How to Protect Yourself This Tick Season

An infectious diseases expert on what to expect for the 2021 tick season and how to keep yourself, your loved ones, and your pets safe.

Man and woman walking on hiking trail with dog

Tick season is upon us, and although the threat of tick bites occurs every summer as people spend more time hiking, walking, or picnicking in grassy areas, experts are predicting an increased risk of tick exposure this year as travel and social interactions increase and new pet owners spend more time outdoors.

With the loosening of COVID-19 restrictions and the rise in vaccinations, more people are traveling and flocking to parks, hiking trails, campgrounds, and vacation destinations throughout the country, potentially causing a surge in tick exposure, says Dr. Sorana Segal-Maurer, director of the Dr. James J. Rahal, Jr. Division of Infectious Diseases at NewYork-Presbyterian Queens and professor of clinical medicine at Weill Cornell Medicine. In addition, says Dr. Segal-Maurer, more than 11 million households adopted a pet during the COVID-19 pandemic, putting more people at risk of getting a tick-borne disease from a tick brought in by their pet — if they don’t take the proper precautions.

To prepare for the 2021 tick season, Dr. Segal-Maurer spoke with Health Matters about how the COVID-19 pandemic might affect this year’s tick season; how to identify and respond to a tick bite; and how to keep yourself, your loved ones, and your pets tick-free when enjoying time outdoors.

Dr. Sorana Segal-Maurer debunks COVID-19 myths

Dr. Sorana Segal-Maurer

How would someone know if they have symptoms of a tick-borne disease rather than COVID-19?
Most tick-borne diseases common to the Northeast — Lyme disease, anaplasmosis, babesiosis, and Powassan virus, all carried by the blacklegged tick — have some similarities to COVID-19. They can present with fever, fatigue, and muscle aches. But the cross-symptoms really end there. With COVID-19, the symptoms can very quickly progress into a respiratory problem. Tick-borne diseases don’t have a respiratory component. You’ll feel lousy, you’ll have fever and aches, but you won’t have a cough, you won’t have pneumonia.

Tick bites also might leave distinct physical marks. In the case of Lyme disease, some people will develop a very particular rash that looks like a target, and in the case of anaplasmosis and babesiosis, you may see what we call petechiae, which look like a rash with little red scattered dots. These aren’t typical with COVID-19.

As more people get vaccinated against COVID-19, some short-term vaccine reactions could mirror symptoms of a tick-borne disease, like fever or muscle aches. Additionally, long-term effects of COVID-19, like fatigue, could be mistaken for a symptom of a tick-borne disease. I advise anyone who may have been in an area where they were exposed to ticks — or who has been bitten by a tick and removed it — and experiences these symptoms to follow up with their doctor.

Are people who have recovered from COVID-19 or been vaccinated against it more susceptible to serious illness if they get a tick-borne disease?
There is no evidence that having had COVID-19 and recovered — or having received the vaccine — makes you any more or less susceptible to serious illness from a tick-borne disease.

What effect will the easing of COVID-19 restrictions have on tick season?
With COVID-19 restrictions being lifted, there may be a lot more risk of tick exposure because people are starved of their social experiences and now we can go out to do more. People may not think about ticks because they’re eager to get out and see friends for an extended period in outdoor settings, and not just in the New York, New Jersey, Connecticut area. You can find ticks from Maine all the way down to the Carolinas and into the Midwest. If you travel to the Wisconsin Dells or Martha’s Vineyard to visit friends or vacation, be aware that ticks are in those areas too.

Another factor that could contribute to an increase in tick-borne illnesses is that COVID-19 drove a pet adoption frenzy. Many people adopted dogs, and they’re going to go outdoors with them. I am concerned that people who never had dogs before are not thinking that their dog could bring ticks back into their home. If a tick attaches to the dog, and then you pet or snuggle with your dog, you might end up exposing yourself to that tick. People need to make sure they have tick and flea collars for their dogs and check with their veterinarian about medication to prevent tick-borne diseases.

What precautions can people take to avoid being bitten?
Wear light-colored clothing so ticks are easier to see, and socks over pants and long-sleeved shirts to prevent ticks from getting near your skin. And don’t forget hats.

Applying a tick repellent with a concentration of DEET of up to 30% has proved effective either due to its smell or its ability to camouflage us when the ticks are putting out their feelers. The other thing that’s been studied is eucalyptus oil for those wishing to avoid DEET. Pretreatment of clothing with permethrin is also very effective, but you have to be careful about its use around cats. If you treat dogs with permethrin, cats need to be kept away from them.

When you’re outside, stay on paths. Once you brush against foliage, you’re putting yourself at risk.

Who’s most at risk for getting tick bites?
Kids are at risk because they might veer off walking paths and run through foliage without realizing it, as are pets because they’re always face-down smelling all these fabulous things outdoors. Hikers are at risk, as is anybody who is active outdoors.

What should you do if you’ve been in an area with ticks?
Immediately do a tick check on yourself, on your children, and on your pet when you get indoors. You can put your clothing into a hot dryer for at least 20 minutes. Water doesn’t kill ticks, but heat does. And then, of course, do a body check. Ticks like to go anywhere it’s warm and protected, like under your arms, between your legs, around private parts, the back of your knees, your neck, in your hair, or behind your ears.

If you find a tick on your body, should you remove it? What is the best way to do it?
Once they attach, they can be difficult to pull out. There are a number of talked-about remedies that do not work and can be dangerous, like using petroleum jelly to “smother the tick” or “burning it off,” which just serves to cause a nasty burn. There’s really no way of doing it other than making sure you have a very sharp pair of tweezers. Not blunt tweezers, because if you squeeze the tick, you increase the potential to infect yourself. Try to pull it out from the mouth straight out, not twisting. That’s very important.

When you’re disposing of it, either flush it down the toilet or drop it in rubbing alcohol in case you end up with a rash and want to bring it in for identification.

Typical Lyme disease bullseye rash.

“Classic” Lyme disease rash in the pattern of a bulls-eye.

CDC/ James Gathany

After removing the tick, what are the next steps?
Call your healthcare provider. If it’s been attached for more than 24 to 48 hours and you can reasonably see it (it is engorged and larger than the size of a poppy seed or grain of sand), it has probably fed. Generally, one dose of the antibiotic doxycycline will be prescribed as a preemptive treatment. If you don’t know that you’ve been bitten and now have symptoms, you have to get a full course of treatment, which will be determined based on your diagnosis.

You can also reach a provider using telehealth. We’ve increased our telehealth resources, expanding access to primary and specialty care. If you think you’ve been bitten by a tick, you can consult with doctor via a video visit, show the doctor your rash, or even show them the tick, and they can put you on a doxycycline preventive regimen and call it in to your pharmacy, all without your having to go to a doctor’s office.

Anything else people should be aware of?
Blacklegged ticks can be infected with multiple diseases. If you’re diagnosed with Lyme, get treated for it, but be vigilant if you have additional symptoms or you don’t feel like you have returned to your baseline. Make sure your healthcare provider looks for all the other infections that we see with these tick-borne illnesses.

Sorana Segal-Maurer, M.D., is director of the Dr. James J. Rahal, Jr. Division of Infectious Diseases at NewYork-Presbyterian Queens and a professor of clinical medicine at Weill Cornell Medicine.