Treatment: When diagnosis is confirmed, treatment with the appropriate antibiotic can begin. Treatment guidelines are often changing and the involvement of an infectious disease specialist is warranted. Although most patients are successfully treated with the appropriate antibiotic regimen, some patients will have continuing debilitating symptoms probably long after the infecting organism has been eradicated. Tick bites and Lyme disease are now common medical conditions of which we should be aware because prevention and prophylactic treatment can prevent the more serious symptoms of Lyme disease, which can sometimes be difficult to cure. More knowledgeable healthcare workers, more effective laboratory tests and better antibiotics are assisting in managing this much more common condition. Now I’m off to get mydoxycycline! Health Prevention: The greatest risk for acquiring a tick is in, or in proximity to wooded areas, tall grasses and shrubs. Kids who play in such places, at cottages and recreational areas are more at risk for bites. Those who golf, hunt, camp and hike are at greater risk for tick bites as well. To help reduce the risk of ticks, clothing and gear can be treated with products containing 0.5% permethrin, and insect repellents containing DEET should be used on the skin. In addition, some protection may be achieved wearing long sleeves, socks and long pants. For persons frequenting such areas, especially if blacklegged ticks and Lyme disease frequency are reported as high, total body inspection each evening is strongly recommended. Since ticks prefer dark and warm parts of the body, the examination should include the hair, groin, umbilicus, ears, armpits and behind the knees. Treatment of Bites: Proper treatment for tick bites is necessary to help prevent the transmission of the bacteria that causes Lyme disease in humans. When a tick is found, it should be removed as soon as possible. Most can do that themselves by carefully pulling it slowly away from the skin in order to extract the complete insect. Put it in a jar, in case later identification is needed. If all of the tick is not successfully removed, a doctor’s visit should occur. If the tick is known to have been there for fewer than 36 hours, thorough washing of the wound with soap and water is the only treatment required, as it takes longer than that for the insect to transmit the bacteria that causes Lyme disease. This timing can be judged by the known exposure times, the amount of engorgement of the tick and the redness of the bite. For bites that occurredmore than 36 hours ago or when the timing is uncertain, the current treatment (which must be administered within 72 hours after the feeding tick has been removed) is the administration of an oral prophylactic antibiotic − usually doxycycline in a single or multiple-dose format. Pregnant women and children under the age of eight will be given another antibiotic. Not every blacklegged tick will transmit the bacteria causing Lyme disease to the person bitten. Following the bite, whether unknown, known, treated or not treated, there is the risk of developing Lyme disease, the risk being greater if not treated at the time of the bite. The prevalence of Lyme disease versus the incidence of tick bites is tracked by each provincial health agency for each area. Symptoms and Diagnosis: Symptoms can develop within 30 days of being bitten and may present as fever, joint or muscle pains, headache or a localized skin rash. This skin redness may occur as soon as seven days after the bite and, in some cases, appears like a bull’s-eye at the site of the tick bite. The onset of symptoms can be variable and vague and make suspected diagnosis difficult, especially if no history is given of a known tick bite. Although the disease is much more prevalent now and doctors more knowledgeable, many patients have gone undiagnosed in the past and have suffered tremendously as the disease progressed. Laboratory testing in Canada for confirmation of Lyme disease has become more accurate and early proper treatment can be initiated to improve the chance of recovery. Lyme Disease Ticks CSANews | SUMMER 2019 | 35
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