The Vault Regulars

Tuesday, April 3, 2012

Post Tick Bite First Aid

I have plenty of time available for reading at the moment and i came across this interesting article that i thought would be beneficial to our outdoor community. 
2 Amendments added below.

Research News Dec 01, 2011 

 The Fraunhofer Institute believes they have come up with a gel that will prevent the contraction of Lyme Disease post tick bites. 

They come out in the spring, and each year they spread further afield. Thirty percent of ticks transmit borrelia pathogens, the causative agent of Lyme borreliosis that can damage joints and organs. The disease often goes undetected. In the future, a new type of gel is intended to prevent an infection – if applied after a tick bite.

For years, Mrs. S. suffered from joint pain and headaches. After an odyssey through doctors’ waiting rooms, one doctor diagnosed Lyme borreliosis – an infectious disease transmitted by ticks. With its bite, the parasite introduced bacteria that then spread throughout the entire body. Mrs. S. is not alone – very often, the disease is recognized too late or not at all, or is not properly treated. Doctors are provided with no clues if the characteristic redness around the bite area is missing. Left untreated, Lyme borreliosis can cause symptoms that resemble rheumatism, damage joints, muscles and nerves and affect the organs.

If found in time, it can be successfully treated. If patients exhibit the disease-specific rash known as erythema migrans, doctors will prescribe antibiotics for several weeks. However, if, as in the case of Mrs. S., the disease has progressed far and is chronic, it is very difficult to treat. Currently, there is no prophylactic treatment and no vaccine against the infection. In the future, a new type of gel is supposed to nip the infection in the bud: the patient applies it locally immediately after the tick‘s bite. Researchers of the Fraunhofer Institute for Cell Therapy and Immunology IZI in Leipzig developed the medication in close cooperation with the Swiss company Ixodes AG and the Institute for Infectious Diseases and Zoonoses of the Ludwig-Maximilian University in Munich (Institut für Infektionsmedizin und Zoonosen der LMU München). Ixodes AG is responsible for developing the formula, while IZI and LMU are carrying out the pre-clinical studies and the serological examinations.

  If the gel is applied immediately to the bite after the tick has been removed and one does not wait for any potential symptoms to show, Lyme borreliosis could be prevented. This is because during the first few days, the bacteria stay right around the spot where the tick bite occurred and spread out only after that. The active ingredient of the gel is azithromycin, which is highly effective against borrelia bacteria and kills them locally in the skin,“ says Dr. Jens Knauer, project manager at IZI. Unlike other antibiotics, there is no known resistance of borrelia strains against azithromycin. Another advantage of the active ingredient: it has few side effects and as a result does not stress the body. It also distinguishes itself by its good depot action of up to five days in the tissue. The treatment is successful only if the medication is applied within the first few days after the tick‘s bite. „This gel, however, cannot be used to treat an established infection; it is suitable only for prophylaxis,“ emphasizes Dr. Knauer.
The pre-clinical studies have already been completed successfully; in mice, the gel was effective even five days after a tick‘s bite. The application has been patented. Starting this past summer, in a clinical phase III study (, the researchers are testing the medication on persons with proven tick bites. Should the results of the pre-clinical studies be confirmed on humans, the gel will help to significantly lower the number of new infections,“ the expert adds. Annually, up to 60,000 are stricken with Lyme borreliosis in Germany alone, according to estimates by the Robert Koch Institute, with an upward trend – since, due to climate change, ticks are expanding their range ever further. „As soon as the gel can be purchased at the pharmacy, persons who are particularly endangered, such as forest rangers, hunters, joggers or soccer players, should always carry it with them,“ Knauer recommends.
Although this jell hasn’t made it to the chemist/pharmacy yet. Keep it in the back of your minds for the near future. I have been lucky, only one tick has made it into my skin but this jell would have given me some peace of mind once i had removed it.
In the meantime take some Permethrin with you when walking in tick country just to minimise the possibility of a bite.
Hope you find this useful.
 (Report from the Institutes media.)

Amendment 1. added 8.50pm 3/4/12. following Maria's comment.

TBE Vaccination In the UK
You cannot get the TBE vaccine on the NHS. Your doctor may be able to order it in for you from a specialised travel clinic, but you will still have to pay for the course of vaccine. You may prefer to go directly to your local travel health clinic.
The best time to start a course of TBE vaccination is during the winter months to make sure you are protected before the start of the tick season in spring.

