The CDC has published “TICKBORNE DISEASES OF THE UNITED STATES A Reference Manual for Healthcare Providers Fifth Edition, 2018” that provides the following advice:

TICK BITES/PREVENTION

Ticks are generally found near the ground, in brushy or wooded areas. They can’t jump or fly. Instead, they climb tall grasses or shrubs and wait for a potential host to brush against them. When this happens, they climb onto the host and seek a site for attachment.

PREVENTION

1. Use Environmental Protection Agency (EPA)-registered insect repellents containing DEET, picaridin, IR3535, oil of lemon eucalyptus, para-menthane-diol, or 2-undecanone. Treat clothing and gear, such as boots, pants, socks and tents with products containing 0.5% permethrin. Additional repellent options are available. For more information, see http://cfpub.epa.gov/oppref/insect/.

2.Treat dogs and cats for ticks as recommended by a veterinarian.

3. Check for ticks daily, especially under the arms, in and around the ears, inside the belly button, behind the knees, between the legs, around the waist, and on the hairline and scalp.

4. Shower soon after being outdoors.

5. For tips on “tick-safe” landscaping for blacklegged ticks, see www.cdc.gov/lyme/prev/in_the_yard.html.

TICK REMOVAL

1. Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible. The key is to remove the tick as soon as possible. Avoid folklore remedies such as using nail polish, petroleum jelly, or heat to make the tick detach from the skin.

2. Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth-parts to break off and remain in the skin. If this happens, remove the mouth-parts with clean tweezers. If you are unable to remove the mouth parts easily, leave them alone and let the skin heal.

3. After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol, an iodine scrub, or soap and water.

TICK BITE PROPHYLAXIS

Antibiotic treatment following a tick bite is not recommended as a means to prevent anaplasmosis, babesiosis, ehrlichiosis, Rocky Mountain spotted fever, or other rickettsial diseases. There is no evidence this practice is effective, and it may simply delay onset of disease. Instead, persons who experience a tick bite should be alert for symptoms suggestive of tickborne illness and consult a physician if fever, rash, or other symptoms of concern develop.

The Infectious Disease Society of America (IDSA) does not generally recommend antimicrobial prophylaxis for prevention of Lyme disease after a recognized tick bite. However, in areas that are highly endemic for Lyme disease, a single dose of doxycycline may be offered to adult patients (200 mg) who are not pregnant and to children older than 8 years of age (4 mg/kg up to a maximum dose of 200 mg) when all of the following circumstances exist:

a. Doxycycline is not contraindicated.

b. The attached tick can be identified as an adult or nymphal I. scapularis tick.

c. The estimated time of attachment is ≥36 h based on the degree of tick engorgement with blood or likely time of exposure to the tick.

d. Prophylaxis can be started within 72 h of tick removal.

e. Lyme disease is common in the county or state where the patient lives or has recently traveled, (i.e., CT, DE, MA, MD, ME, MN, NH, NJ, NY, PA, RI, VA, VT, WI).

Source

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