RESUMO
This review highlights the causative organisms, clinical features, diagnosis, and treatment of the most common tick-borne illnesses in the United States, including Lyme disease, Rocky Mountain spotted fever, anaplasmosis, ehrlichiosis, tularemia, Powassan virus, and alpha-gal syndrome. Tick bite prevention strategies and some basic tick removal recommendations are also provided.
Assuntos
Doenças Transmitidas por Carrapatos , Humanos , Doenças Transmitidas por Carrapatos/diagnóstico , Doenças Transmitidas por Carrapatos/terapia , Doenças Transmitidas por Carrapatos/epidemiologia , Animais , Medicina Selvagem , Doença de Lyme/diagnóstico , Doença de Lyme/terapia , Doença de Lyme/epidemiologia , Febre Maculosa das Montanhas Rochosas/diagnóstico , Febre Maculosa das Montanhas Rochosas/terapia , Febre Maculosa das Montanhas Rochosas/epidemiologia , Estados Unidos/epidemiologia , Carrapatos/virologia , Picadas de Carrapatos/terapia , Ehrlichiose/diagnóstico , Ehrlichiose/epidemiologia , Ehrlichiose/terapia , Ehrlichiose/tratamento farmacológico , Anaplasmose/diagnóstico , Anaplasmose/epidemiologia , Anaplasmose/terapiaRESUMO
BACKGROUND: Oral immunotherapy (OIT) is a promising treatment for food allergies. Our aim was to establish the long-term safety and efficacy of a novel red meat (RM) OIT in galactose-alpha-1,3-galactose (alpha-gal) allergy in adults. METHODS: Out of 20 patients with confirmed RM allergy, five (41.66%) underwent an early OIT, seven (58.33%) underwent a delayed protocol and eight patients who were not desensitized formed the patient control group. 15 and 27 day RM OIT for early-onset and delayed-onset alpha-gal allergy were administered, respectively. Desensitized patients were recommended to continue eating at least 100 g RM every day for 6 months and every other day in the following 6 months. After a year, the consumption was recommended 2/3 times in a week. Patients were followed up with skin tests with commercial beef and lamb extracts, fresh raw/cooked beef and lamb and cetuximab and also with serum alpha-gal specific Immunoglobulin-E (sIgE) in the first and fifth years. RESULTS: All patients who underwent OIT became tolerant to RM. During the 5 year follow-up, the median alpha-gal sIgE concentration gradually decreased in nine patients who consumed RM uneventfully while remained unchanged in the control group (p = .016). In two patients, rare tick bites acted as inducers of hypersensitivity reactions with concomitant elevation of alpha-gal sIgE concentrations whereas one patient with low follow-up alpha-gal sIgE concentrations consumed RM uneventfully after frequent tick bites. CONCLUSIONS: Our study showed the long-term safety and efficacy of alpha-gal OIT. Additionally, alpha-gal sIgE seems to be a potential biomarker to monitor OIT.
