Doxycycline criteria #2: 36+ hour attachment or engorged appearance
Borrelia transmission generally requires 36-48+ hours of attachment, so prophylaxis is reserved for ticks that meet that threshold.
D
Steps
schema.org/HowTo
01
Estimate attachment time from the last known tick check (e.g., last shower, last full-body scan).
02
If the timeline is uncertain, judge engorgement: a flat, slate-grey nymph is likely under 24 hours; a coffee-bean-shaped, swollen tick is likely 36+ hours.
03
Save the tick or a sharp side-view photo so the clinician can confirm engorgement.
04
If attachment is clearly under 36 hours and the tick is flat, prophylaxis is generally not indicated.
05
When in doubt, the clinician decides; engorgement is the more reliable signal than memory.