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

Correctly identifying a tick is an important first step after a bite. Knowing the type of tick can help determine which diseases may be associated with that exposure and what signs and symptoms to monitor in the days and weeks that follow.

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 determine both the type and life stage of a tick. Certain life stages, particularly nymphs, are more likely to transmit disease. Keep in mind that nymphs and larvae are very small and can be difficult to distinguish without magnification.

If you find a tick in Virginia, consider reporting it to the VDH Virginia Tick Survey—particularly if the tick was not attached. If a tick is attached to your body, it is recommended to safely remove it and keep it (for example, in a sealed bag or container) in case identification or testing is needed later.

Since 2018, the lone star tick has been the most commonly submitted species in the state. Bites from this tick have been associated with several conditions, including Alpha-gal syndrome, Ehrlichiosis, Heartland virus disease, Rocky Mountain spotted fever, STARI, and Tularemia.

Consider testing the Tick

Not all ticks carry disease, but some species can transmit multiple pathogens. Testing a tick is not always necessary, but in certain situations, it may provide helpful additional information.

If you were bitten by a tick that was attached and engorged, your lab results are negative, and you are experiencing symptoms consistent with Lyme disease or another tick-borne illness, you may consider having the tick tested. In some cases, tick test results can provide information that complements human diagnostic testing.

However, it is important to understand:

A positive result in a tick does not mean you were infected
A negative result does not completely rule out exposure

Diagnosis and treatment decisions should always be made in consultation with your healthcare provider.

Tick-borne disease testing in humans is not perfect. False-negative and false-positive results can occur, particularly in the early stages of illness. In Virginia, under Virginia Code §32.1-137.06, healthcare providers are required to include a notice with Lyme disease test results explaining these limitations.

While not all providers or public health agencies routinely recommend tick testing, having information about the tick may help guide conversations about care and next steps and provide peace of mind, as many ticks do not carry disease. Perspectives on testing may vary, and results can support more informed discussions with your provider.

Tick testing services:

TickCheck – www.tickcheck.com | (866) 713-TICK
TickReport – www.tickreport.com | (413) 545-1057
Ticknology – www.ticknology.org | (970) 305-5587

Monitor Symptoms

After a tick bite, it’s important to monitor your health over the next few days to weeks. Not everyone bitten by a tick will become ill, but early recognition of symptoms can significantly impact treatment and recovery.

Some symptoms may appear within a few days, while others can take weeks or longer to develop. For example, a rash associated with Lyme disease may appear several days after a bite, while symptoms of Alpha-gal syndrome can occur hours after eating red meat and may develop weeks to months after the bite.

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.

Be on the lookout for:

Fever or chills
Fatigue or unusual tiredness
Headache
Muscle or joint aches
Swollen lymph nodes
Rash

If you experience symptoms—especially after a known or possible tick bite—contact your healthcare provider and share details about your exposure.

Early evaluation can help prevent more serious illness.

Get Tested

If you are experiencing symptoms or think you may have been exposed to a tick-borne disease, testing is an important part of the process, but it is important to understand that testing is just one piece of the overall picture.

For Alpha-gal syndrome, diagnosis requires both clinical symptoms and a positive blood test for alpha-gal–specific IgE antibodies. In most cases, a result of ≥ 0.10 kU/L is considered positive. Results should always be interpreted alongside symptoms, particularly delayed allergic reactions after consuming mammalian products. To learn more, check out this Guide to the Diagnosis and Testing of Alpha-gal Syndrome for ICD codes and test information, developed by the Alpha-gal Alliance, or visit our Alpha-gal in Virginia page.

For Lyme disease, traditional testing typically involves a two-step process using ELISA followed by Western Blot. A positive ELISA leads to confirmatory testing, where a Western Blot is considered positive if specific antibody band criteria are met—at least 2 of 3 bands (23, 39, 41) for IgM or at least 5 of 10 bands (18, 23, 28, 30, 39, 41, 45, 58, 66, 93) for IgG.

In addition, immunoblot testing is now available and provides more detailed and sensitive detection of antibodies. A positive immunoblot result generally indicates that antibodies to Borrelia are present based on defined band patterns, although exact criteria may vary slightly by test. Immunoblot test results are typically reported as positive, negative, or indeterminate, along with band-level details

It is important to understand that tick-borne disease testing is not perfect. False-negative results can occur, particularly in the early stages of illness, meaning results may sometimes feel uncertain—especially when symptoms are present, but tests are negative. For this reason, diagnosis should always consider symptoms, exposure history, and clinical judgment, not test results alone.

For Lyme disease and co-infections, some patients seek care from a Lyme-literate doctor (LLMD). However, many LLMDs do not accept insurance and may be difficult to access. It is important to find a provider who will listen to you, take your concerns seriously, order appropriate testing, and work with you to make a clinical diagnosis.

If initial test results are negative but symptoms persist, additional testing through specialty laboratories may be considered. These tests are often more expensive but may provide more comprehensive information, and not treating Lyme disease and TBDs early can be more expensive in the long term. Examples include IGeneX, Vibrant Wellness, DNA Connections, and Armin Labs. Decisions about additional testing should be made in consultation with a healthcare provider.

Important to Remember

A positive test indicates an immune response, not necessarily an active infection on its own
A negative test does not fully rule out disease, especially early after a bite
Results should always be interpreted alongside symptoms and exposure history

Learn More

Visit our For Patients page for information on what to do after your diagnosis.

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