Tick Bite Information - 72hr Window Lyme antibiotics

[boogaloo]

The default at the Local Hospital (Kemptville): they no longer collect the tic for testing. They treat you as if it was positive and give you the doxycycline if you know you were bit in the last 72 hrs.

Just a heads up on the doxycycline. I was bitten by a black legged tick about 14 months ago and was given a prescript for doxycycline. It messed me up bad. The Dr. (not my own) who gave it to me prescribed 3 times a day for 21 days. Damn near killed me. After 15 days I called my own Dr. and he told me to stop taking it. He said maximum dosage is 2 times a day for 10 days. More than a year later I still have bouts of pressure in my skull, blurred vision and sensitivity to sun light. Be aware..........Daniel

[Moosehead]

Just a heads up on the doxycycline. I was bitten by a black legged tick about 14 months ago and was given a prescript for doxycycline. It messed me up bad. The Dr. (not my own) who gave it to me prescribed 3 times a day for 21 days. Damn near killed me. After 15 days I called my own Dr. and he told me to stop taking it. He said maximum dosage is 2 times a day for 10 days. More than a year later I still have bouts of pressure in my skull, blurred vision and sensitivity to sun light. Be aware..........Daniel

Wow. Our trip resulted in 2 big pills - that was it.... sorry to hear about your experience. Crazy that a bug that small can cause so much trouble whether it's reaction to treatment or Lyme itself. Pass the Deep Woods Off!

[Fenelon]

Two pills? I thought the standard was a full 10 days of doxy. I'd demand the full doxy regime or I go see another doctor. My first action if I find one on me is to determine if it's an Ixodes or Dermacentor tick that's on me. Ixodes is the one you have to worry about. If it's an Ixodes on me, regardless of species, I would go and get the doxy, regardless of how long it was attached. Every outdoor person should learn how to ID them. Usually it's an American/brown dog tick that I find. It does not transmit the Lyme bacteria.

Easy way to tell if it's Ixodes or Dermacentor - look at the scutum (the back plate). Dermacentor ticks are usually quite colourful, with a whitish cream mosaic pattern. A smaller , darker tick with no scutum colour raises my alarm. I then look at the anterior perimeter edge of the abdomen. Dermacentor ticks have a row of festoons (look like little beads) that rim the bum of the ticks. Ixodes is smooth. You can see all of this easily with a magnifying glass. Don't rely on the erethyma migrans (bulleseye) rash thing as not all people that are Lyme positive get it. Don't rely on survellience reports from your Health Unit to determine if there is a Lyme "endemic" population in your area. A data point is not logged on the federal Health Canada site unless it is a confirmed positive case. Assume that you have Lyme positive Ixodes ticks in your area. All it takes is a migrating bird to carry them throughout the area.
Don't assume the average emerg doctor knows more about Lyme than you do ! I'll never forget taking a student to Peterborough Emerg and the doctor refused to give her antibiotics. She had textbook bullseye rash, we had a fully engorged Ixodes tick from her, and she'd just come from an endemic area. We took her to Lindsay instead and they immediately put her on doxy. The Pineridge Health Unit then called to educate the Peterborough doctor.

[Ouzel]

If you want to know what us doctors know, here it is. The single dose treatment mentioned earlier is under 'Prophylaxis'. One dose of Doxycycline, 200 mg. It is recommended that all 4 criteria listed have been met to proceed with that treatment option.
https://www.canada.ca/en/public-heal...e-disease.html

[Fenelon]

If you want to know what us doctors know, here it is. The single dose treatment mentioned earlier is under 'Prophylaxis'. One dose of Doxycycline, 200 mg. It is recommended that all 4 criteria listed have been met to proceed with that treatment option.
https://www.canada.ca/en/public-heal...e-disease.html

I'd be a rather unhappy and vocal camper in emerg if a doctor denied me a 20 cent dose of doxy simply because I did not meet all of the below mentioned criteria:

[COLOR=#333333]Prophylaxis


[COLOR=#333333]Prophylaxis treatment can be started if the patient meets all of the following 4 criteria.

1. The tick can be reliably identified as a blacklegged tick and is estimated to have been attached for more than 36 hours.
   
   • This is based on the degree of engorgement or by certainty of when the individual was bitten.
   
   
2. Prophylaxis will be started within 72 hours after the feeding tick has been removed.
3. The local rate of Borrelia burgdorferi infection in ticks is more than 20% (check with local public health).
4. Doxycycline is not contraindicated.