Assuntos
Hipersensibilidade Alimentar , Carne Vermelha , Picadas de Carrapatos , Adulto , Bovinos , Humanos , Animais , Ovinos , Galactose , Picadas de Carrapatos/terapia , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/terapia , Carne Vermelha/efeitos adversos , Alérgenos , Biomarcadores , Imunoterapia , Imunoglobulina E , Carne/efeitos adversosRESUMO
The incidence of tickborne diseases in the United States is increasing; reported cases more than doubled from >22,000 in 2004 to >48,000 in 2016 (1). Ticks are responsible for approximately 95% of all locally acquired vectorborne diseases reported by states and the District of Columbia, with Lyme disease accounting for >80% of those cases (2). After a tick bite, persons might seek care at an emergency department (ED) for tick removal and to receive postexposure prophylaxis, which has been shown to effectively prevent Lyme disease when taken within 72 hours of a high-risk bite (3). Using data from CDC's National Syndromic Surveillance Program (NSSP), investigators examined ED tick bite visits during January 2017-December 2019 by sex, age group, U.S. region, and seasonality. During this 36-month period, 149,364 ED tick bite visits were identified. Mean cumulative incidence was 49 ED tick bite visits per 100,000 ED visits overall; incidence was highest in the Northeast (110 per 100,000 ED visits). The seasonal distribution of ED tick bite visits was bimodal: the larger peak occurred during the spring and early summer, and the smaller peak occurred in the fall. This pattern aligns with the seasonality of a known and abundant human-biter, the blacklegged tick, Ixodes scapularis (4). Compared with other age groups, pediatric patients aged 0-9 years accounted for the highest number and incidence of ED tick bite visits; incidence was higher among male patients than among females. Tick bites are not monitored by current surveillance systems because a tick bite is an event that in and of itself is not a reportable condition to health departments. Syndromic surveillance of ED tick bite visits can provide timely information that might predict temporal and geographic risk for exposure to tickborne diseases and guide actionable public health messaging such as avoiding tick habitats, wearing repellent consistently when outdoors, and performing regular tick checks during times of increased tick bite risk.
Assuntos
Serviço Hospitalar de Emergência/estatística & dados numéricos , Vigilância de Evento Sentinela , Picadas de Carrapatos/terapia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Criança , Pré-Escolar , Feminino , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Pessoa de Meia-Idade , Estações do Ano , Picadas de Carrapatos/epidemiologia , Estados Unidos/epidemiologia , Adulto JovemRESUMO
Alpha-gal syndrome (AGS) describes a wide spectrum of hypersensitivity reactions mediated by specific IgE to the α-gal epitope (galactose-α-1,3-galactose) ubiquitously expressed on glycolipids/glycoproteins of most mammals. This fascinating new entity has completely changed the paradigms of allergy as allergic response is directed against an oligosaccharide and the reactions can be both immediate and delayed. They appear to be stimulated only by tick bites which induce production of α-gal specific IgE antibodies that lead to (at times fatal) hypersensitivity response. AGS is completely different to previously described anaphylaxis to tick saliva. It provides unique insight into the interplay between different arms of the immune system and the role of ectoparasites in the development of anaphylaxis to food and medication in patients at risk of tick bites including travellers. This review summarises recent advances in our understanding of its clinical presentation, pathomechanism and role of various tick species in the development of AGS.
Assuntos
