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What To Do After a Tick Bite

Published: 05/02/2017


Lyme Disease Symptoms

The most common early symptom of Lyme disease is an expanding red rash (erythema migrans) that occurs 3-30 days after being bitten. Fever, joint and muscle pains may also occur. Untreated infections can lead to clinical findings in skeletal, cardiac, and nervous systems. Disseminated manifestations of disease include: arthritis characterized by recurrent, brief attacks of joint swelling; lymphocytic meningitis; cranial neuritis (such as Bell’s palsy); encephalitis; and second or third-degree atrioventricular block.


What to do after a tick bite

  • Remove the tick properly, ideally using tweezers or a tick spoon.
  • Identify the tick and the engorgement level, or length in time of attachment. Tick identification is available for free through the University of Maine Cooperative Extension and more information can be found at
  • Clean the area around the bite, and instruct the patient to watch for signs and symptoms for 30 days.
  • Testing of the tick is not routinely recommended because even if the tick tests positive for Lyme, that does not mean it was attached long enough to transmit the disease. Even if the tick tests negative that does not mean that was a patient’s only exposure, and it does not eliminate the possibility of anaplasmosis or babesiosis.
  • Prophylaxis after a tick bite is not routinely recommended but can be considered under specific circumstances including:
    • Tick has been identified as an engorged deer tick that has been attached for over 24 hours
    • Exposure occurred in an area where there is a high rate of infected ticks. Areas south of Bangor have the highest rate of infected ticks in the state. There are limited data from the more northern counties on the rate of infection among ticks.
    • Prophylaxis can be started within 72 hours. Even if prophylaxis is used, monitoring for symptoms for 30 days is recommended.
  • There are no data showing if prophylaxis is effective in preventing anaplasmosis, and a single dose of doxycycline will not have an effect on babesiosis. Therefore, even if prophylaxis is used, monitoring for symptoms for 30 days is recommended.

Source: Maine Center for Disease Control and Prevention, 2017PHADV003 – 2017 Lyme and other Tickborne Diseases Information

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