Tick-Borne Illness - FAQ

Where are ticks found on Martha's Vineyard?
Ticks are found throughout Martha’s Vineyard, in all of New England, most of the Mid-Atlantic, and increasingly in the Midwest and West Coast. Deer ticks tend to concentrate in moist, shady, leaf-littered areas, often at the perimeter of landscaped yards (watch this video for quick tips to protect yourself.)

What does the expanding rash look like?
The rash is red and can appear in several different forms. Common to all them is that the rash expands in size over the course of a day or two. A number of different rash presentations are shown on the website (see signs and symptoms). We thank Dr. Tim Lepore, Nantucket Cottage Hospital, for the use of these photos.

Can you get a tick-borne illness from handling a tick or having it crawl on you?
No. A tick must bite and remain attached for 48 to 72 hours for disease transmission to occur. Infection, often with the smaller nymphs, may occur without one’s knowledge. So one should be watchful for symptoms even in the absence of a known tick bite.

How should one dress to prevent tick exposure?
It is best to wear long pants with the pants legs tucked into socks. One can also reduce tick exposure by wearing protective clothing/socks impregnated with a tickicide such as permethrin.

When do most tick infections occur?
Most tick infections occur in the spring through early summer and are attributed to bites from the deer ticks in their small, nymph stage (see lifecycle). Because of the nymph’s small size many people who develop a tick-borne illness are unaware of ever having been bitten. So in addition to inspecting one’s body for ticks, one most also be particularly vigilant for symptoms.

How do I remove a tick once imbedded?
Ticks should be removed promptly upon detection. Care should be taken to avoid getting potentially infectious tick blood on the skin of either the patient or the one removing the tick. The proper technique is shown in the video (here). The bite location should be wiped with alcohol after tick removal.

What should I do if I pull a tick off of me?
If you pull a deer tick off of you, you may want to save the tick for identification, seek medical care, and, if it is appropriate for you, receive a one day dose of doxycycline. This prophylactic treatment has been shown to reduce the risk of becoming infected and developing symptoms. Whether or not you choose early prophylactic treatment, you want to be particularly watchful for the emergence of symptoms over the next 3 to 30 days. If they do appear, you must be immediately evaluated and treated where appropriate with a two to three week course of antibiotics. While various options are suitable, the Island’s Boards of Health recommend early prophylactic therapy started within 72 hours of the time the tick is removed, followed by vigilance in the event symptoms still occur.

Is there a cure for Lyme disease?
A dosage of antibiotics can effectively treat Lyme disease in the early stages. If left untreated the symptoms may resolve but come back later presenting with joint, cardiac, and neurologic complications. Here again antibiotics are prescribed typically in oral form, but intravenous therapies are available as well.

How long should I wait before treating a tick bite?
A tick bite may be treated immediately after removing a tick provided that the tick has been on the patient for no more than 72 hours. The treatment is provided before symptoms develop and consists of just a one day dose of antibiotic. Lyme disease must always be treated with a two to three week course of antibiotics as soon as signs and symptoms are detected. Signs and symptoms typically appear within 3 to 30 days of being bitten. Blood tests are often used to confirm diagnosis. They take up to two weeks to become positive after symptoms develop and should not be used as a reason to delay treatment if the diagnosis of a tick-borne disease is suspected.

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