Lyme disease target lesion

About 80 percent of people with Lyme disease from a tick bite develop a target lesion, or bull’s-eye rash. It’s not always so visually well-defined.

by James Hubbard, M.D., M.P.H.

Where I come from, it’s tick season. I suspect it is in your area too. On many a tree leaf or tall grass, the tiny blood-suckers lie in wait—ready to pounce on any warm-blooded creature that gets within distance—eager to share their multiple array of germs.

The CDC lists twelve tick-borne diseases in the U.S. alone. Early recognition and treatment is vital to prevent permanent disability, even death. But these diseases can be hard to diagnose. Symptoms can be very general—say, fever and muscle aches—and their onset can be delayed for days or weeks. Tick-borne diseases can be hard for a doctor to pen down.

So what if no doctor is available? Here are a few steps you can take to decrease your chance of a devastating outcome.

Tips to Repel and Reveal

If you’re going to be outside in grass or among trees:

  1. Apply tick repellents containing DEET or your favorite homemade variety.
  2. Wear light-colored clothes and a hat so the ticks will be easier to see.
  3. Feel for ticks every few hours. The sooner you get one off the better. For instance, removing a tick within thirty-six hours greatly decreases your risk for Lyme disease.
  4. When you get inside, inspect your body well. Feel every nook and cranny. Do the same with a mirror. I’ve found ticks on a person’s scalp, under an arm, behind an ear, in an ear, in a belly buttock, next to the anus, in the genital area.

The Correct Way to Remove Ticks

It’s important to remove the tick the right way.

  1. Use tweezers. You should have some in your first-aid kit anyway.
  2. Grab the tick’s head as close to your skin as possible. Squeezing its body increases the risk of squirting its germs right into you. That’s the last thing you want. By grabbing its head you also have a better chance of pulling out those barbed pincers it has stuck into your skin.

The CDC recommends not using things like a hot match head, petroleum jelly, or nail polish. Apparently, it might cause the tick to inject more of its innards.

After you remove the tick, clean the area with soap and water, or alcohol, and apply a little antibiotic ointment.

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Rocky Mountain Spotted Fever rash

Rash from Rocky Mountain spotted fever. One of the few rashes that can, also, involve the palms of the hands.


How to Recognize a Tick-Borne Infection

Many of the diseases you get from ticks cause nonspecific symptoms like fever and body aches that can come on several days, even weeks, after the bite. Also, in as many as half the cases, the infected person has no recollection of a tick bite. So you need a high index of suspicion.

  1. Know the tick-borne diseases prevalent in your area. Check the CDC or your state health department website. Know the symptoms and the treatment. Do it now, so you’ll know in case the Internet goes down.
  2. Consider the time of year. Tick season is spring and summer. That’s not flu season. The flu and other fever-causing viruses are very contagious, so if a lot of people in your group have the same symptoms at the same time, it’s more likely a contagious virus. If you’re the only one, that points more to a tick-borne disease.
  3. If you’re “lucky enough” to have a target lesion from Lyme disease (about 80 percent do) or a rash from Rocky Mountain spotted fever, that helps pin down the diagnosis, but that’s not always the case.

How to Treat a Tick-Borne Disease If You Can’t Get to a Doctor

If you don’t know otherwise by checking the CDC website, fourteen days of doxycycline twice a day hits most infections. Be sure to read up on precautions. For example, doxy is not to be used if pregnant. For those not allergic to penicillin, amoxicllin is a second choice against Lyme disease. All of these are prescription meds.

For Rocky Mountain spotted fever, chloramphenicol (prescription) is an alternative, but I’ll bet you don’t have that in your medical bag. Many times with that disease you’re going to be sick enough that you need to get to a hospital if there’s any way possible.

As with most illnesses and injuries, prevention is the best medicine. Does anyone have any tricks to keep the ticks away?

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Lyme disease target-lesion photo courtesy CDC. Rocky Mountain spotted fever rash photo courtesy CDC/ James Gathany.