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Tick bite: what to do and when to see a doctor

The Moscow region is not a hotspot for tick-borne encephalitis, but Lyme disease occurs here every season and ticks travel home from country houses all summer. Remove the tick as quickly and cleanly as possible, keep it for testing, and watch the bite and your temperature for three weeks.

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What to do right now

Remove the tick at once
Grip it with tweezers or a loop of thread as close to the skin as possible and pull upward with a gentle rocking motion. Do not twist or squeeze the body. Remove any remaining head like a splinter.
Do not pour anything on it
Oil, alcohol or petrol make the tick regurgitate into the wound, which increases the risk of infection.
Keep the tick
Alive, in a jar with a damp cotton pad. In Moscow, laboratories of Rospotrebnadzor and commercial labs test it for encephalitis and borreliosis within one or two days.
Disinfect the site
Iodine or chlorhexidine. Write down the date of the bite.
Watch for 3 weeks
An expanding ring-shaped redness around the bite means Lyme disease and requires antibiotics. Fever, headache and weakness after 1–2 weeks require examination.

Call an ambulance if

A bite in an area endemic for encephalitis and less than 96 hours have passed — immunoglobulin is decided quickly
The tick cannot be removed, or part of it remains and the site is inflamed
Expanding ring rash, fever or headache after a bite
A child under 3, a pregnant woman, or a bite on the head or neck
Multiple bites

What not to do

Do not smother the tick with oil or burn it
Do not crush the tick with your fingers
Do not wait for symptoms if the bite was in an endemic region — immunoglobulin works only in the first days
Do not take antibiotics "just in case" without examination

What the crew does

Tick removal with disinfection, extraction of remaining parts
Examination, risk assessment, referral for tick testing
Advice on follow-up; antibiotics if prescribed by a doctor
Admission to an infectious diseases hospital if encephalitis is suspected

This page is for information and does not replace a medical examination. If the condition worsens, call the crew: +7 (985) 887-82-52.

This page in Russian: Russian version.

Questions

Where can a tick be tested in Moscow?

At the Rospotrebnadzor Centre for Hygiene and Epidemiology, the Central Research Institute of Epidemiology, and commercial laboratories such as Invitro and Gemotest. Bring it alive within 24 hours.

Is immunoglobulin needed in Moscow?

Moscow and most of the surrounding region are not endemic for tick-borne encephalitis. Immunoglobulin is given if the bite happened in an endemic region — Tver, Yaroslavl, the Urals, Siberia — or if the tick tests positive.

How much does a call-out to remove a tick cost?

Call-out 6,000 ₽ inside the MKAD; removal and disinfection are included. If the tick is already out and you feel well, a clinic visit is enough.