Anafilaxia/imunologia , Dissacarídeos/imunologia , Hipersensibilidade a Drogas/imunologia , Epitopos , Hipersensibilidade Alimentar/imunologia , Imunoglobulina E/imunologia , Picadas de Carrapatos/imunologia , Alérgenos/imunologia , Anafilaxia/diagnóstico , Anafilaxia/epidemiologia , Anafilaxia/terapia , Animais , Dessensibilização Imunológica , Hipersensibilidade a Drogas/diagnóstico , Hipersensibilidade a Drogas/epidemiologia , Hipersensibilidade a Drogas/terapia , Hipersensibilidade Alimentar/diagnóstico , Hipersensibilidade Alimentar/epidemiologia , Hipersensibilidade Alimentar/terapia , Humanos , Proteínas de Insetos/imunologia , Prognóstico , Fatores de Risco , Saliva/imunologia , Picadas de Carrapatos/diagnóstico , Picadas de Carrapatos/epidemiologia , Picadas de Carrapatos/terapiaRESUMO
OBJECTIVE: Lyme disease is an emerging infection in Canada caused by the bacterium belonging to the Borrelia burgdorferi sensu lato species complex, which is transmitted via the bite of an infected blacklegged tick. Populations of blacklegged ticks continue to expand and are now established in different regions in Canada. It usually takes more than 24 hours of tick attachment to transfer B. burgdorferi to a human. The diagnosis of early localized Lyme disease is made by clinical assessment, as laboratory tests are not reliable at this stage. Most patients with early localized Lyme disease will present with a skin lesion (i.e., erythema migrans) expanding from the tick bite site and/or non-specific "influenza-like" symptoms (e.g., arthralgia, myalgia, and fever). Signs and symptoms may occur from between 3 and 30 days following the tick bite. The care of pregnant patients with a tick bite or suspected Lyme disease should be managed similarly to non-pregnant adults, including the consideration of antibiotics for prophylaxis and treatment. The primary objective of this committee opinion is to inform practitioners about Lyme disease and provide an approach to managing the care of pregnant women who may have been infected via a blacklegged tick bite. INTENDED USERS: Health care providers who care for pregnant women or women of reproductive age. TARGET POPULATION: Women of reproductive age. EVIDENCE: In November 2018, Medline, EMBASE, PubMed, and CENTRAL databases were searched for 2 main categories: (1) Lyme disease and (2) other tick-borne diseases. Because the main focus was Lyme disease, and considering the limited number of the articles, no further filters were applied for publication time or type of study. For other tick-borne diseases, the results were restricted to a publication date within the last 10 years (2008-2018). The search terms were developed using MeSH terms and keywords including Lyme Disease, Pregnancy, Pregnant Women, Pregnancy Complications, Ehrlichiosis, Anaplasmosis, Rocky Mountain Spotted Fever, Babesiosis, Tularemia, Powassan Virus, Encephalitis Viruses, Tick-Borne, Tick-Borne Diseases, Colorado Tick Fever, Q Fever, Relapsing Fever, and Southern Tick-Associated Rash Illness. All articles on Lyme disease and other tick-borne diseases with a target population of pregnant women were included; other groups and populations were excluded. VALIDATION METHODS: The content and recommendations of this committee opinion were drafted and agreed upon by the authors. The Board of Directors of the Society of Obstetricians and Gynaecologists of Canada approved the final draft for publication.
Assuntos
Doença de Lyme , Complicações na Gravidez/terapia , Picadas de Carrapatos , Doenças Transmitidas por Carrapatos , Adulto , Animais , Antibacterianos/uso terapêutico , Canadá , Feminino , Humanos , Doença de Lyme/diagnóstico , Doença de Lyme/tratamento farmacológico , Doença de Lyme/prevenção & controle , Gravidez , Picadas de Carrapatos/prevenção & controle , Picadas de Carrapatos/terapia , Doenças Transmitidas por Carrapatos/diagnóstico , Doenças Transmitidas por Carrapatos/prevenção & controle , CarrapatosRESUMO
The Ixodes tick is an important arthropod vector in the transmission of human disease. This 3-part review highlights the biology of the Ixodes tick and manifestations of related diseases. Part 1 addresses the Ixodes tick biology and life cycle; local reactions; and Lyme disease, the most prevalent of associated diseases. Part 2 will address human granulocytic anaplasmosis, babesiosis, Powassan virus infection, Borrelia miyamotoi disease, tick-borne encephalitis, and tick paralysis. Part 3 will address coinfection with multiple pathogens as well as methods of tick-bite prevention and tick removal.
