Ticks and Lyme Disease - When transmission occurs

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Stash

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Just heard an excellent item on the radio from a medical doctor.

You don't get the disease from the initial bite of the tick but when the tick becomes engorged, then essentially regurgitates back into your skin to "make room to eat more". This makes sense (to me) as it's essentially a one-way flow of blood for the first day or so.

What this means is:

  1. Find the tick early and remove quickly
  2. When removing the tick try not to squeeze the body. I would assume that trying to use your fingers rather than sharp tweezers would tend to squeeze fluids back into your body

I'd be interested in any educated responses to verify, clarify or contradict this information.
 
Just heard an excellent item on the radio from a medical doctor.

You don't get the disease from the initial bite of the tick but when the tick becomes engorged, then essentially regurgitates back into your skin to "make room to eat more". This makes sense (to me) as it's essentially a one-way flow of blood for the first day or so.

What this means is:

  1. Find the tick early and remove quickly
  2. When removing the tick try not to squeeze the body. I would assume that trying to use your fingers rather than sharp tweezers would tend to squeeze fluids back into your body

I'd be interested in any educated responses to verify, clarify or contradict this information.

I was told (by a doctor) that a tick needs to be attached for at least 24-48 hours for the tick to begin to infect. These links may help:

http://www.cdc.gov/ncidod/dvbid/lyme/ld_humandisease_symptoms.htm
http://en.wikipedia.org/wiki/Lyme_diseasehttp://www.aldf.com/
http://www.lyme.org/
http://www.mayoclinic.com/health/lyme-disease/DS00116
 
There seems to be quite a lot of information and misinformation about ticks and Lyme Disease. According to the International Lyma and Associated Diseases Society, "Fewer than 50% of patients with Lyme disease recall a tick bite. In some studies this number is as low as 15% in culture-proven infection with the Lyme spirochete." Reference: www.ilads.org

If that is true, then it would seem the tick does not have to stay on the body until it is engorged. The tick can be very small, but once it is filled with blood, I would think that it would be noticable.
 
The transmission of Lyme disease from the tick to human is actually a fascinating process and the subject of substantial current research. Perhaps someone here is even more up to date on this than I am and will correct my greatly simplified version:

1. The causative organism of lyme disease (Borrelia burgdorferi) has an outer surface protein that grabs onto a receptor in the stomach of deer ticks. This has been nicely described in the literature as a bus rider holding onto a strap. This allows the Borrelia burgdorferi bacteria to remain inside the tick gut until the tick is attached and feeding on blood.

2. Once the the tick attaches and starts a blood meal, temperature change, the presence of blood in the tick's stomach, and other factors signal a change in the bacteria's protein coat. The protein that allowed the bacteria to stay in the tick's stomach stops being produced and a new one allowing the bacteria to live in the salivary glands has its production ramped up. Thus the bacteria moves to the tick's salivary glands where it is "spit" into the human host. It now seems likely the bacteria are not regurgitated from the stomach, but instead migrate through the gut wall and then into the salivary glands. This process takes time, hence the advice to remove ticks as quickly as possible.

3. A further reason quick removal makes sense is that other changes also occur on the bacteria's surface. These changes increase the diversity of the protein coat and make it harder for the immune system to mount a response. The longer the tick feeds, the greater the diversity of the protein coat.

There is some suggestion that while most transmission of Borrelia burgdorferi requires at least 24 hours to occur, there have been documented cases of transmission in less time. Further, it is important to remember that Lyme is not the only disease that can be caused by a tick bite. For all kinds of reasons, it is a good idea to take precautions to avoid being bitten, carefully inspect daily if in a high-tick area, and attempt to remove ticks without squeezing the body--or leaving part of the tick buried in the skin (often hard--especially with a deer tick the size of a pinhead).

VT
 
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Here's more from my friend about her experience with Lyme:

"From personal experience, however, 10 years ago, I did not have a tick on me before I went running. 3 miles later when I did my tick check when I got home, I did have a tick on me. I removed it immediately, and from it, I DID contract lyme disease. And it was the size of a speck of dust. So this thing was not engorged."
 
Here's more from my friend about her experience with Lyme:

"From personal experience, however, 10 years ago, I did not have a tick on me before I went running. 3 miles later when I did my tick check when I got home, I did have a tick on me. I removed it immediately, and from it, I DID contract lyme disease. And it was the size of a speck of dust. So this thing was not engorged."
This is a very difficult thing to prove because she must also be certain that she did get the lyme from an undiscovered tick.

