Tick Season: What to Watch For After a Bite

Tick season does not end when summer does. Adult blacklegged ticks stay active through the fall, and they can look for a host on any winter day that is above freezing. After a bite, remove the tick, watch for a rash or fever over the next few weeks, and keep one more thing in mind: a lone star tick bite can lead to alpha-gal syndrome, an allergy to red meat that often shows up hours after a meal.

Why October still counts

The CDC says the greatest risk of a blacklegged tick bite is in the spring, summer and fall, and that adults may look for a host any time winter temperatures are above freezing. The New York State Department of Health also reminds people that ticks stay active into the fall.

Fall chores put people right where ticks wait. Blacklegged ticks live in shady, moist spots at ground level. They also live in lawns and gardens, especially at the edges of woods and around old stone walls. Raking leaves, clearing a garden bed and walking the dog on a wooded path all count.

The ticks you are most likely to meet

The blacklegged tick, often called the deer tick, is the most common tick in New York. It can carry Lyme disease, anaplasmosis and babesiosis.

The lone star tick is the one most tied to alpha-gal syndrome. The state health department says New Yorkers are diagnosed with alpha-gal syndrome every year, particularly on Long Island, where lone star ticks are common.

How to remove a tick

The CDC's steps are simple:

• Use clean, fine-tipped tweezers and grasp the tick as close to the skin as you can.
• Pull it away with steady, even pressure. Do not twist or jerk it.
• If the mouthparts stay in and do not come out easily, leave them alone.
• Clean the bite and your hands with soap and water.
• Check the rest of your body. Where there is one tick, there may be others.

Skip petroleum jelly, heat and nail polish, which can agitate the tick, and do not crush it with your fingers. If you have trouble getting a tick out, call your health care provider.

What to watch for in the weeks after

The state health department suggests watching the bite for 30 days. If you develop a rash, a fever or flu-like symptoms in the weeks after a bite, see your doctor and tell them about the tick.

Tick-borne infections like Lyme disease are for your physician to diagnose and treat. That is not my part of the picture.

The reaction that comes hours later

Alpha-gal syndrome works differently. Alpha-gal is a molecule found in most mammals. After a tick bite, the immune system can start reacting to it. Symptoms usually start 2 to 6 hours after eating red meat or dairy, so a reaction in the middle of the night may not seem connected to dinner at all.

Signs to watch for:

• Hives or an itchy rash
• Swelling of the lips, throat, tongue or eyelids
• Nausea, vomiting, stomach pain, heartburn or diarrhea
• Coughing, wheezing or trouble breathing
• Dizziness, feeling faint or a drop in blood pressure

This can happen even if the tick was removed promptly. A physician diagnoses alpha-gal syndrome from your history, an exam and a blood test.

Where I fit in

My role is the alpha-gal side, alongside your allergist. For people already diagnosed, I offer SAAT, the Soliman Auricular Allergy Treatment. It adds to your allergist's care and never replaces it. I am a trained and certified SAAT provider on Dr. Soliman's official practitioner list. The evidence is limited and early, one published case series with no comparison group, so I never call it a cure or promise results. Keep carrying your epinephrine as prescribed, and make any decision about eating a trigger food with your allergist, never on your own. The SAAT page explains each step.