Assuntos
Babesiose/fisiopatologia , Ixodes/fisiologia , Doença de Lyme/fisiopatologia , Dermatopatias Infecciosas/fisiopatologia , Infestações por Carrapato/fisiopatologia , Animais , Babesiose/parasitologia , Babesiose/terapia , Humanos , Ixodes/crescimento & desenvolvimento , Ixodes/parasitologia , Estágios do Ciclo de Vida , Doença de Lyme/parasitologia , Doença de Lyme/terapia , Doenças Parasitárias/parasitologia , Doenças Parasitárias/fisiopatologia , Doenças Parasitárias/terapia , Picadas de Carrapatos/fisiopatologia , Picadas de Carrapatos/terapia , Infestações por Carrapato/terapiaAssuntos
Doença de Lyme , Picadas de Carrapatos , Animais , Antibacterianos , Diagnóstico Diferencial , Florestas , Jardins , Alemanha , Humanos , Ixodes , Doença de Lyme/diagnóstico , Doença de Lyme/patologia , Doença de Lyme/terapia , Pele/patologia , Picadas de Carrapatos/diagnóstico , Picadas de Carrapatos/patologia , Picadas de Carrapatos/terapiaRESUMO
BACKGROUND: Lyme disease (LD), a multisystem infection caused by the spirochete Borrelia burgdorferi sensu stricto (B. burgdorferi), is the most reported vector-borne disease in North America, and by 2020, 80% of the population in central and eastern Canada could live in LD risk areas. Among the key factors for minimising the impact of LD are the accurate diagnosis and appropriate management of patients bitten by ticks. In this study, the practices of Quebec general practitioners (GPs) on LD diagnosis and management of patients bitten by infected ticks are described. METHODS: Eight years (2008 to 2015) of retrospective demographic and clinical data on patients bitten by infected Ixodes scapularis (I. scapularis) ticks and on the management of suspected and confirmed LD cases by Quebec GPs were analysed. RESULTS: Among 50 patients, all the antimicrobial treatments of LD clinical cases were appropriate according to current guidelines. However, more than half (62.8%) of erythema migrans (EM) were possibly misdiagnosed, 55.6%, (n = 27) of requested serologic tests were possibly unnecessary and the majority (96.5%, n = 57) of prophylactic antimicrobial treatments were not justified according to current guidelines. CONCLUSIONS: These observations underline the importance for public health to enhance the knowledge of GPs where LD is emerging, to minimise the impact of the disease on patients and the financial burden on the health system.
Assuntos
Clínicos Gerais/estatística & dados numéricos , Doença de Lyme/diagnóstico , Padrões de Prática Médica/estatística & dados numéricos , Animais , Anti-Infecciosos/uso terapêutico , Humanos , Ixodes , Doença de Lyme/tratamento farmacológico , Doença de Lyme/terapia , Quebeque , Estudos Retrospectivos , Inquéritos e Questionários , Picadas de Carrapatos/complicações , Picadas de Carrapatos/tratamento farmacológico , Picadas de Carrapatos/terapiaRESUMO
INTRODUCTION: Tick bites, which may lead to Lyme disease, often prompt patients to consult their primary care physicians (PCPs). The aim of the present study was to assess how and how often PCPs in the Franche-Comté region of France manage tick bites. MATERIAL AND METHODS: Standardized questionnaires were sent to a random sample of 400 PCPs in the Franche-Comté region, requesting their voluntary and anonymous participation. The questionnaires collected socio-demographic details and practice-related information about tick-bite prophylaxis, Lyme serology, and tick-borne encephalitis vaccination. RESULTS: The crude response rate was 54.5% of the PCPs contacted. Tick-bite prophylaxis was prescribed as per current guidelines. However, Lyme serology seemed to be largely overprescribed for tick bites and in case of erythema migrans. A clear lack of knowledge about tick-borne encephalitis vaccination was also observed. DISCUSSION: PCPs provide the first line of care for patients presenting with tick bites. This study showed that although PCPs of the Franche-Comté region manage tick bites as per current guidelines, they need further training on Lyme serology limitations and availability of tick-borne encephalitis vaccination.
