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BITES & TICKS


INSECT BITES AND TICK REMOVAL


Written by Dr James Douglas, Tweeddale Medical Practice, Fort William Health Centre, Fort William


The correct advice and management of insect bites and tick removal is a vital step in the prevention of lyme borreliosis in Scotland.


yme borreliosis can be prevented by prompt and correct tick removal. Primary lyme borreliosis (erythema migrans) can be cured with antibiotics. Secondary lyme borreliosis is a low prevelance, high impact condition in Scotland which can cause signifi cant morbidity and debility.


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The prevention strategies seek to reduce the prevelance and impacts of lyme borreliosis.


PHARMACY ADVICE:


Q. Is it a midge bite, horsefl y/ clegg bite or a tick bite?


A. Midge bites will give itchy rash on exposed face, arms and legs which will itch for 24 – 48 hours. A horsefl y/clegg bite is likely to be on the head, face or arms. The customer is likely to remember the bite. The tick bite may not be immediately apparent and may declare itself in the evening after outdoor activity.


Q. Are midge bites a problem?


A. The biology of midgies has been extensively studied in Scotland and there are no apparent disease links from midge bites.


Symptomatic treatments including anti-histamine creams or tablets might soothe symptoms.


Prevention includes, clothing, nets 32 - SCOTTISH PHARMACIST and insect repellents.


Q. What else can be confused with midge bites?


A. Bed bugs may cause extensive unexplained bites on the limbs and body which persist beyond 48 hours and require bedding to be washed.


Scabies produces a characteristic itchy rash on the wrists, arms and trunk with a characteristic history of several family members affected and an insatiable itch.


Q. What are the impacts of a clegg/horsefl y bite?


A. Bees, wasps and horsefl ys are an annoyance in good summer weather. Horsefl ys can produce quite an allergic, painful type response in some people which requires oral antihistamines.


Standard checks for suitability of oral antihistamines by the Pharmacist are required. Antibiotics are not routinely prescribed for infl amed bites but referral to GP of Out of Hours Service may be required in some people e.g. those prone to leg cellulitis.


Q. What is the best method of tick removal?


A. Pharmacists have a key role in the public health campaign to encourage early, safe removal of ticks.


Dr James Douglas fi rst aid kits or rucksacks.


• Traditional folk remedies of tick removal including, Vaseline, cigarettes, butter, alcohol and fi nger nails are best avoided.


Q. What is the problem with ticks in Scotland?


Please Stock The Tick Removal Cards Or Twister Claw Hammer Type For Scottish Ticks.


The ixodid ticks carry the bacterial spirochete parasite borrelia garinii and it takes up to 8 hours for the tick to latch on and draw blood with an anti-coagulant in its salvia and thus exchange the borrelia parasite from its stomach into the human. Squeezing the body of the tick will only facilitate this process!


• Please recommend removal devices for humans which get underneath the tiny tick and lift it off whole.


• Advise against the use of tweezers or tick removal devices based on the tweezer method.


• Advise tick removers in personal and home fi rst aid kits.


• Advise local outdoor workers to carry tick removal devices in van


A. Many people think of ticks as being quite big but this is because they are used to seeing balloon-like ticks on a dog or cat but they are in fact very small. Unfed, the largest tick


A. The undergrowth in the countryside from spring until autumn is covered in tiny ticks which live on deer, rodents and ground nesting birds. Up to 10% of ticks may carry bacteria in the stomach of the tick which is transferred to people and animals when the tick attaches itself and feeds off our blood. If the tick is removed quickly and correctly there is no risk to health but there is a risk of developing Lyme disease if this is not done properly. March to October are the at risk months in Scotland for ticks.


Q. What do the ticks look like?


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