Lyme Disease Transmission – Reducing Risk

Lyme Disease Rash

Quick removal of a tick reduces the risk of Lyme disease transmission

Prompt removal of any ticks is one of the best means of reducing the risk of Lyme disease transmission. Daily tick checks can help locate any adult or nymph ticks and ensure their removal before they are likely to have transmitted bacteria such as Borrelia. Preventing tick bites is clearly advisable in itself, with light clothing helping to show up any ticks, and insect repellents useful in keeping ticks and other mites and insects at bay. Careful removal of a tick is also important however as crushing the tick may cause it to regurgitate its contents and thereby cause infection. Removing the tick via gentle pressure decreases the risk of Lyme disease transmission over keeping the tick in place but even if the tick is accidentally crushed during removal the risk of infection is still low compared to doing nothing (Piesman, et al, 2002).

The degree of protection provided by tick removal decreases steadily the longer the tick is in place with a steep decline after 60hrs to the point where no protection is apparent at 66hrs. Leaving a tick in place for more than two and a half days therefore is as likely to result in infection as leaving the tick in place indefinitely. Where a tick is in a hard-to-reach place it is advisable to have someone assist in removing it. A doctor can help with this if a patient is not confident of removing the tick safely themselves. Attempting to remove a tick from a pet may also be difficult if they are hard to keep still and a veterinarian may be required to help in such cases. Ticks should not be attempted to be removed using paraffin, lit matches, or other folk methods; a simple pair of tweezers or forceps is all that is required. Many commercially available tick removal devices are no better than normal tweezers and may actually increase the risk of crushing the tick during removal. Adult ticks are commonly around the size of an apple pip whereas nymphal ticks may be as tiny as a pinhead. Daily checking, of all family members and household animals, is important therefore to reduce the risks of Lyme disease transmission, with many people using magnifying glasses to aid this process.

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References

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Rudolf I, Sikutová S, Kopecký J, Hubálek Z. Salivary gland extract from engorged Ixodes ricinus (Acari: Ixodidae) stimulates in vitro growth of Borrelia burgdorferi sensu lato. J Basic Microbiol. 2010 Jun;50(3):294-8.

Gilmore RD Jr, Howison RR, Dietrich G, Patton TG, Clifton DR, Carroll JA. The bba64 gene of Borrelia burgdorferi, the Lyme disease agent, is critical for mammalian infection via tick bite transmission. Proc Natl Acad Sci U S A. 2010 Apr 20;107(16):7515-20. Epub 2010 Apr 5.

Marchal C, Schramm F, Kern A, Luft BJ, Yang X, Schuijt T, Hovius J, Jaulhac B, Boulanger N. Antialarmin effect of tick saliva during the transmission of Lyme disease. Infect Immun. 2011 Feb;79(2):774-85. Epub 2010 Dec 6.

Mylonas I. Borreliosis During Pregnancy: A Risk for the Unborn Child? Vector Borne Zoonotic Dis. 2010 Oct 6. [Epub ahead of print]

Bockenstedt LK, J Mao, E Hodzic, SW Barthold, D Fish (2002) Detection of attenuated, non-infectious spirochetes after antibiotic treatment of Borrelia burgdorferi infected mice. J Infect Dis 186:1430-7

Purser JE, Lawrenz MB, Caimano MJ, Howell JK, Radolf JD, Norris SJ. A plasmid-encoded nicotinamidase (PncA) is essential for infectivity of Borrelia burgdorferi in a mammalian host. Mol Microbiol. 2003 May;48(3):753-64.

Piesman, J., Dolan, M.C. Protection Against Lyme Disease Spirochete Transmission Provided by Prompt Removal of Nymphal Ixodes scapularis (Acari: Ixodidae). Journal of Medical Entomology 39(3):509-512. 2002.