Assuntos
Médicos de Atenção Primária , Padrões de Prática Médica/estatística & dados numéricos , Picadas de Carrapatos/terapia , Doenças Transmitidas por Carrapatos/prevenção & controle , Adulto , Amoxicilina/uso terapêutico , Animais , Vetores Aracnídeos/microbiologia , Vetores Aracnídeos/virologia , Doxiciclina/uso terapêutico , Vírus da Encefalite Transmitidos por Carrapatos/imunologia , Encefalite Transmitida por Carrapatos/epidemiologia , Encefalite Transmitida por Carrapatos/prevenção & controle , Encefalite Transmitida por Carrapatos/transmissão , Doenças Endêmicas , Feminino , França/epidemiologia , Fidelidade a Diretrizes/estatística & dados numéricos , Humanos , Doença de Lyme/diagnóstico , Doença de Lyme/epidemiologia , Doença de Lyme/prevenção & controle , Doença de Lyme/transmissão , Masculino , Pessoa de Meia-Idade , Educação de Pacientes como Assunto , Guias de Prática Clínica como Assunto , Prevenção Primária/métodos , Estudos de Amostragem , Testes Sorológicos/estatística & dados numéricos , Inquéritos e Questionários , Picadas de Carrapatos/microbiologia , Picadas de Carrapatos/virologia , Doenças Transmitidas por Carrapatos/epidemiologia , Doenças Transmitidas por Carrapatos/transmissão , Vacinas ViraisRESUMO
The tick-borne disease Rocky Mountain spotted fever (RMSF) can have deadly outcomes unless treated appropriately, yet nonspecific flu-like symptoms complicate diagnosis. Occupational health nurses must have a high index of suspicion with symptomatic workers and recognize that recent recreational or occupational activities with potential tick exposure may suggest RMSF.
Assuntos
Enfermagem do Trabalho/métodos , Febre Maculosa das Montanhas Rochosas/diagnóstico , Picadas de Carrapatos , Doença Aguda , Antibacterianos/uso terapêutico , DEET/uso terapêutico , Doxiciclina/uso terapêutico , Humanos , Fatores de Risco , Febre Maculosa das Montanhas Rochosas/tratamento farmacológico , Febre Maculosa das Montanhas Rochosas/epidemiologia , Picadas de Carrapatos/prevenção & controle , Picadas de Carrapatos/terapia , Estados Unidos/epidemiologiaRESUMO
BACKGROUND: Early and complete removal of ticks using the right technique is important to reduce tick-transmitted diseases. Several chemical and mechanical detachment techniques have been described previously. OBJECTIVE: We aimed to compare the performance of 4 tick-detachment techniques that are widely used in human beings and to determine the optimal method from these techniques. METHODS: A cross-sectional study was conducted on 160 patients between April and June 2010. Patients with reported tick bite were reviewed retrospectively and divided into the following 4 groups according to the tick-detachment technique used: card detachment, lassoing, freezing, and tweezers. Performance of each technique was evaluated according to the number of fully detached, nondetached, and crushed ticks and the duration of application. RESULTS: Of the 160 tick-bite cases assessed, we found the following efficacy rates: 82.5% (33/40), technique using tweezers; 47.5% (19/40), lassoing technique; 7.5% (3/40), card detachment; and 0% (0/40), freezing technique. The efficacy rate of the technique using tweezers was significantly higher than that of the other 3 techniques (P < .05). LIMITATIONS: This was a relatively small sample size and not designed as a randomized clinical trial. CONCLUSION: Tick detachment using tweezers, performed in an appropriate manner, is the easiest and most effective technique.
