lasts for at least six hours), and check your body regularly for ticks.

Ticks in Connecticut can carry the pathogens that cause Lyme disease and, more rarely, anaplasmosis, babesiosis, ehrlichiosis and, in very rare cases, Rocky Mountain spotted fever, but it takes a lot for a tick bite to make you sick. Dr. Henry M. Feder Jr.Professor of Family Medicine at the University of Connecticut School of Medicine explains:

What do deer ticks and lone star ticks carry?

The Connecticut Agricultural Experiment Station (CAES) obtains thousands of ticks for analysis each year. CAES tests deer (black-legged) ticks for three pathogens. Borrelia burgdorferi (The bacterium that causes Lyme disease) Anaplasma phagocytophilium (The causative bacterium of anaplasmosis) Babesia microti (the parasitic culprit of babesiosis) Additionally, the map shows areas in Connecticut where infected ticks have been found.

What has changed in the last decade is that the Lone Star tick has been introduced into Connecticut. About 6% of the ticks sent to CAES are Lone Star ticks. Ehrlichia chaffeensisthe pathogen that causes ehrlichiosis.

CAES analyzes more than 3,000 deer ticks each year, and over 40% of them contain at least one pathogen.Borrelia burgdorferi, Anaplasma phagocytophiliumand/or Babesia microtiFortunately, being bitten by an infected tick does not usually result in clinical illness. Borrelia burgdorferiAfter being bitten by an infected deer tick, the risk of developing anaplasmosis or babesiosis is about 10%.The risk of developing anaplasmosis or babesiosis after being bitten by an infected tick is unknown but is probably less than 10%.

What factors increase the risk of tick-borne diseases?

Living in an area with a lot of ticks is dangerous. Ticks mate on deer, so as the deer population increases so does the tick population. The proportion of infected ticks is another danger. Deer ticks are Borrelia burgdorferi When they feed Borrelia burgdorferiThere are infected rats. For example, Elizabeth Park in Hartford has deer ticks, but the local rats do not carry them, so they are not infected. Borrelia burgdorferiIf you go to the areas of Old Lyme, East Lyme, Haddam and Colchester, there are many infested rats in those areas and you are at higher risk of contracting Lyme disease after a tick bite. Deer ticks in Simsbury, West Hartford and Farmington are less likely to be infected. Borrelia burgdorferiYes, you are infected. If you are bitten by a deer tick in these areas, you are less likely to develop Lyme disease than if you are bitten in Old Lyme, East Lyme, Haddam or Colchester.

In some ways, finding a tick on your body is a good thing, because it means the tick hasn't finished feeding on your blood yet.

To transmit Lyme disease, an infected deer tick must be attached for at least 36 hours, but usually more than 48 hours. To transmit disease, the tick must attach, feed on blood, and swell. People who check for ticks daily and are good at finding ticks (on themselves and their children) can reduce their risk of contracting Lyme disease and other tick-borne diseases.

But even if the tick has been on your body for 48 hours and is fully expanded, does that necessarily guarantee you will get sick?

In many cases, you never realize it has happened because the tick becomes completely engorged and falls off. For Lyme disease, all you need to do is call your doctor and say, “I have a tick on me and it's probably been two days,” and many doctors will prescribe you double-dose doxycycline (two 100 mg capsules), which is very effective at preventing Lyme disease infection. There are no studies on preventing anaplasmosis or babesiosis after a tick bite.

Lyme disease is far more common in Connecticut (and the United States) than anaplasmosis or babesiosis. There are approximately 2,200 cases of Lyme disease reported in Connecticut each year, compared to 70 cases of anaplasmosis and 200 cases of babesiosis. This compares to thousands of Connecticut residents who are bitten by ticks.

Lyme disease usually presents with a characteristic circular red rash, with or without fever. Anaplasmosis and babesiosis usually present with fever, chills, headache, malaise, and joint pain, but no rash. Ehrlichiosis and Rocky Mountain spotted fever (Rickettsia rickettsii, Tick-borne infections in dogs are very rare in Connecticut.

What about the concern that these bacteria will develop resistance to antibiotics?

Doxycycline, two 100 mg capsules, can be used to prevent Lyme disease after a tick bite (if taken within 72 hours of the bite). Borrelia burgdorferi has never developed resistance to doxycycline, so doxycycline can be used multiple times after a tick bite without risk of resistance. Doxycycline or amoxicillin are also used to treat Lyme disease (10 to 28 day treatment periods). No resistance has been reported after multiple treatment periods.

What about “chronic Lyme disease”? You consider it a “misinformation.” Why?

The term “chronic Lyme disease” means that a Lyme infection persists after standard antibiotic therapy. Borrelia burgdorferiIt is the bacteria that causes Lyme disease, but has not been scientifically proven to survive doxycycline or amoxicillin therapy. Borrelia burgdorferi Possible reasons for escaping antibiotic therapy include: (1) hiding in places where antibiotics cannot reach, (2) forming protective biofilms, (3) becoming resistant to antibiotics, and (4) requiring higher doses or longer durations of antibiotic treatment. None of these theories have been scientifically proven.

So why do some people fare worse after contracting Lyme disease?

The initial symptoms of Lyme disease (rash, facial paralysis, arthritis) may be accompanied by nonspecific symptoms such as fever, headache, brain fog, joint pain, and/or severe fatigue. With antibiotic therapy, the rash and fever subside within 24-48 hours, but the nonspecific symptoms such as headache, brain fog, joint pain, and/or severe fatigue may persist for weeks or months. The causes of nonspecific symptoms after infection are an area of ​​intense research. Nonspecific debilitating symptoms can follow Lyme disease, mononucleosis (initially called “chronic mononucleosis”), and more recently, “long COVID.” In the case of Lyme disease, Borrelia burgdorferi Infections go away, in the case of mononucleosis the Epstein-Barr virus goes away, in the case of COVID the COVID-19 virus goes away. These post-infectious syndromes are similar to chronic fatigue syndrome. In acute illnesses, our body produces cytokines that make a person feel miserable. Presumably this production of cytokines (or something like it) continues after the initial infection has subsided. Therefore, treating chronically as if the initial illness was still present is not helpful (except for the placebo effect of medications).

Stories of “chronic Lyme disease” are all over the news, popular magazines, and especially the Internet. Many people personally know a loved one, friend, or friend of a friend who suffers from “chronic Lyme disease.” Many of these people are being treated by a network of doctors who believe that Lyme disease can explain symptoms that mainstream doctors cannot. What's interesting is that this network of doctors practices all over the United States, even in areas where Lyme disease does not exist.

A group called LymeScience has published a map using CDC data showing the geographic location of Lyme support groups, but it doesn't match the Northeast and Minnesota/Wisconsin where Lyme is prevalent. After contracting Lyme, some people experience debilitating symptoms (called “post-Lyme symptoms” and not “chronic Lyme”) that run parallel to “long COVID.” However, if this map is any guide, it's likely that many people diagnosed with “chronic Lyme” never had Lyme.

Most people who develop Lyme disease and other tick-borne diseases are unaware of their tick bites because deer ticks are about the size of a poppy seed and tick bites usually do not cause symptoms. Being careful and checking for ticks after bites outdoors can reduce your risk of developing a tick-borne disease. Most tick-borne infections have obvious signs and symptoms and are treatable. The idea that a tick bite causes persistent, untreatable “chronic Lyme disease” is a misinformation.