Tick bites: What should you do after removing a tick?

After a recent trip to Mississippi, my 8-year-old son came back with a nasty souvenir: A fat black tick embedded in the flesh below his waist band.

He found it when we got back to Alabama and had probably picked it up a day earlier during a hike in the woods around Oxford. The kid is a magnet for bugs and rashes, so he wasn’t afraid of the eight-legged pest plugged into the skin below his belly button.

But I was. I grew up in central Texas, an area with plenty of mosquitoes and fire ants, but not a lot of ticks or tick-borne diseases.

My husband used tweezers to remove the insect and we shoved it into a plastic Ziploc bag. I immediately called his pediatrician to see if I needed to make an appointment with the doctor. The nurse said no but suggested sending the tick to a lab that identifies them and tests for pathogens.

The largest of these labs, the Tick Research Lab of Pennsylvania, started testing ticks in 2005. Their website launched in 2019, which made it easier for people to send ticks in for testing, said Nicole Chinnci, director of the lab. The lab received between 20,000 and 30,000 ticks every year and can identify the type and test for pathogens.

“When they submit their tick for testing, they’ll receive information about what type of tick it is, so we’ll identify it down to its genus and species, its life stage and we also evaluate engorgement to see how long the tick might have been attached and feeding to give you a better idea of your risk,” Chinnci said.

The lab offers three different panels, from a basic screening that covers the most common tick-borne illnesses to a more advanced panel that screens for rarer pathogens. It’s not a diagnostic test, so health insurance and health savings accounts can’t be used for payment. A basic panel costs about $50 and more comprehensive options go up to $175.

“It is really important to have tick testing done,” Chinnci said. “Because it will be the first level of you being able to identify if you’ve been exposed to a tick-borne illness. Tick-borne illnesses have hallmark symptoms, and they are very common among illnesses that we see, especially with COVID, so there will be a lot of misdiagnoses that will occur.”

It’s important to get treated as early as possible if you have caught an illness from a tick, Chinnci said.

Dr. Walter Schrading, a wilderness medicine expert at UAB Heersink School of Medicine, said that kind of tick testing might be more necessary in the Northeast and Midwest, where Lyme Disease is much more common. He does not recommend saving ticks that have attached to people or animals.

“The first thing is to remove the tick as soon as possible,” Schrading said. “And that is best done by using a pair of tweezers and just grasping the head of the tick as near as possible to the skin and then you just pull straight back with gentle, steady pressure.”

It takes time for a tick to transmit bacteria or other pathogens to humans or pets, Schrading said.

“If a tick has been attached for less than 24 hours, it’s very unlikely to transmit any of those diseases,” Schrading said.

You can prevent tick-borne illnesses by wearing long sleeves and pants and using insect repellent with DEET. He also recommends doing tick checks after hikes. People should inspect themselves or a partner from head-to-toe, paying special attention to the scalp, armpits, groin and areas around the waistband. Removing ticks quickly can reduce the risk of catching Lyme Disease or spotted fever rickettsiosis.

The most common signs of tick-borne illnesses are rashes. Lyme Disease can often be identified by a bull’s eye rash and Rocky Mountain Spotted Fever can cause red splotches or dots that appear a day or two after a fever.

“The things to watch for is if the area the tick was attached to a day or two later becomes red or you see an expanding red rash going out from the lesion in kind of a circle, that a particular rash that’s associated with Lyme Disease,” Schrading said. “Or you come down with a fever-like flu-like illness after the tick bite.”

Our son’s tick was identified as a lone star tick by the lab where we sent it. It tested negative for Lyme Disease and Rocky Mountain Spotted Fever. Which was reassuring, even if it was unnecessary.

But next time, I might not save the tick.

“For the most part, no, you don’t need to save the tick,” Schrading said. “Flush it in the toilet or throw it in the trash.”

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