Assuntos
Primeiros Socorros/instrumentação , Picadas de Carrapatos/terapia , Carrapatos , Animais , Estudos Transversais , Humanos , Estudos RetrospectivosRESUMO
CONTEXT: Tick paralysis is a neurotoxic envenoming that mimics polio and primarily afflicts children, especially in hyperendemic regions of the Western United States of America (US) and Eastern Australia. OBJECTIVE: To compare the epidemiology, clinical and electrodiagnostic manifestations, and outcomes of tick paralysis in the US versus Australia. METHODS: A comparative meta-analysis of the scientific literature was conducted using Internet search engines to identify confirmed cases of tick paralysis in the US and Australia. Continuous variables including age, time to tick removal, and duration of paralysis were analyzed for statistically significant differences by unpaired t-tests; and categorical variables including gender, regional distribution, tick vector, tick attachment site, and misdiagnosis were compared for statistically significant differences by chi-square or Fisher exact tests. RESULTS: Tick paralysis following ixodid tick bites occurred seasonally and sporadically in individuals and in more clusters of children than in adults of both sexes in urban and rural locations in North America and Australia. The case fatality rate for tick paralysis was low, and the proportion of misdiagnoses of tick paralysis as Guillain-Barré syndrome (GBS) was greater in the US than in Australia. Although electrodiagnostic manifestations were similar, the neurotoxidromes differed significantly with prolonged weakness and even residual neuromuscular paralysis following tick removal in Australian cases compared with US cases. DISCUSSION: Tick paralysis was a potentially lethal envenoming that occurred in children and adults in a seasonally and regionally predictable fashion. Tick paralysis was increasingly misdiagnosed as GBS during more recent reporting periods in the US. Such misdiagnoses often directed unnecessary therapies including central venous plasmapheresis with intravenous immunoglobulin G that delayed correct diagnosis and tick removal. CONCLUSION: Tick paralysis should be added to and quickly excluded from the differential diagnoses of acute ataxia with ascending flaccid paralysis, especially in children living in tick paralysis-endemic regions worldwide.
Assuntos
Picadas de Carrapatos/epidemiologia , Paralisia por Carrapato/epidemiologia , Carrapatos , Adolescente , Adulto , Fatores Etários , Idoso , Idoso de 80 Anos ou mais , Animais , Austrália/epidemiologia , Distribuição de Qui-Quadrado , Criança , Pré-Escolar , Diagnóstico Diferencial , Erros de Diagnóstico , Feminino , Síndrome de Guillain-Barré/diagnóstico , Síndrome de Guillain-Barré/terapia , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Prognóstico , Características de Residência , Medição de Risco , Fatores de Risco , Estações do Ano , Fatores Sexuais , Picadas de Carrapatos/diagnóstico , Picadas de Carrapatos/fisiopatologia , Picadas de Carrapatos/terapia , Paralisia por Carrapato/diagnóstico , Paralisia por Carrapato/fisiopatologia , Paralisia por Carrapato/terapia , Fatores de Tempo , Estados Unidos/epidemiologia , Procedimentos Desnecessários , Adulto JovemRESUMO
Medical Officers (MOs) and Medical Branch Ratings (MBRs) must maintain an awareness of the risk of vector-borne diseases among deployed personnel. Personnel working in the maritime environment may not expect to be at risk of tick bites, as ticks typically occupy habitats with dense vegetation such as forests or scrub land. However, tick-borne pathogens can cause serious and sometimes fatal disease, and therefore the risk of tick bites and associated diseases should be recognised. We present a case of a tick bite in a member of a ship's company eight days after leaving port. The tick was identified as a brown dog tick (Rhipicephalus sanguineus), a species known to thrive indoors. We describe several important tick-borne diseases which can be transmitted by R. sanguineus and explore best practice for tick removal and aftercare. Finally, we outline the appropriate management of suspected tick-borne disease in deployed personnel in the maritime environment.
Assuntos
Militares , Rhipicephalus sanguineus , Picadas de Carrapatos/diagnóstico , Picadas de Carrapatos/terapia , Animais , Humanos , Masculino , Picadas de Carrapatos/etiologia , Adulto JovemRESUMO
Tick bites and tick-borne infections are an increasingly large problem. There is a wide range of precautions that citizens can take, but compliance is low. Mobile technology can offer a solution here, as they allow citizens to access health information in context. In this article, we discuss the development of requirements for a mobile app to support citizens in dealing with ticks and tick bites. First, we identified organizational stakeholders based on relevant protocols, and primary end-users via a systematic risk determination procedure. Then, we profiled end-users based on 25 in-depth interviews. We consulted organizational stakeholders via a focus group. The mobile app should primarily motivate citizens to check themselves for tick bites after visiting a risk area. The app should also include a tick radar, alerts to remind people to check for tick bites, and the possibility to document tick bites. Our experiences underline the necessity of thoroughly investigating the designated end-users and their context of use in order to tailor preventive health advice, and we demonstrate how this can be done. Finally, this case shows the need to create persuasive health technology in order to maximize citizen compliance.