Doug
 
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My son was bit several times (this year, IIRC). Me too.

We were told by our son's paediatrician that they are under new rules this year. They don't want to see a patient unless the tick has been in for 24+ hours or the patient is showing symptoms (high fever, target, flu symptoms, etc...).

Like others said, current science says that a tick needs to be embedded for 24 hours. But there's more. Apparently the commonly used test for Lyme is inaccurate, there are many false positives and false negatives. And worse, there might be several derivatives of the Lyme bacteria and many of those don't actually cause illness. So even the more accurate test may have you taking an antibiotic for something that wouldn't hurt you.

Given this, the doc said that if we were certain it was before 24 hours, we shouldn't see him unless there are symptoms; but we should treat the bite area with a disinfectant.

Opinions differ on this, NPR had a show with a medical professional who thought that fibromyalgia and chronic fatigue syndrome were caused by undiagnosed Lyme infections.

[Edit: The cynical side of me has to wonder if this tradeoff was decided by our HMO.]
 
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Ditto!!

Here's more from my friend about her experience with Lyme:

"From personal experience, however, 10 years ago, I did not have a tick on me before I went running. 3 miles later when I did my tick check when I got home, I did have a tick on me. I removed it immediately, and from it, I DID contract lyme disease. And it was the size of a speck of dust. So this thing was not engorged."


One of my situations was very similar to this. I have had Lyme numerous times(as have many friends/family members) and each time the symptoms were very different(mild flu, Bell's Palsy to ICU and emergency operation on the heart). If you or anyone you like has flu-like or unexplainable symptoms - get tested and then retested if necessary!!

The recovery has been quick (4hrs) to still getting treatment over 10yrs later because of faulty diagnosis.......
 
In Albany

I highly recommend a new documentary, Under Our Skin (http://www.underourskin.com/). It just opened in New York City, and deals extensively with how Lyme disease is misdiagnosed--often intentionally.

It's playing in Albany, NY today and tonight at the Spectrum Theater.
http://www.spectrum8.com/showing/index.html#12

A dramatic tale of microbes, medicine, and money, Under Our Skin plays like a taut thriller -- but it is our own lives that may be at stake. This riveting film, a documentary with the propulsion of a narrative, investigates the untold story of Lyme disease, an emerging epidemic larger than AIDS. Each year thousands go undiagnosed or misdiagnosed, or told that their symptoms are "all in their head." Following the stories of patients and physicians as they battle for their lives and livelihoods, the film brings into focus a haunting picture of our health care system and its inability to cope with a silent and growing danger.
 
The film will be playing throughout New England this summer, including Portsmouth on July 30. To find a theater new you, go to http://www.underourskin.com/screenings.html

I saw it this spring and will try to see it again -- once was not enough as there is so much information to take in and think about.
 
ticks

An engorged deer tick is still pretty small and not necessarily noticeable unless you are really looking. I had Lyme once. I had a huge bulls eye rash behind my knee. I never noticed a tick. My husband had a bulls eye rash in his groin and flu symptoms and never noticed a tick. We never had any complications re: Lyme disease. The worst thing was taking the antibiotic and having to stay out of the sun. Even the sun through the car window felt like my skin was burning.
 
I am currently being treated for Lyme from a supposed recent tick transmission. This makes the 4th time (over the course of several years), that I've been treated. I did not experience any noticeable symptoms, but have been experiencing heart pains (might be due to anxiety which can be more predominant with Lyme patients).

I don't know how I got Lyme this time. I haven't been hiking. I did do some brush trimming in the spring (my mom's yard in New Jersey). I was also taking TicTox; an herbal tincture that I was using to battle remaining spriochetes??? I know, not very scientific.

I own no pets.

Can we talk about DEET? Is that really the answer? Or are we going to generate superbugs and pollute are food chain and water supplies with it? (I'm going to try to start a DEET thread).
 
Can we talk about DEET? Is that really the answer? Or are we going to generate superbugs and pollute are food chain and water supplies with it? (I'm going to try to start a DEET thread).
There are plenty of older threads on the topic.

The best chemical defense is permethrin (a contact insecticide, Repel Permanone, Sawyer Permethrin) on your clothing and DEET on exposed skin. Tuck long pants into your socks, tick checks etc... I suppose you could also tape the cuffs of a long sleeve shirt too. Light colored clothing makes ticks easier to spot.

Doug
 
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