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.
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. Pre-treatment 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 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?
Yes. Once they attach, they’re very 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.
After removing the tick, what are the next steps?
Call your healthcare provider. If it’s been attached for more than 24–48 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. In general, it’s one dose of doxycycline 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. Because of COVID-19, we’ve increased our telehealth resources, expanding access to all 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 into your pharmacy, all without you having to go into 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. Because COVID is still a risk, people should wear face masks in public places, wash their hands when they get home, and practice social distancing.