Once Bitten: What to do if you meet a tick on the trail this summer

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Photo by 24K-Production - Getty Images

A tick warning sign on a trail

It’s summer and Wisconsinites are out! While this is always my favorite season, I’m increasingly disturbed by the surge of an accompanying dark menace. Last May, on a coolish day wearing several layers, I hiked a well-groomed trail in Door County. While eating dinner later that evening, I casually ran my hand over my collar bone only to discover a small deer tick which I unwittingly pulled out. Preserving the tick in a ziplock bag, I sent it to “TickCheck” for testing the following Monday.  Results came back—Borrelia (Lyme) and Babesia! ARGGGGHHH!

Deer ticks carrying an array of infectious agents are active and are everywhere, even in the city! Many who are bitten by ticks remain unaware of the serious infections these tiny pests transmit. Due to climate change, tick habitats are expanding and more of them carry disease. Wisconsin has one of the highest incidences of Lyme in the country (lookup CDC map-Yikes!). 

What to do?

An ounce of prevention…

First defend. Ticks can’t fly or jump. They cling to clothing as you brush past vegetation, usually at ground level.

• Use repellent. My go to is non-toxic cedar oil (e.g.,  CedarCide) that shows effectiveness similar to DEET, but doesn’t last as long, reapply every 1-2 hours. Second choice is picaridin, effectiveness akin to DEET but a lower toxicity profile.  
• Use Permethrin-Treated Clothing—Studies show pronounced reduction with this strategy.  Buy them or DIY.  My gardening outfit is refreshed with permethrin yearly.  I also don rubber gardening boots.  You can also treat camping gear.
• Walk the middle of trails, away from vegetation where ticks lurk.
• Wear long sleeves and pants tucked into your socks; light colors help you spot them.
• Shower soon after outdoor activities and do a thorough body check.  Attend to behind the ears, hairline, armpits, waistband, groin, behind knees.
• Heat dry your clothes.
• Don’t forget pets make great carriers even with tick prevention medication.

I admit, I didn’t totally adhere to my own advice on the aforementioned hike.

Found a tick attached?

1. Take a deep breath.  The goal is to remove the tick intact. With a fine-tipped tweezers grasp close to the skin.  Pull upward with steady pressure.  Don’t twist or squeeze.  Wait for the tick to release.  Don’t rush.  Buy a tick removal kit now so you are prepared.  Keep the tick!!
2. Test the tick to determine tick species, estimated length of attachment and infections. Store in a sealed bag and send to a lab like TickReport, TickCheck or Ticknology ASAP.
3. Mark the Bite Site—Draw a circle with a pen to monitor changes.

Are antibiotics necessary?

Even with tick test results, the answer to this question can be complex.  If it is a deer tick, many “Lyme literate” physicians would reflexively say yes and for at least three weeks sometimes six.  In most conventional medicine settings, the recommendation is a single dose of doxycycline. This vast disparity in approach is emblematic of current limitations in our understanding of this daunting infection.

Here are things I would consider

• Was it attached for more than 24 hours?
• Did testing demonstrate a blood meal?
• Are organisms identified?
• Is there a rash? (especially if bull’s eye)
• Any symptoms?

Even if the above are all “no,” you could still be infected, but odds are leaning in your favor. If one develops a rash or demonstrates symptoms, antibiotics for sure and even 4-6 weeks. Somewhere in between, it becomes a challenging judgment call.

Symptoms to know about

Acute Lyme:  Flu-like, fatigue, headaches, joint or muscle pain, swollen nodes.

Chronic Lyme: Migratory joint pain and inflammation, neuropathy with numbness or tingling, brain fog, mood changes and severe fatigue.

Why be so aggressive with a tick bite? Too many people are suffering from unrecognized debilitating chronic Lyme disease or co-infections for lots of reasons—tick bite missed, diagnosis missed, treatment too short and of course ticks are everywhere, especially here!

I struggled with what to do about my tick bite. The tick was only lightly attached and on me for less than seven hours. A blood meal could not be demonstrated with testing, but those organisms were disconcerting. Right or wrong, I opted for a week of antibiotics to be on the safe side. Still symptom free!

The content of this article is for informational purposes only and is not meant to serve as medical advice or as information to facilitate self-treatment.