I bet many of the people who come into emerg do not have the tick for inspection. Even if you have the tick, how long does it take to submit the specimen to a lab for ID confirmation, and get the results back? Not sure how any entomologist could key an Ixodid tick out to species using the available taxonomic keys if the mouthparts are missing (probably common to have them missing on tiny nymphs when they are extracted). Again, I'd take the local tick survelliance data with the local health unit with a grain of salt. From what I've read, they only log a data point for positive clinical cases in humans after lab confirmation with PCR/western blot tests. Imagine the number of people living in Ontario with undiagnosed Lyme. Your vet will tell you about the three horses and 32 dogs that were treated for Lyme within half an hour of your house, yet the federal data says there's no endemic population of ticks. Take a look at the national border cases. You'll see hundreds of reported cases on the US side, then next to nothing only miles away on the Canadian side (different criteria for reporting, Canadian testing not accurate for all the serotypes of the bacteria that have evolved?).
What's the danger for a doctor to err on the side of caution and administer the single dose of doxy ? Last time I checked it's handed out like candy for up to one month doses for common UTIs, etc.

[Ahuntr300]

I agree that the 2 pill dose should be given on request, just to be sure, and most doctors will do that no problem.

On the other hand, the risk is so small when the criteria is not met, that the doctors are probably right in not recommending the 2 pill dose of doxy as it is a strong drug and could have some bad side effects.

[Fox]

Just a heads up on the doxycycline. I was bitten by a black legged tick about 14 months ago and was given a prescript for doxycycline. It messed me up bad. The Dr. (not my own) who gave it to me prescribed 3 times a day for 21 days. Damn near killed me. After 15 days I called my own Dr. and he told me to stop taking it. He said maximum dosage is 2 times a day for 10 days. More than a year later I still have bouts of pressure in my skull, blurred vision and sensitivity to sun light. Be aware..........Daniel

I got very sick with it when using is as a Malaria pill, but they told me all the wrong things about it at the travel doc.

What the first doctor gave you would be grounds for a lawsuit for sure, not that you would win.

Doxy strips your body of all bacteria, it can mess you up and you have to take measures to counter the effects with good bacteria, but the wrong dose is not the drugs fault.

[mosquito]

I got very sick with it when using is as a Malaria pill, but they told me all the wrong things about it at the travel doc.

What the first doctor gave you would be grounds for a lawsuit for sure, not that you would win.

Doxy strips your body of all bacteria, it can mess you up and you have to take measures to counter the effects with good bacteria, but the wrong dose is not the drugs fault.

CBC says 24,000 KILLED by medical accidents and Canadian malpractice puts it at 44,000, here is the CBC.... and the anti firearm doctors worry about firearms.
https://www.cbc.ca/news/science/medi...-year-1.514758

When taking a new medication I like to google it and see what I can learn quick about it, I worked on a medical project over a decade ago for a Pharmacy related system and there is a ton or do's and don'ts and never's and instructions that are often on that sheet or paper they print. The doctor may have just wrote tid (three times daily) instead of bid (twice daily) or the pharmacist misinterpreted, a good pharmacist will check if they are suspicious other.... can't say.


You can't get Peremethrin in Canada EXCEPT in insecticide and for animals and at almost 20X to 30X the concentration of the Sawyer spray
https://sawyer.com/products/permethr...ent-treatment/
(.5%)

https://canadianrockiestrailguide.co...%20or%20abroad.


"Permethrin spray designed for use on clothing (0.5% strength) is not available in Canada, but it can be purchased online and shipped into the country (at considerable expense).

—Permethrin for use on horses and livestock (10% strength) is available in Canada. (Many outdoors folk purchase the agricultural-strength version and dilute it for their personal use.)

—The Government of Canada publication on Travel Health and Safety entitled “Insect bite prevention” recommends applying a permethrin insecticide to clothing and other travel gear for greater protection. It also states: “Although permethrin is not available in Canada, travel health clinics can advise you how to purchase permethrin and pre-treated gear before or during your trip.” (Presumably by making a shopping trip south across the border before you embark.)



As a non medical official I cannot recommend an action, but I know one of the local stores has it for spiders and I know the dollar store has spray bottles and small measuring cups (don't use the kitchen ones! if for no other reason your last view in life may be the back on an accelerated frying pan approaching your head ).

[Moosehead]

If you want to know what us doctors know, here it is. The single dose treatment mentioned earlier is under 'Prophylaxis'. One dose of Doxycycline, 200 mg. It is recommended that all 4 criteria listed have been met to proceed with that treatment option.
https://www.canada.ca/en/public-heal...e-disease.html

Thank you. This is exactly what was done at our local emergency dept. We had the tick on-hand plus a positive ID that it was indeed a deer tick from the tick ID website (Bishop's University entomology). We were told it would take about a month to get test results from the tick re. Lyme.