Assuntos
Informação de Saúde ao Consumidor , Troca de Informação em Saúde , Aplicativos Móveis , Picadas de Carrapatos/terapia , Doenças Transmitidas por Carrapatos/terapia , Diagnóstico Precoce , Humanos , Avaliação de Resultados da Assistência ao Paciente , Fatores de Risco , Inquéritos e Questionários , Picadas de Carrapatos/diagnóstico , Doenças Transmitidas por Carrapatos/diagnósticoRESUMO
INTRODUCTION: Rural primary health centers frequently treat patients with tick bites. This study compares everyday clinical practice at our primary healthcare center to practices recommended by current scientific evidence. PURPOSE: To describe the everyday management of tick bites by different healthcare professionals and to compare this management to evidence-based therapy guidelines. DESIGN: Cross-sectional, descriptive observational study. METHODS: Data was collected through an anonymous self-completed questionnaire. The form was filled out by a consecutive sample of nurses, physicians and pediatricians of the clinical management unit of Medina-Sidonia (Cádiz). RESULTS: Most nurses in the sample group use some type of product to facilitate the extraction of the tick (10 of the 11 surveyed nurses, 90.9%). The most frequently used products were chloroethyl and local anesthetic. In addition, nine nurses use gentle traction with tweezers (81.82%) to remove the tick. In the physician sample group, 3 out of 12 respondents (25%) prescribe antibiotics in all cases and nine stated that they knew which antibiotic should be used as first choice. In both cases, a high number of healthcare providers confirm giving post-extraction advice to patients: 11 in the medical community (91.66%) and nine nurses (81.82%). CONCLUSIONS: We conclude that the performance of the healthcare providers that integrate this study does not closely follow general recommendations for extraction, treatment and follow-up care in patients with tick bites. Therefore, there is a need to improve the level of knowledge to ensure quality care in these instances.
INTRODUCCIÓN: En los centros de salud rurales se reciben con cierta frecuencia personas afectadas por picadura por garrapata. Hemos querido comparar el trabajo diario del equipo de atención primaria con la evidencia científica actual. Objetivos: Describir los métodos y tratamientos habituales ante una picadura por garrapata en la práctica diaria de los diferentes profesionales que componen la muestra, y compararlos con las recomendaciones generales que aportan mayor evidencia científica. MATERIAL Y MÉTODOS: Se trata de un estudio observacional, descriptivo y transversal, realizado mediante la recolección de datos a través de cuestionario auto cumplimentado anónimo. Este instrumento se aplicó a una muestra consecutiva constituida por enfermeros, médicos y pediatras de la Unidad de Gestión Clínica de Medina Sidonia (Cádiz, España). RESULTADOS: Una gran mayoría de enfermeros usa algún tipo de producto para facilitar la extracción del artrópodo (10 de los 11 encuestados, 90,91%), siendo los más utilizados el cloroetilo y la anestesia local. De ellos, 9 la realizan mediante tracción suave con pinzas (81,82%). De los médicos y pediatras, 3 de los 12 encuestados (25%) prescriben tratamiento antibiótico profiláctico en todos los casos. De los restantes, 9 facultativos afirman conocer cuál es el de elección y su posología. En ambos casos es elevado el número de profesionales que indican dar consejos post extracción, 11 en el colectivo médico (91,66%) y 9 en enfermería (81,82%). CONCLUSIONES: Se concluye que la actuación de los profesionales que han participado en este estudio en muchos aspectos no siguen las recomendaciones actuales para la extracción y tratamiento/seguimiento de pacientes afectados por picadura por garrapata. Por tanto, es necesario aumentar el grado de conocimientos de los mismos para garantizar una asistencia de calidad.