What to Do if Bitten
Carefully Remove the Tick
Use fine-tipped tweezers and get as close to the skin as possible. Pull the tick straight up and out, slowly and carefully.
Do not twist the tick or pull the tick out at an angle. Do not use your fingers to pull the tick out.
Wash the bite area with soap and water.
Save the Tick
Don't throw the tick away if it has been attached. Save it! Put it in a zip lock bag or small container. Label it with the date, where you found it on your body, and how long you think it was attached. Ticks can carry multiple diseases and testing the tick can provide more reliable results that the human tests that are available as well as peace of mind. However, just because a tick tests positive, it does not mean you will test positive. The risk for disease increases with the amount of time the tick is attached. See below for more information on where to get ticks tested.
Identify the Tick
TickSafety.com provides detailed information on how to identify a tick, including images of when they are engorged. You can also submit a picture or text a picture to 703-828-4343 for free identification.
You can also use this tick identification chart from the Virginia Department of Public Health to identify the type and stage of your tick. Ticks with a frown face are most likely to feed on people and stages with a red cross are the tick stage most likely to transmit disease. Nymph and larva stages can be very difficult to identify without a microscope.
If you find a tick in Virginia, consider reporting it to the VDH Virginia Tick Survey. Since 2018, the Lone Star tick has been the most submitted tick in Virginia. If bitten by a Lone Star tick, people can get Alpha-gal Syndrome, Ehrilichiosos, Heartland Virus, Rickettsia, Rocky Mountain Spotted Fever, Southern Tick Associated Rash Illness (STARI), and Tularemia. Click to learn more about the tick-borne diseases most common in Virginia.
Consider testing the Tick
Not all ticks carry a disease, but some carry multiple diseases. The only tick in Virginia not known to be infectious to humans is the Asian Longhorned Tick. After identifying the tick, consider sending the tick to a lab to get tested when the tick has been attached and engorged, your test results are negative, you are experiencing common symptoms of Lyme, and you are not getting a clinical diagnosis. Tick testing is more reliable than current tick-borne disease tests available for humans. However, just because a tick is positive for a disease, it does not mean you are. It will still require a diagnosis from your doctor. It is not uncommon to get false negative tests. In Virginia, under Title 32.1-137.06, doctors are required to include a notice with Lyme disease test results stating how tests vary and may produce inaccurate results.
In addition, doctors do not always support testing for tick-borne diseases so having the results from the tick can be helpful for getting appropriate care and treatment. It can also give peace of mind, as not all ticks carry diseases. Here are some places where you can mail ticks for testing.
TickCheck www.tickcheck.com (866) 713-TICK
TickReport www.tickreport.com (413) 545-1057
Ticknology www.ticknology.org (970) 305-5587
Monitor how you are feeling. If you have flu-like symptoms or start experiencing strange symptoms that you have not felt before, schedule an appointment to see a doctor. The longer you wait to get diagnosed and start treatment, the higher the risk for more chronic and long-term impacts.
Common symptoms associated with tick-borne diseases include fever, chills, body aches and pains, headaches, fatigue, joint pain, paralysis, and rashes. The chart on the right illustrates the top 5 symptoms patients reported in a patient experience survey for Lyme disease, Rocky Mountain Spotted Fever, Alpha-gal Syndrome, and then all types of tick-borne diseases combined.
If you develop symptoms, see a healthcare provider and ask to get tested. Alpha-gal requires an allergy test so you may need to be referred to an allergist.
It is best to see a Lyme Literate Doctor (LLMD); however, most patients cannot start this way as most LLMDs do not take insurance. Therefore, tests to request from a traditional medical doctor are:
LabCorp (recommended) or Quest: There is a 50% false negative on the (in bold) tests.
Elisa AND Western Blot WITHOUT reflex (ask for results and make sure you get results that show bands, not just positive/negative. Most traditional doctors will do Elisa and will not order Western Blot UNLESS Elisa is positive. Try to get BOTH.
CD57 (Natural Killer Cells and T Lymphocytes)
ANA (Antinuclear Antibodies)
RF (Rheumatoid Factor)
ESR (Erythrocyte Sedimentation Rate)
EBV (Epstein Barr Virus)
RMSF (Rocky Mountain Spotted Fever)
TBRF (Tick Borne Relapsing Fever)
Herpes Simplex Virus 1 and 2 (VERY common in east coast Lyme patients)
C Reactive Protein
Vitamin B panel
Vitamin D levels
C3a and C4a (Quest only)
Thyroid panel: including T3 Reverse, TSH, T3 Free and Thyroxine Free
There is a 50% false negative on the above TBD (in bold) tests.
If they turn up negative, then move on to the other companies (more expensive) tests:
IGeneX: The best test there is, but is VERY expensive. But not treating Lyme and TBD early is VERY expensive.
Vibrant Wellness (second best to IGeneX) but less expensive
Great Plains Laboratory for Bartonella