Worldwide, ticks are second only to mosquitoes as vectors in transmitting disease to humans. Ticks are not insects, but are arthropods, similar to spiders. The most common illnesses caused by ticks are Rocky Mountain Spotted Fever, Erlichiosis, Tularemia, and Lyme Disease. As with mosquitoes, it is the organisms in the tick's saliva that are primarily responsible for causing disease, not the bite itself.

A tick is crawling on my arm! As long as it is handled properly, there is little to no risk of becoming ill if the tick has not yet attached itself. Only ticks that are attached and feeding can transmit a disease. When removing the tick, wear protective gloves so you don't spread bacteria from the tick to your hands. If bare hands are used to remove the tick, be sure and wash with soap and water. Once removed, don't crush the tick as this could transmit disease. Instead, rinse it down a sink or flush it in a toilet.

What do I do if I find a tick that is attached to the skin? Even if the tick has attached itself, the risk of acquiring a tick-borne infection is quite low. For example, there is only a 1-2% chance of acquiring Lyme disease from an observed tick bite, even in an area where the disease is extremely common. In most cases, ticks remain attached and feeding for a number of hours before the organisms that cause disease are transmitted. It is true, however, that the earlier that the tick is removed from the skin, the less risk there is of becoming infected.

What is the best way to remove an embedded tick? A number of methods of removing ticks have been suggested. Many of these, such as the use of a smoldering match, fingernail polish, or coating with Vaseline, are not advisable. These methods increase the possibility of the tick passing infected saliva into the host's bloodstream. The goal is to remove the entire tick and in particular the head and mouthparts. The proper method for tick removal is as follows:

1. Use tweezers to grasp the tick as close to the skin surface as possible.
   
   
2. Pull backward with even, steady pressure. Since the tick's mouthparts are barbed, not spiral, twisting does not make removal easier.
   
   
3. Avoid squeezing or crushing the body in order to minimize expressing potentially infectious saliva from the tick.
   
   
4. After removing the tick, disinfect the skin and hands thoroughly with soap and water. Thoroughly cleanse the bite area with soap and water or a mild disinfectant.
   

It would be helpful for your doctor if you can provide information about the tick bite, such as the size of the tick, if it was attached to the skin, and how long it was attached. If possible, save the tick (putting it in a small container in the freezer is a good method) for identification in case you become ill.

What do I do after removing the tick? In most instances, the site of the tick bite heals in a few days without complications. Application of an antibiotic cream to the area may help prevent a local infection. Otherwise, taking Benadryl for itching or a mild analgesic such as acetaminophen (Tylenol) or ibuprofen (Advil) may be all that is necessary. You should continue to monitor for signs or symptoms of tick-borne disease for at least a month after the tick bite. You should call your health care provider if any of the following develop:

• You develop a red, bulls-eye rash at the site of the tick bite or a skin rash with tiny purple or red spots.
  
  
• The area of the bite becomes more swollen or painful, or drains pus.
  
  
• You develop flu-like symptoms such as fever, headache, muscle aches, or joint pain up to a month after a bite.
  

What can be done to reduce the likelihood of a tick bite?

• Use a chemical repellent with 20-30% DEET on the skin. The insecticide, permethrin, is also effective when applied to clothing personally or during the manufacturing process.
  
  
• Ticks may be seen more easily for removal when wearing light-colored clothing
  
  
• Avoid tick habitat (wooded or bushy areas with high grass and leaf litter)
  
  
• Conduct a full body check upon return from potentially tick-infested areas. Use a hand-held or full-length mirror to view all parts of your body. Also check your children and pets.
  

In some cases, early treatment with antibiotics is recommended. This is particularly true in areas with a high incidence of Lyme disease (parts of New England, parts of the mid-Atlantic states, and parts of Minnesota and Wisconsin).