Ticks are a diverse animal species that needs a host for its developmental cycle. The tick can be hosted by an animal or a human. By attaching (stabbing) an animal or human, the tick takes its blood meal, which it needs for its life cycle. The tick lives for about 3 years and takes only three blood meals in those three years.

In our climate (almost all of Europe), ticks are dormant in the colder part of the year, while they are extremely active during the spring. Heat, light and humidity favor the life and reproduction of ticks. In BiH, most people have experienced a tick bite at least once in their lives. Areas that ticks love are grassy, ​​bushy and forest vegetation.

A tick can be a vector (carrier) of the cause of several different diseases, and the most important thing for humans is that it can transmit Lyme borreliosis. This disease is caused by the bacterium Borrelia burgdorferi, whose vector is the tick Ixodes ricinus. Of the 30 species of ticks that can be attached to humans, only this type of tick is a potential carrier of this disease.

We are witnessing that there is a great fear of ticks, for which there is no particularly justifiable reason. Lyme borreliosis is a potentially dangerous disease. However, if we take into account the fact that in the whole of Europe, only one species of tick out of 30 that infects humans transmits the cause of this disease, we will see that the possibility of infection is small. Due to the fear of Lyme borreliosis, unnecessary therapy is often prescribed to people with tick bites. Antitetanus vaccination, therapeutic doses of antibiotics and serological tests are often recommended. Such a practice has been abandoned and it would be very useful to follow the new protocols applied worldwide for the prevention and treatment of Lyme borreliosis.

How to prevent tick bites?
⦁ After spending time in nature, examine the whole body to see if a tick is hooked. Also pay attention to the scalp (in the hair), and hard-to-reach places such as the spaces between the toes, groin, etc. Ticks love warm and humid places and flee from the surface of clothing towards the skin to get to suitable ground, and this is where the skin is thin and well-circulated. It is often the skin of the groin and waist. You can use extra light and a magnifying glass when examining, because the small ticks are the size of a poppy seed, so they are easy to overlook or replace with ben and other normal changes on the skin.

⦁ Take off the clothes you wore during your stay in nature and put them in the washing machine as soon as possible. Let it stand in the machine for about half an hour before washing, because the tick can stay in it before it attaches to the skin, which usually takes at least 24 hours. Standing in the washing machine, the tick will not get moisture, and in such an atmosphere, it dries out and dies. By just washing the laundry in the machine, the tick will not die, because it will get the heat and humidity it loves. But if you leave it locked in the machine for a while before washing, you will achieve the goal.

⦁ The tick attaches to the skin only after 24 hours on the human body, so you can perform a body examination a day or two after staying in nature to be sure. The tick, once attached to the skin, remains attached for 3 days taking its blood meal and then detaching to lay eggs.

⦁ You can also use various repellents (insect repellents) when going outdoors. You can find them at the pharmacy.

What if I see a tick on my skin?
Don’t panic and don’t let fear stop you from taking the right steps. There is no reason to be afraid. Even if you have a tick that has transmitted the cause of the disease to you, Lyme disease is completely curable when it is detected. Therefore, calmly take the following steps.

Do the following:
- Take a pair of tweezers, or any tick remover, there are different types on offer, grasp the tick's head as close to the skin as possible (avoid the soft part of the tick) and pull it out of the skin with a firm, light motion. skin and whether you have well covered a part of the tick near the skin.
- When removing the tick, check the skin for any residue. If there is a "foot" left, all you need to do is clean the area with alcohol. Such a remnant will be "rejected" by the organism itself. If necessary, leave it to a medically educated person to remove the rest.
- Follow the place where the tick was, but also all the other skin, for the next month. In case a rash appears (as in the picture above), contact your family clinic to prescribe antibiotic therapy.

Don’t do this:
- It is completely wrong to put any means on the tick, such as: Vaseline, gasoline, soap, any oil, alcohol, nail polish, etc. These agents may cause the tick to leave the skin, BUT it will also shut off its air supply, which will irritate it and cause it to release the contents of the small intestine into the bloodstream, thus transmitting a possible pathogen to you.
- Do not squeeze the tick, tear it off with your fingers, pluck it, scratch it in that place, light it or stun it with cigarette smoke, or in any other way allow it to be traumatized. All of this causes it to release the contents of the gut into your bloodstream, and this is what you want to avoid in order to prevent potential disease as a result of tick bites.
- When removing the tick, do not twist it, just pull it out as mentioned above.
- When removing the tick with tweezers, catch it as close to the skin as possible. Avoid touching the soft part of the tick for the above reasons.

If you remove the tick yourself

If you have contacted a medically educated person
- The medical professional will remove the tick as described above. He will take your medical history and give you further instructions. If necessary (if you have symptoms of Lyme borreliosis or ALL the conditions of the protocol for prescribing prophylaxis are met), the doctor will prescribe antibiotic therapy and, if necessary, refer you for further treatment.
- If you see a tick and want it removed by a professional or suspect any problem related to this area, contact your family doctor (family medicine dispensary or associated health center).

For medical professionals:
Prophylactic antibiotic therapy should be prescribed ONLY to patients who meet
ALL of the above criteria:
- A tick has been identified as an adult or nymph of the species Ixodes ricinus. Since medical professionals are not trained to recognize the type of tick, follow other criteria.
- The tick has been attached to the skin for at least 36 hours
- Prophylaxis can be started within 72 hours of tick removal
- Tick infestation with the pathogen Borrelia burgdorferi in that region is> 20%. Our area belongs to such areas, although there are no direct statistical data from BiH.
- If Doxycycline is not contraindicated (eg allergies, pregnancy, etc.).
Additional recommendations:
- Do not prescribe ana-te after a tick bite
- Abandon the practice of administering therapeutic doses of antibiotic therapy after a tick bite without manifest Lyme disease
- If the criteria are met, prescribe a single dose of 200 mg Doxycylin per os with the recommendation to monitor the injection site for the next month.
- Do not prescribe other antibiotics for prophylactic purposes because they have not shown efficacy.

Finally, if we take into account that no studies have been conducted in BiH to determine the degree of tick infestation with Borrelia burgdorferi pathogen and that there are no experts in the health care chain who could recognize that this is a tick species that is a vector of borreliosis, we can conclude that if the tick has remained on the skin for more than 36 hours and if it is possible to prescribe prophylaxis in a timely manner, within 72 hours of removing the tick, that it is indicated to give two capsules of Doxycylin per os once as Lyme disease prophylaxis. Otherwise, a prophylactic dose of antibiotics should not be given. It is only necessary to educate patients to follow the appearance of the rash for the next month.