Lyme disease and tick attachment duration 
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 Lyme disease and tick attachment duration

Lyme disease and tick attachment duration

The issue:

How long must a tick that is infected with the Lyme disease bacteria be
attached to a person before the bacteria is transmitted to the person?

Summary of "answers" from the references below:

"as soon as they bite"
three hours
a few hours
several hours
after only 6 hours
after 8 hours
many hours
12-24 hours
16-24 hours
18-49 hours
less than 24 hours
as early as 24 hours
at least 24 hours
24 hours
more than 24 hours
24-48 hours
36 hours
36-24 hours
36-48 hours
42 hours
48 hours/2 days
after 48 hours
72 hours
greater than or equal to 72 hours
some days

See complete file with references at:

Lyme disease and tick attachment duration

Also see:

Antibiotic Prophylaxis After Tick Bite For Prevention Of Lyme Disease -
An Annotated Bibliography

For more information about Lyme disease, see:

Lots Of Links On Lyme Disease


1: Rev Clin Esp. 1996 Sep;196(9):584-7.

[Evaluation of methods of tick removal in human ixodidiasis]

[Article in Spanish]

Oteo JA, Martinez de Artola V, Gomez-Cadinanos R, Casas JM, Blanco JR,
Rosel L.

Servicio de Medicina Interna, Hospital de La Rioja, Logrono.

BACKGROUND: There are two questions regarding tick transmitted diseases
(Ixodidae) not sufficiently elucidated: How to remove the arthropod?
and: should
antibiotic prophylaxis be administered after the bite? SUBJECTS AND
 From June 1st, 1991, to December, 31, 1992, all patients who were
attended at La
Rioja Hospital relating immediate bite or tick bite within the 48 hours
were prospectively studied. In all those patients an epidemiological
inquiry was
obtained, which included, apart from personal data and risk factors for
bites, how arthropods had been removed, health exam and {*filter*} drawn for
serological study for Borrelia burgdorferi and Rickettsia conorii. The
was repeated at one, two, four and six months after the bite. The
removal method
used at the Hospital was by pulling with fine tweezers and later
with iodine povidone. RESULTS: Out of a total of 52 individuals who
with the established criteria, only 41 ended the follow-up. A 63.4
percent of
patients experienced some type of complication, including 3 cases of LB
(erythema migrans). With regard to the type of removal method and the
development of complications, only three patients who had ticks
pulled with tweezers experienced complications compared with 23
patients who used other methods (p = 0.0058). With regard to specific
complications (LB and/or spotted fever) and/or development of B.
burgdorferi or R. conorii infection significant differences were also
observed when tweezers were used for removal of ticks compared with
other tick removal methods (p < 0.05). CONCLUSION: The removal of
ticks with tweezers significantly protects from the development of
complications and infection by tick-borne microorganisms. Antibiotic
prophylaxis is recommended when the removal of the arthropod is
carried out by using a method other than the recommended one.

PMID: 8966318 [PubMed - indexed for MEDLINE]

2: Am Fam Physician. 2002 Aug 15;66(4):643-5.

Summary for patients in:
     Am Fam Physician. 2002 Aug 15;66(4):646.

Tick removal.

Gammons M, Salam G.

Michigan State University College of Human Medicine, East Lansing, USA.

Many methods of tick removal that have been reported in the literature
proved to be unsatisfactory in controlled studies. Some methods may
even cause
harm by inducing the tick to salivate and regurgitate into the host.
Ticks are
best removed as soon as possible, because the risk of disease
increases significantly after 24 hours of attachment. The use of a
medium-tipped, angled forceps offers the best results. Following tick
the bite area should be inspected carefully for any retained
mouthparts, which
should be excised. The area is then cleaned with antiseptic solution,
and the
patient is instructed to monitor for signs of local or systemic
illness. Routine
antibiotic prophylaxis following tick removal generally is not
indicated but may
be considered in pregnant patients or in areas endemic to tick-borne

Publication Types:
     Review, Tutorial

PMID: 12201558 [PubMed - indexed for MEDLINE]

3: J Med Entomol. 2002 May;39(3):509-12.

Protection against lyme disease spirochete transmission provided by
removal of nymphal Ixodes scapularis (Acari: Ixodidae).

Piesman J, Dolan MC.

Division of Vector-Borne Infectious Diseases, National Center for
Diseases, Centers for Diseases Control and Prevention, Ft Collins, CO

Public health recommendations for Lyme disease prevention generally
daily tick checks and prompt removal of attached ticks as a means of
the risk of acquiring Lyme disease in highly endemic regions. In the
study, we determined whether crushing nymphal ticks during removal with
increased the risk of B. burgdorferi transmission, what degree of
from transmission of B. burgdorferi was provided by removal of nymphal
scapularis Say at specific intervals, and whether commercial devices
for tick removal worked when tested against nymphal I. scapularis. Both
via gentle pressure (26% transmission) or crushing the tick (30%
caused a significant decrease in transmission as compared with the sham
(70% transmission). The degree of protection provided via tick
removal decreased
steadily up to 60 h of attachment; between 60 and 66 h, a dramatic
falloff in
protection occurred to the point where no protection was observed at 66
Finally, commercial tick removal devices varied widely in their
efficacy for the
removal of attached nymphal I. scapudaris.

PMID: 12061448 [PubMed - indexed for MEDLINE]

4: J Infect Dis. 2001 Mar 1;183(5):773-8. Epub 2001 Feb 1.

Effect of tick removal on transmission of Borrelia burgdorferi and
phagocytophila by Ixodes scapularis nymphs.

des Vignes F, Piesman J, Heffernan R, Schulze TL, Stafford KC 3rd, Fish

Department of Epidemiology and Public Health, Yale School of Medicine,
Haven, CT 06520-0834, USA.

The effect of feeding duration on pathogen transmission was studied for
individual ticks infected with either laboratory or field strains of
the Lyme
disease spirochete Borrelia burgdorferi and field strains of Ehrlichia
phagocytophila, an agent of human granulocytic ehrlichiosis. Infected
Ixodes scapularis were allowed to feed individually on mice, and equal
were removed at 24-h intervals for < or =96 h. Mice were assayed for
by culture, serologic testing, and polymerase chain reaction (PCR)
analysis. Fed
ticks were assayed by culture or PCR analysis. Transmission of B.
did not occur during the first 24 h among 66 attempts, with maximum
occurring between 48 and 72 h. A model estimating the probability of
from individual ticks removed by patients in a Lyme disease-endemic
area yielded
an overall probability of 4.6%. Infected I. scapularis nymphs
transmitted E. phagocytophila within 24 h in 2 of 3 attempts, which
indicates that daily tick removal may not be adequate to prevent
human infection with this agent.

PMID: 11181154 [PubMed - indexed for MEDLINE]

Thu, 27 Sep 2007 08:57:54 GMT
 [ 1 post ] 

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