Three weeks ago I was bitten by a tick. I’m sure I got it off before 24 hours, but the bite mark is still red, about the size of a pea. It hasn’t grown in size. Is it unusual to have a bite mark for that long? Could it be that the proboscis is still in there?
Everybody reacts differently to tick or mosquito bites. Then again, everyone has a different reaction to watching Duck Dynasty. And, there are three possibilities to consider even with individual variation in response to tick bite: (1) The tick creates a small hole in your skin. Therefore, like sticking yourself with a fish hook, you could get a local infection from skin bacteria (cellulitis). Any streaks of redness coming from a bite could be cellulitis and need to be evaluated by your doctor. (2) You could be allergic…my bites itch like crazy for weeks. Ticks leave a little bit of their exoskeleton in the bite (the microscopic backwards facing barbs on the mouthparts sometimes come off) and this attracts immune cells that can cause local redness and itching. Pulling a tick out usually leaves behind even more tick mouthpart materials. Although some may think it gross, it is no different than getting a splinter, which is usually walled off by your body so that it is harmless (splinters too can cause cellulitis which needs to be seen by a doctor; someone in Rhode Island just lost a limb due to flesh-eating bacteria from thorn prick cellulitis). Or, it simply works itself out, depending on how deep it is, because the skin is constantly shedding flakes of the outermost layers. This is why it does not matter if the tick “head” is left in. (3) It could be Tularemia. The Vineyard is uniquely blessed with having dog (wood) ticks (we could say the same about tourists) that are not uncommonly infected by the bacteria that cause Tularemia. Everyone knows about landscapers breathing it in, but it is naturally out there as a tick-transmitted infection. When you get Tularemia from a tick bite, a red area doesn’t enlarge much but turns into an ugly divot and your nearest lymph nodes get big. Usually you will also have a high fever. So any ugly red divot in your skin, nearby swollen glands, and fever needs to be checked out pronto by a doc.
Visit the MV Tick Borne Disease Initiative website, sponsored by the Island-wide boards of health (www.mvboh.org) for tips on prevention.
Sam Telford is Professor of Infectious Disease and Global Health at Tufts University Cummings School of Veterinary Medicine.