[Evaluation of methods of tick removal in human ixodidiasis].

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 METHODS: 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 before were prospectively studied. In all those patients an epidemiological inquiry was obtained, which included, apart from personal data and risk factors for tick bites, how arthropods had been removed, health exam and blood drawn for serological study for Borrelia burgdorferi and Rickettsia conorii. The protocol 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 disinfection with iodine povidone.

RESULTS: Out of a total of 52 individuals who complied 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.