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You’ve been bitten by a tick. Now what?

Man and woman on hiking trail

Here’s how to reduce your risk of Lyme disease and other tick-borne illnesses in the minutes and days after one of the little vampires sinks in.

Kate Rockwood

By Kate Rockwood

Ticks may be best known for transmitting Lyme disease, but that’s hardly the only illness these tiny bloodsuckers can cause in humans. Ticks in the United States can transmit more than a dozen pathogens. You’ll find anaplasmosis in the Northeast and Upper Midwest, and ehrlichiosis in the Southeast and south-central states. And across the eastern, central and western states, Rocky Mountain spotted fever is more common. It’s enough to make you want to swear off the outdoors.

But before you do, know this: Proximity to a tick isn’t enough to put you in danger. Ticks transmit disease to humans only through biting. First they feast on the blood of an animal that’s been infected (say, a reptile, mammal or bird), and then they bite a human and pass on that infection-causing pathogen.

Ticks and the diseases they carry also vary by geography. Lyme disease, for instance, can cause serious, long-term damage if the infection spreads to your heart, joints and nervous system. But the bacteria that causes Lyme disease is carried only by blacklegged ticks, also referred to as deer ticks. And only those in the northeastern and north-central U.S. are commonly infected with the bacteria, according to the Centers for Disease Control and Prevention. (If you need medication to treat a tick bite, the Optum Perks app can help you find the best deal at pharmacies near you. Download it now.)

Tick season begins ramping up in spring and peaks in June and July. If you’ll be outdoors this summer, and particularly in that window, make sure you have your tick-defense strategy in place. Here’s how:

Preventing tick bites

Tick prevention starts even before you set foot outside, says Jean Tsao, PhD, a professor in the department of fisheries and wildlife at Michigan State University. If you can, dress in white or light-colored clothing. That makes it easier to spot the tiny arachnids. Opt for high socks or hiking pants that cinch tightly around your ankles. If you’re comfortable looking a little funny, you can also tuck your pants into your socks. And wear closed-toed shoes to limit the amount of exposed skin.

Spray the clothing you’ll be wearing in woodsy areas with the insecticide permethrin. This repellent will last up to 6 washes and can kill ticks on contact, says Tsao. But you’ll still want layers of protection. So even if you’ve pretreated your hiking gear, you’ll want to apply DEET or other EPA-registered tick repellent onto your exposed skin.

Finally, watch where you’re walking. If you’re hiking, the center of the trail is the safest spot. It’s also where you’re least likely to come into contact with poison ivy. (That’s one of the itchy conditions you can get from your kids. Read more here.)

What to do within hours of a tick bite

Sometimes a tick breaks through your barriers and takes the opportunity to chomp. The first thing you need to do is remove it. Forget the folklore about burning it away with a lighter or smothering it with nail polish. Instead, use fine-tipped tweezers or a specialized tool called a tick key. Grab the critter as close as you can to where it’s attached and give it a steady tug. Avoid twisting, which might cause the tick’s mouthparts to break off and get stuck in your skin.

Once the tick is out, take a breath. Your chance of getting a tick-borne disease within minutes is very low. The pathogen’s journey from the tick’s stomach to its salivary glands and into your bloodstream is slow and complicated, says Amesh Adalja, MD. He’s an infectious disease specialist at Johns Hopkins University.

In fact, a review in the journal Ticks and Tick-borne Diseases found that it takes more than 24 hours of tick-feeding time for the Lyme pathogen to pass from tick to human. The germs that cause babesiosis and anaplasmosis work slowly too. If you remove the tick within minutes or hours of it biting you — even if the bug is infected, and even if part of the mouth gets stuck in your skin — you should be in the clear.

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That’s not true for other tick-borne diseases, such as Rocky Mountain spotted fever, which can be transmitted in just a few hours. And the Powassan virus, which is found in the northeastern states and Great Lakes region, can infect humans in as little as 15 minutes. So if you spot a tick, get it out swiftly — especially if you’re in an area where those pathogens are common.

The rule to follow is to always do a thorough skin check after being in areas where ticks are likely. Ticks love dark, damp places on the human body, which can also be some of the hardest spots to check (think: armpits, groin, bellybutton, back of knees, hairline). Ask a family member or hiking buddy to help make sure you’re in the clear. And if you find and remove a tick, that means there could be others — so check again.

What happens when you don’t know how long the tick has been attached?

It’s possible to discover a tick feasting on your blood even if you haven’t recently been deep into the woods. Maybe it attached while you were walking through your yard. Or maybe it hitched a ride on your dog and found you to be a more delicious host. Undisturbed, an immature tick might stay attached for 3 or 4 days, while adult females might gorge on a host’s blood for as many as 10 days.

Just like with a fresh bite, time is important — so make haste in grabbing those tweezers and pulling the engorged tick from your skin. While there’s no need to rush to the emergency room, you’d be smart to check in with your doctor.

If you live in an area where Lyme disease is common, for instance, your doctor may suggest a single dose of prophylactic antibiotics, such as doxycycline (Targadox®). This can reduce your risk of acquiring the disease even if the tick was attached for more than 36 hours. (Save money on antibiotics with the Optum Perks discount card, accepted at more than 64,000 pharmacies nationwide. Get yours now.)

What to do if you spot symptoms after a tick bite

You can be bitten by an infected tick without ever feeling the bite or seeing the bug. Once sated (which can take days), the blood-filled tick will detach on its own and fall away from your skin.

So you should always keep an eye out for anything unusual after time outdoors in a place where ticks might be present. Symptoms may appear weeks after the tick bite, and they’re similar for many tick-borne diseases. Things to watch for include:

  • Fever or chills
  • Aches and pains, including headache, fatigue and muscle aches
  • Rash, which may vary depending on the disease. With Lyme disease, for instance, up to 80% of infected people develop a circular rash at the site of the tick bite. Rocky Mountain spotted fever can appear as flat, pink, non-itchy spots on the wrists, arms and ankles. They might eventually spread to your torso.

Symptoms may be mild, or they may be severe and require hospitalization. That’s why it’s important to talk to your doctor at the first sign of a possible tick-borne disease. The doctor will be able to determine both the cause of infection and course of treatment. The more proactive you are, the less you have to worry about. With early detection and treatment, most people recover quickly.

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