How to spot and deal with tick bites

Ticks carry a passenger responsible for at least one potentially very nasty disease when they decide to borrow some of your blood. But what are the signs and symptoms of a tick bite, and what can you do in the event of finding a tick on you? I’ve been speaking to the director of the Scottish Microbiology Reference Laboratory at NHS Highland, Sally Mavin.

Sally - for the majority of people you would generally see a rash. Now some people would say it's a bullseye rash or a target rash. So it looks a bit like a dartboard with central clearing and then a quite distinctive ring. But actually it's not as clear cut as that. In some situations you can just get a general rash around a tick bite. But the trigger point for us to have further investigations and maybe some antibiotics is if the rash spreads. So it's not just a localised redness around a tick bite, just a localised reaction. It's actually the spreading rash. The bacteria can stay just within the skin and cause this rash and if treated, it'll go away quite quickly and you may never have any other problems. But you can also get a flu-like illness alongside the rash so you can feel quite grotty for a time. And sometimes even after you've had antibiotics you can still feel grotty for some time. So you can still have tiredness and headaches, maybe a little bit of brain fog. In some people though the bacteria can spread through the body so it can spread along the nerves and in the blood system and it can cause a variety of different symptoms. So it's often known as the great imitator because it can mimic lots of other conditions so it can cause neurological symptoms, joint symptoms like arthritis, occasionally cause some heart problems as well and other skin conditions. So there's a range of symptoms that you can get.

Will - All of this so far to my mind has been focused very much on Lyme disease, as it should be as this is the most common disease to contract from tick bites. But there seems to be also rumblings that there are certain other illnesses that might be coming along with tick bites as well.

Sally - Yeah, so since 2019 there have been a few cases of tick borne encephalitis that have been recorded in the UK and that's for the very first time. So tick borne encephalitis is found throughout many parts of the world, Scandinavia, throughout Europe and Russia. But we've now started to see some cases coming out from the UK So these are cases that have been caught from ticks that have bitten people within the UK themselves. So not just travelling to different countries. There's very small numbers so far, but we are aware now it is in the UK and it's something that we need to start looking out for

Will - As part of your job is to look at Lyme disease diagnostics, are you seeing an increase in the number of tick bite diseases?

Sally - Well our focus is obviously on Lyme disease because that is the most common tick-borne disease that we have in the UK and in the laboratory it's quite difficult to say if numbers are really on the rise or not. We definitely, there's an increased awareness of tick-borne diseases amongst the general public and amongst our medical professionals. But diagnostics have improved over the years as well. So I think we're picking up more cases than we did before. In parts of Europe they certainly feel that case numbers are stabilising slightly. It'll be interesting to see over the next few years. Obviously the pandemic affected the health service, affected testing and people going to their GPS and things. So it will be interesting to see how things progress over the next few years. But certainly with other tick-borne diseases, they're still thankfully very rare within the UK so you have other diseases such as anaplasmosis, you have babesiosis for example. We all need to detect very few cases throughout Europe. But again, that is something we need to be aware of and need to consider moving forward, especially with changes in climate and things and tick habitat changing, tick spreading into new areas and the diseases that they carry with them spreading into new areas.

Will - Absolutely. I think the last thing we need to do right now is get complacent if numbers are stabilising, but I would be doing everyone a disservice if I didn't have you here and ask you to talk us through what you should do should you be bitten by a tick.

Sally - Okay, well I know it can be scary for those especially that have been bitten by a tick for the very first time, but you shouldn't panic. It's really important to remember that not everybody that gets bitten by a tick is going to get poorly. Not everyone's going to get Lyme disease or one of those other diseases, but it is important to remove a tick as quickly as possible after you notice it because that will reduce any chance of the disease passing on to you from the tick. I think it'd actually be really important if everybody had tick removal devices within the first aid kits at home or at work or in your cars. So you can buy purpose made tick removing devices. You have tick removal cards that they're the size of a credit card that you can keep in your wallet. You also have tick twisters that I know you can buy from your vets. They're all very helpful and very useful for removing ticks. And you can also use fine tip tweezers as long as you hold them parallel to the skin and then pull up. They're very useful tools as well, especially for the very small ticks that you might come across. It is really important though, I just want to emphasise, that you shouldn't try and burn ticks off or smother them in Vaseline or anything like that because that could potentially distress the tick and cause it to regurgitate its contents into you, which you really wouldn't want. But yeah, there's a large number of devices out there that you can safely remove ticks.