Vaccination course

The TBE vaccine is usually given in three doses, with the second dose given one to three months after the first dose, and the third dose given five and 12 months after the second dose.
If you need more urgent protection, two doses of the vaccine can be given at least two weeks apart. In this case, the third dose should be given five to 12 months after the second dose.
If you are under 60, you should have your first booster three years after your original course of the vaccine. Further boosters should be given every three to five years.
If you are over 60, you should have booster doses every three years. This is because studies have shown that TBE immunity (resistance) does not last as long in older people.

Side effects

Any reactions to the TBE vaccination are usually mild and do not last long.
Adults may experience swelling, redness and pain at the site of the injection. Other possible side effects include tiredness, headache, muscle pain and nausea.
Children usually experience mild side effects such as pain and tenderness at the site of injection, restlessness and headache. They may also experience a fever (temperature of 38C (100.4F) or above) after their first dose of the vaccine. In very rare cases, a more serious reaction can cause meningitis.


You should not have the vaccination if:
  • You are allergic to eggs (as the vaccine contains egg protein). 
  • You have a fever.
You must also tell your doctor or nurse if any of the following apply to you:
  • You have problems with your immune system.
  • You have a brain disorder.
  • You are pregnant.
  • You are breastfeeding.
You may still be advised to have the vaccine, but your doctor or nurse will need to check your risk with a travel medicine specialist before giving it to you.
Amendment 2. Added 10.32 6/4/12
I made enquiries at Boots and Nomad travel yesterday and was stunned.
Nomad travel. First have a consultation with a nurse at Nomad. Cost £20.
No need to go to your GP. No prescription needed.
3 shots required. First shot £55
2nd shot within 3 months of the 1st. Cost £55
Then a booster shot 6 - 12 months later cost £55.

 They told me that they would do the vaccination but only with a prescription from my GP.
But, they said that almost all GP’s would do the vaccination at the surgery and therefore would not need to pay a nurse like you would at Boots.
You will probably (i think you will) have to pay for the serum.
That’s quite a fair response from Boots.

GP next then.


Jake said...

I was bitten by a tick once, and decided to go to a doctor 'just in case'. Persuading him to test for a disease which I might not have and for which I had no symptoms was a challenge - in fact, he refused and after some persuasion the next doctor I saw agreed. Turned out I did have Lyme Disease, and was promptly treated. So something like this would have been wonderful! I dread to think what things could be like now if I hadn't found an open minded doctor. So it goes to show that all it takes is one bite, and if your gut is telling you something, for Christ's sake, go with it!

Thanks for posting this, I'd never have found it otherwise.


AlanR said...

Hi Jake,
Thanks for reading the post. Sometimes we can get a bit blase about insect bites. But as you have pointed out it is important to get treatment as early as possible. This Jell would give you some peace of mind if you are in the middle of a long backpack.

GeoffC said...

An interesting piece. Strange this tick thing, it seems to have been thrust into public consciousness only in recent times, we had never thought about their existence at all until a couple of years ago. In many thousands of miles of backpacking we have had exactly one tick eack, on separate occasions, and that was shortly after we read that first article about them!. Just lucky?. I really don't know, but now we often hear of walkers especially in the far NW brushing off dozens of the blighters at a wild camp.

-maria- said...

We have also the TBE in Finland. Our family have been vaccinated against it, and when we had our most recent shots last spring, the nurse told about some cure against borreliosis which was under testing phase. I wonder if it was this jell or something else.

I remember that when I was a kid we didn't worry about ticks at all. I guess there were some tick-borne diseases on Aland islands, but not in mainland Finland. Nowadays ticks are a real nuisance apart from the northernmost part of the country.

AlanR said...

I'm with you Geoff. In 40yrs of hiking and backpacking it's only in the last few that i have become more and more aware of the problem. Why it has proliferated i don't know but it definitely has.
Quite a few of my friends have had tick problems and talking to 2 well know long distance backpackers recently i was told that they were covered in them on one wild camp in Scotland.
We wild campers usually pick nice sheltered spots to set up the tent but unfortunately these can be the spots used by deer and sheep and ticks also.

Andrew W said...

Very interesting Alan.
Shame it is not available considering the number of early ticks.
Mind you this sudden cold snap in Scotland might kill a load of the little buggers

AlanR said...

