Lyme Disease: Tips, Tricks, and Prevention

Lyme disease is in the news again. It’s been propelled there by the viral success of the book Bitten, which claims that the tick-borne illness was the result of an American bioweapons project gone horribly wrong. The story caught even more traction when US Congressman Chris Smith, a Republican representing parts of New Jersey, read the book. Smith found its message so compelling that he successfully proposed an amendment to require the US Department of Defense to report to whether the military “experimented with ticks and other insects regarding use as a biological weapon between the years of 1950 and 1975.”

However thrilling Bitten may be, the book is more science fiction than science fact. “There’s evidence in the U.S. that Lyme disease was here before Columbus came around,” Phil Baker, executive director for the American Lyme Disease Foundation, told VICE News in July. And as for Lyme’s presence in Europe, Ötzi, the famous ice mummy discovered in the Eastern Alps, showed traces of the Lyme genome in his 5,600-year-old DNA.

Today, Lyme disease continues to exist primarily in the Northeast and Upper Midwest United States, as well as Ötzi’s old stomping grounds of northwestern and central Europe. The infection is fairly common, with several hundred thousand suspected cases reported to date. And the number of suspected cases has grown over the last decade as summers have become hotter and winters have become warmer and milder. This change in climate has been a boon for growing populations of deer and white-footed mice, the preferred hosts of the deer ticks and blacklegged ticks that transmit Lyme disease to humans. According to scientists with the CDC, the math of Lyme disease’s increasing prevalence is simple: more deer and white-footed mice means more ticks, and more ticks means more tick-borne illnesses.  

There is currently no vaccine to prevent Lyme disease in humans. But before you resort to cowering in your house, terrified of crossing paths with these bloodthirsty eight-legged creepy-crawlies, you should know that when it comes to Lyme disease, an ounce of prevention is truly worth a pound of cure. And with the proper techniques, tick bites are very preventable.  

It helps to first understand how ticks make their way onto humans. Deer and blacklegged ticks do not have wings, and they cannot fly or jump onto their intended prey. The only way for a person to pick up a tick is to come into direct contact with it. Adult ticks can usually be found clinging to tall grasses, brush, or shrubs. They tend to hitch a ride on humans who brush up against these plants. Pinhead-sized deer and blacklegged tick larvae and nymphs thrive in damp, shady spots near the ground. These young ticks are more likely to find their way onto you via your shoes or bare feet.

Once a tick has found a host to cling to, it will usually climb up until it finds a warm, protected, and preferably moist spot to settle into for feeding time. This is why most attached ticks are found in the folds around the back of the knee, neck, groin, bellybutton, armpit, and behind the ear. Because ticks can be quite tiny – as small as a poppy seed in their nymphal phase – most people do not feel the ticks’ mouthparts burrowing into their skin. The tick then settles in for the long haul, feeding for days.

According to Dania Richter of the Charité University Hospital in Berlin, any parasites inside the tick, such as the Lyme disease-causing spirochete bacteria Lyme borreliosis, make their way from the tick’s guts into its bloodstream, then into its salivary glands, and are finally transmitted into the host. Because of this lengthy process, you are unlikely to become infected with Lyme disease within the first 36-48 hours after being latched onto by an infected tick.    

To prevent tick bites, wear light-colored clothing during outdoor activities so that you can see if any of the little critters have hitched a ride on you. Tuck your pants legs into your socks; covering up keeps ticks from latching on. Apply an insect repellent containing DEET to your skin. And if you enjoy the outdoors and live in an area where Lyme disease is prevalent, you might wish to look into clothing, hiking gear, and even tents treated with the insecticide permethrin. A University of Rhode Island study found that people who wore permethrin-treated shoes and socks were almost 74 times less likely to suffer a tick bite than those who wore untreated footwear.  

After hiking, gardening, and other outdoor activities, throw your clothing in the laundry and hop in the shower. A good scrub-down will rinse off any unattached ticks. Drying your clothes on high heat for at least five minutes after they’ve been in the wash should kill any ticks that caught a ride home on your clothing.  

Your final and best line of defense is a nightly full-body tick check. According to the American Lyme Disease Foundation, “this ritual is perhaps the single most effective current method for prevention of Lyme disease.” Because as many as 3 in every 4 tick bites occur at or near home, it’s also important for parents check over their children after outside play.

If you do find that a tick has attached itself to your skin, don’t panic. Most deer and blacklegged ticks do not carry Lyme disease, and as stated above, infected ticks do not transmit the bacteria that causes Lyme disease until they have been attached for many hours.

Carefully remove the tick by grasping its head with tweezers and firmly pulling it directly away from your skin. Despite widely-dispersed urban legends, ticks will not back out of the skin if burnt with a match, smothered with petroleum jelly, or doused with alcohol, nail polish, or other irritants.

Sometimes, despite best efforts to remove the entire tick, the tick’s head and/or mouthparts will remain lodged in your skin. You may be able to remove them during a second pass with the tweezers, or you may need to consult with your doctor to completely extract the tick.    

If possible, save the tick in a sealed container such as a pill bottle or sealable plastic sandwich bag. Your local public health authority can help you find details on how and where to send a tick for testing and identification. Otherwise, dispose of the tick once you are sure it is dead. Ticks can be killed by drowning them in rubbing alcohol or freezing them in a sealed container overnight. Ticks should never be squashed between the fingers.  

Wash your hands and the tick bite area with soapy water, disinfectant, rubbing alcohol, or hand sanitizer.

Monitor the bite site for the next 30 days. If you develop any of the following symptoms of early Lyme disease, contact your doctor immediately:

1.     A solid red blotch or bullseye-shaped rash that expands outward from the site of the tick bite. In darker-skinned individuals, this rash, called erythema migrans, may look more like a dark, blotchy, or circular bruise.  

2.     Chills

3.     Fever of 100 to 102 degrees F

4.     Muscle and joint aches

5.     Fatigue

6.     A stiff, achy neck

7.     Tingling and/or numbness in the hands and feet

8.     Swollen lymph nodes

9.     Drooping of one side of the face, and/or facial paralysis    

Your doctor will order blood tests that can determine if you are battling a Lyme disease infection. He or she will likely prescribe an antibiotic such as doxycycline. It’s important to follow your doctor’s instructions for treatment. With prompt treatment, most patients completely recover within a month. If Lyme disease goes untreated until it reaches its later stages, however, long-term outcomes worsen and the infection becomes much more difficult to successfully treat.