Tick parts remaining in the wound are not a problem and will shed as the skin naturally sloughs. 9 The tick should be loosened by gentle twisting before it can be finally pulled out slowly. Tick removal is best achieved by using fine-tipped tweezers or forceps, and grasping the tick as close to the skin as possible. The implication is that, the faster a tick is removed, the lower the potential risk of becoming infected with a Borrelia. In animal studies, transmission rates 18–24 hours post-attachment ranged from 0–50% with nearly complete transmission occurring after 72 hours. Therefore, an infection is less likely during the first 12 hours after the tick has attached. 5 – 8Īs Borreliae live in the intestines of ticks, it takes time before the bacteria are transmitted to the host. Clothing should be placed in a hot dryer for 20 minutes to kill any ticks still present. When returning home, a shower should be taken soon and a thorough body inspection for any adhering tick should be conducted, with particular emphasis on searching the backs of the knees, armpits, and groin area. Walking in the centre of trails is recommended to avoid brushing against any vegetation.
This includes light-coloured clothing, long-sleeved shirts, and long trousers with hems tucked into the boots or socks, and the wearing of rubber boots. During outdoor activities in tick-prone areas, the wearing of protective clothing is advisable. Ticks are most easily spotted on light-coloured clothing unfortunately, however, ticks also are preferentially attracted to light-coloured clothing. The Royal College of General Practitioners has produced an e-learning course on Lyme borreliosis available to all health professionals ( ). As no vaccine is available against Lyme borreliosis, prevention of tick bite offers the best protection against this condition. A booster should be administered after 3–5 years thereafter.
Vaccination is recommended for all those who live in TBE risk areas or who will travel to these regions. It has been estimated that >3000 people are affected each year in the UK. The incidence (per 100 000 inhabitants/year) was 43 in the Netherlands, 130 in Switzerland, and 300 in Austria.
Borreliosis is a notifiable disease in only a few European countries, so numbers reported vary between regions, and large numbers go unreported. As opposed to TBE, borreliosis can affect people anywhere where I. 3 Vaccination and tick bite prevention strategies should be exercised for travellers with recreational and/or outdoor exposure in endemic areas.Īccording to various estimates, around one in ten ticks in Western Europe carries Borrelia burgdorferi s.l., although in some regions this can be as high as one in five. 3, 4 The European Centre for Disease Prevention and Control has published a map on tick distribution in Europe. In Europe, TBE is endemic in 27 countries, including the Czech Republic, Slovakia, Austria, southern Germany, and the Baltic states. In endemic regions, TBE vaccination is recommended for children and adults who are potentially exposed to the bite of I. In Europe, up to 3% of nymphs carry the TBE virus and up to 5% of adult ticks. The risk of becoming infected with a tick-borne disease largely depends on three factors: the density of the tick population, the proportion of ticks infected with a pathogen (infection rate), and factors relating to human behaviour that influence the risk of exposure. The larval and nymphal stages require blood for development and only feed once, whereas a female feeds on blood for the protein to produce eggs and is capable of laying around 2000–3000 eggs. In the juvenile stages (larvae and nymphs), it has an extremely broad host range, including small mammals and birds, whereas the adult tick tends to feed on larger mammals such as deer and occasionally humans. ricinus does not climb very high in the foliage (maximum height is 1.5 m), nor does it jump or fly. These organs are located towards the end of the first pairs of legs and are able to detect various host odours, humidity, body heat, vibrations, and carbon dioxide. When ‘questing’, they sway their forelegs back and forth exposing a structure known as the ‘Haller’s organs’. They lie in ambush on the tip of a blade of grass (or other plant material) with their front legs out in a behaviour known as ‘questing’ ( Figure 2), waiting for a host to pass by in order to latch on to. The ticks are quite passive in their search for a host. This means that their ideal habitats include woodlands with low scrub, especially along the outskirts of woods and clearances, and also in marshy areas, city parks, and gardens. ricinus prefers warm, humid environments and tends to be found in locations where humidity exceeds 80% relative humidity (RH).
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