Hi Maria,
That's a good point. I never thought about seeing if we can get vaccinated against it here in UK. I will make enquiries soon. Thanks
If you hear of any jell treatment being sold in Finland then please let me know.

AlanR said...

Hi Andrew,
I think Maria's comment is a very valid one. Maybe we can get vaccinated here in UK. It's worth a chat with the doc.

Andrew W said...

Certainly worth enquiring.
I may give the Dr a call.
Failing that, my sister in law is a GP.

markswalkingblog said...

Alan, thanks for the info. Like some of the other comments - I have only had one tick when I was a boy on a family holiday in Scotland. My father burnt it out with a cigarette - the old remedies are the best :) But 40 years ago no-one talked or knew about Lymes disease

-maria- said...

I tried to find information on ticks and the jell, but it seems that no jell is available at the moment here either. But I will let you know, if something comes up.

BTW, the TBE vaccination is provided free of charge by our local "NHS" only on Aland islands. The rest of us need to pay for the vaccination, but it is widely available - you just A) need to have a prescription and buy it at the pharmacy and have a nurse to inject it (also the "NHS" nurses can give it to you), or B) go to a private clinic where they store the vaccine and they can give it to you.

If I have understood correctly, so the TBE is not so widely spread in the UK, but you better check that information. The borreliosis is our common fiend.

AlanR said...

I think it’s worth having. You can also ask at places like Nomad travel and Boots Chemist. Just reading the Boots web page, they charge £20 for the consultation but then delete the charge against the vaccination cost so thats not a bad deal.

AlanR said...

Thanks Mark. The more we find out about it the better the decision making process. I think if i was doing a long distance walk i would definitely have it. It only takes one infected tick and you could end up very ill.
I think this new jell will be going straight in the first aid kit anyway.

AlanR said...

Thanks Maria,
I have now amended the blog post to show how it is available here in UK. It is on a private, pay for it basis.
So at least we can get it.

Louise said...

Well, I've had a few ticks now, I even managed to get one from the Christmas Tree as I helped to put it up a couple of years ago, so don't think there is much of a dormant period. Our youngest picks them up locally quite regularly, just playing out, so you don't even have to go into the hills. Our youngest daughter seems to attract them too. Yes we live in Scotland, as you know, but not exactly in the wilds! When I camped in Glen Affric on the Challenge last May, it was heaving with the tiniest ticks I have ever seen, nymphs presumably.
We need more sheep that have been dipped to roam around and mop up the ticks.

AlanR said...

Gosh, that's a worry Louise. If i was you i would go for the inoculations. You can't be too careful with the children. I suppose like everything else, Global warming is to blame.Ha. Funny it's snowing here and windy as hell.

Alan Sloman said...

It is a bit of a pig when you walk on your own; There's no-one to check you over in the places you can't see.
I have had dozens of ticks over the years and have usually spotted them. Sometimes it's involved the mirror on my compass to view the sweatier regions...
There was one particular tick that was a real problem when I was on a TGO Challenge quite a few years ago now - but I'll save that story for a blog post.

QDanT said...

markswalking blog burn out with a cig is not recommended neither is smothering in Vaseline or squeezing and pulling which make the Tic regurgitate it's stomach contents which is where the bacteria are, getting underneath the Tic and twisting out with fine point tweezers or I carry see
though I must admit to never having been bitten, my Ferrets used to get loads on though
cheers Danny

AlanR said...

I know what you mean Al. Do the blog post before TGO C.

AlanR said...

That’s good advice Danny. Thanks.
I have some more info on getting the jab. I will post an amendment asap.

Unknown said...

I was appalled to see the BBC yesterday suggesting pulling out ticks with your fingers but then blithely saying, "make sure you get it all out" - dear God, don't you know people take what you say seriously?!? Use tweezers or a specialist device. Good post Alan, as usual. Topical right now as well, so it's timely.

Thought I would point this out: "If patients exhibit the disease-specific rash known as erythema migraines..." it looks, often, a little bit like a bullseye although can be more blurred and generalised. Worth noting this.

AlanR said...

Hi Maz,
I didn't see the BBC coverage of this. Pity.
Like you say, now is the time to make folks aware of what can happen and what can be done. No point in being aware after the event.

The bullseye rash is what you need to be looking not to get. And if you do get it see the GP asap.

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