Lyme disease is diagnosed based on symptoms, a physical exam, the possibility of exposure to infected ticks and laboratory testing. If your healthcare provider suspects Lyme disease, you may be asked to provide a blood sample for testing. Laboratory testing is not recommended for patients who do not have symptoms consistent with Lyme disease.
Laboratory tests support clinical care when used correctly and are performed using validated methods in an accredited laboratory. In BC, laboratory testing to diagnose Lyme disease is done by the BC Public Health Microbiology and Reference Laboratory (BC PHMRL), a laboratory accredited by the College of American Pathologists (CAP) and the Diagnostic Accreditation Program (DAP). BC PHMRL follows the US Centers for Disease Control & Prevention and Public Health Agency of Canada recommended process to assess for evidence of antibodies against the Lyme disease bacteria.
Blood tests based on antibodies may not be positive in early infection. There are two important implications:
- Symptoms of early Lyme disease (e.g. rash as above) following tick exposure may be treated by your doctor on clinical grounds, even without a positive test.
- Repeat testing a few months after an initial negative test may be wise if there are ongoing symptoms.
If you have symptoms such as fatigue, pain, poor sleep and problems with brain function and test negative for Lyme disease, please consult the BC Women's Hospital Complex Chronic Disease Program for further support.
What if I find a tick?
The most important thing is to make sure that you remove all the tick, including the mouth parts that are buried in your skin. Also, do not squeeze the body of the tick when you are removing it. This can force its stomach contents into the wound and increase the chance of infection. If you have found a tick, you have three choices:
- remove the tick yourself;
- get someone else to remove the tick for you. (This is when you can't reach it or see it clearly, for example if it's on your scalp, or some other hard-to-reach place); or
- get your family doctor to remove it.
How NOT to remove a tick!
Some people think you can remove a tick by covering it with grease, gasoline or some other substance. This does not work! It only increases the chance of you getting an infection. Holding something hot (for example, a match or cigarette) against the tick also does NOT work! Again, this will only increase the chance of an infection or accidentally burning yourself.
If you decide to remove the tick yourself, follow the instructions below.
When should you remove the tick?
You should only remove the tick yourself, or get a friend or family member to remove it, if the tick is not buried very deep into your skin. If the tick has been on your skin for less than two hours, it has probably not had a chance to burrow into your skin. If the tick is just on the surface of your skin, or only biting on to the outside skin layer, you can remove it following the instructions below.
When should you get a doctor to remove the tick?
You should go to your doctor to get the tick removed if it has buried itself deep into your skin. This usually happens if the tick has been on you for several hours, or even a day or two. When a tick has burrowed deep into your skin, it is very hard to remove the tick without leaving some mouth parts behind, which can cause infection.
How to remove a tick?
Remove the tick right away (if possible, wear disposable gloves when handling an engorged tick):
- Use tweezers or forceps to gently get hold of the tick as close to the skin as possible. Don't touch the tick with your hands.
- Without squeezing the tick, steadily lift it straight off the skin. Avoid jerking it out. Try to make sure that all of the tick is removed.
- Once the tick has been removed, clean the bite area with soap and water, then disinfect the wound with antiseptic cream.
- Wash your hands with soap and water.
If your doctor wants to have the tick tested:
- Save the tick in a container with a tight fitting top.
- Dampen a small cotton ball and put it into the tick container to keep the tick alive. (A live tick is necessary for culturing the spirochete which causes Lyme disease.)
- Label the container with date shipped, name and address of person bitten or what type of animal the tick was from, what part of the body was bitten, and what part of the province the tick probably came from.
- Also include the name and address of your family physician.
- For laboratory testing, this container should be mailed as soon as possible (BC residents only):
BC Public Health Microbiology and Reference Laboratory
655 West 12th Ave.
Vancouver V5Z 4R4 BC Canada
Ask your doctor for further advice
To protect yourself against tick and insect bites:
- Walk on cleared trails wherever possible when walking in tall grass or woods.
- Wear light coloured clothing, tuck your top into your pants and tuck your pants into your boots or socks.
- Put insect repellent containing DEET on all uncovered skin. Reapply as frequently as directed on the container.
- Check clothing and scalp (covered or not) when leaving an area where ticks may live.
- Check in folds of skin. Have someone help you check hard-to-see areas. When a tick is located, remove it immediately. Check the whole body! Don't stop when you find one tick. There may be more. Make sure the lighting is good so that you will not miss seeing the ticks.
- Regularly check household pets for ticks.