A Guide to Preventing Tick Bites

Spending more time outdoors is one of the best parts of the spring and summer, but it’s important to remember to protect yourself from pests, like ticks. Fortunately, there are some simple ways to prevent tick bites, which can occur year-round, but especially around May, June, and July, when larva ticks begin to mature into the next life stage, known as nymphs. Nymph ticks are tiny and very hard to spot, and they are on the hunt for blood to feed on to survive.

Dr. Brian Fallon, director of Columbia’s Lyme and Tick-Borne Diseases Research Center and a psychiatrist with NewYork-Presbyterian/Columbia University Irving Medical Center, and Dr. Rafal Tokarz, assistant professor of epidemiology at the Center for Infection and Immunity at Columbia University’s Mailman School of Public Health, spoke with Health Matters for tips to prevent tick bites and acquiring a tick-borne illness. They also shared what to do if you find a tick on you.

Ticks will wait on leaves or blades of grass and grab onto whatever warm-blooded mammal brushes by. If you plan on being in a wooded, leafy area, spray your clothes ahead of time with permethrin. For your skin, using repellent is a good way to prevent tick bites.  Look for ones that contain 20 to 30 percent of either DEET or picaridin, or repellent containing 30 percent of oil of lemon eucalyptus.

Tick nymphs are about the size of a poppy seed and dark brown, making them very difficult to see. Wear light-colored, long-sleeved shirts, and pants, which should be tucked into your socks. If you see a tick on your clothes, simply brush it off.

If you have a lawn and shrubbery, keep everything neatly trimmed. Ticks like dark, moist spaces so a cut lawn that gets lots of sun can reduce the number of ticks.

After you’ve gone camping or hiking or spent time gardening or mowing the lawn, here are a few places to check for ticks:

• Hair
• Ears
• Underarms
• Groin
• Waist
• Behind your knees
• Belly button

If you have kids, put their clothes in the washer and dryer to kill any ticks before performing a tick check. Perform a tick check on any pets, too, if they’ve explored areas where ticks are prevalent.

Pull upward with steady, even pressure. Don’t twist or jerk the tick, and don’t use petroleum jelly or a match to burn it off. Once you have removed the tick, thoroughly clean the bite area and your hands with rubbing alcohol or soap and water.

If the black-legged tick, the species that carries the microbe that causes Lyme, is removed within 24 hours, you substantially reduce the risk of acquiring Lyme disease. In most cases, the tick must be attached for 36 to 48 hours or more before the Lyme disease bacterium can be transmitted. If the tick was on longer than 36 hours or if you feel sick after a tick bite of a shorter duration, it’s a good idea to see a doctor.

Lyme disease doesn’t always present with an easily identifiable rash with a bulls-eye shape in the middle. More often it’s a solid rash that starts small and expands in size over a few days. There might also be no rash at all, or there may be multiple rashes. Also, be on the lookout for viral-like symptoms, such as a fever, stiff muscles, fatigue, and painful joints.

Lyme disease is rarely fatal, but it can be if it affects the heart. Most often a doctor will prescribe common antibiotics, like doxycycline or amoxicillin, and a vast majority of the time a person will recover fully. Some people have an immune system strong enough to kill the bacteria without antibiotics, meaning even though they are infected, they will not show symptoms. But if you suspect you may have Lyme disease, it’s best to seek medical attention.

The dog tick, much larger than the black-legged tick, is also endemic in the Northeast. It carries microbes that cause tularemia and Rocky Mountain spotted fever. The rash associated with Rocky Mountain spotted fever typically starts on the hands and feet; early recognition and treatment with antibiotics is needed to avoid dangerous and sometimes deadly complications. Tularemia is a much rarer but serious disease characterized by fever, enlarged and painful liver and spleen, and often a skin ulcer.

The lone star tick, which until recently was primarily found in the South, has expanded its geographic range and is now also found in the Northeast. The lone star tick is an aggressive hunter, moving about 3 times faster than the black-legged tick. The lone star tick may carry the microbes that cause ehrlichiosis, which manifests most often as a viral -like illness, with fever, chills, severe headaches, nausea, confusion, and muscle pains; unlike a virus, it should be treated with the antibiotic doxycycline. The lone star tick may also carry a substance called alpha-gal that, after a bite, triggers a delayed allergic reaction to red meat (but not to chicken or fish).

Ticks live through the winter, though they are far less active at that time of year. If the daytime temperature rises above 45 degrees, ticks may emerge to feed. If you take a walk through woods where ticks are prevalent on an unseasonably warm winter day, be sure to check yourself, your kids, and your pets for ticks.