The risk of acquiring a tick-borne infection is quite low, even if the tick is actually infected with a disease. For example, the risk of acquiring Lyme disease from an observed tick bite is only 1.2 to 1.4 percent, even in an area where the disease is extremely common.

• How to Remove a Tick
• After the Tick has Been Removed
• What to Look for Following a Tick Bite

How to Remove a Tick

The proper way to remove a tick is by using tweezers. The use of a smoldering match or cigarette, nail polish, Vaseline or kerosene should be avoided, since they may irritate the tick and cause it to inject fluids into the wound.

The proper technique for tick removal includes the steps listed below.

1. Use tweezers to grasp the tick as close to the skin surface as possible.
   
2. Pull the tick backwards gently, but firmly, using an even, steady pressure. Do not jerk or twist the tick.
   
3. Do not squeeze, crush or puncture the body of the tick, since its fluids may contain infectious agents.
   
4. After removing the tick, disinfect the skin and hands thoroughly with soap and water.
   
5. If sections of the tick's mouth remain in the skin, leave them alone. They will be expelled on their own. Attempts to remove these parts with tweezers may result in significant tissue damage.

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After the Tick has Been Removed

It will be helpful for your doctor if you can provide information about the size of the tick, if it was attached to the skin, if it was engorged (full of blood), and how long it was attached.

Ticks that transmit Borrelia burgdorferi (the agent of Lyme disease) and a number of other tick-borne infections in the northeast, midwest and southeast United States are brown and approximately the size of a poppy seed or pencil point. Ticks that are black and the size of a pencil eraser, are most likely dog ticks, which rarely transmit Rocky Mountain spotted fever.

Ticks that are not attached, still flat, tiny and not full of blood, and were just walking on the skin, could not have transmitted Lyme disease. Only ticks that are attached and feeding can transmit a disease. After arriving on its host's skin, a tick that spreads Lyme disease usually takes 24 hours or more to attach to the skin.

Even if a tick is attached, it must have contact with blood in order to transmit a disease such as Lyme disease. At least 36 to 48 hours of blood contact is required for a tick to spread Lyme disease. After this amount of time, the tick will be engorged with blood. An engorged tick is larger than an unengorged tick. One study has shown that in persons who have a tick attached to them for less than 72 hrs, only 1.1 percent developed Lyme disease.
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What to Look for Following a Tick Bite

Observe the area of the bite for the development of an expanding redness, which would suggest erythema migrans (EM), the characteristic rash of Lyme disease. The rash is usually a salmon color, although in rare cases it can be an intense red. The color may be almost uniform. The lesion typically expands over a few days and usually causes no symptoms, although burning or itching has been reported. As it expands the rash can become clear in the center, develop into a lighter color than its perimeter, or even develop into a series of concentric rings giving it a "bull's eye" appearance.

In people with early localized Lyme disease, EM occurs within less than one month of the tick bite, typically within a week. However, only about one-third of people recall the tick bite that gave them Lyme disease.

Components of tick saliva can cause a short-lived (24 to 48 hours) rash that should not be confused with EM.

Up to 90 percent of patients with Lyme disease will develop EM; 10 percent of these people may have multiple lesions. If EM or symptoms suggestive of Lyme disease develop, the patient should see his or her doctor for proper diagnosis and treatment.

Lyme disease usually causes a low-grade fever and aches. A runny or stuffed nose and stomach complaints are very uncommon. A very high fever is also uncommon and suggests that the illness may not be Lyme disease or may be a dual infection with two tick-borne organisms. The latter occurs in certain endemic areas including Wisconsin, Minnesota, New York, New Jersey, Connecticut and Massachusetts.
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