It's time for our annual ticks-are-back blog post, which for some ghoulish reason is always our most popular. This year we're adding the latest tickborne illness, so stay tuned.
We'll start by checking off the three usual cautions:
Avoid tall grass and shrubs
If you get bitten, watch out for a bullseye rash
Wear long pants and tuck them into your socks, and prefer light-colored pants to make the ticks easier to spot
But you knew these things. So this article focuses on lesser-known tick factoids. This list will sound scary, but keep in mind that millions of us are bitten by ticks every year. Fortunately, only a small percentage of people who are bitten end up with an illness as a result.
Nonetheless, with so many millions of tick bites, that "small percentage" adds up: across the Northeast, Rockies, mid-Atlantic and Midwest (and areas of other states), the total number of cases of tickborne illnesses this summer will exceed the number of heart attacks and diabetes hospitalizations combined in the <65 population.
Hence it pays to heed this advice.
(1) It is possible to buy tick-repellent clothing and tick repellent for your yard
New technology allows permethrin, which disables ticks, to be woven directly into the thread of clothing. We rarely mention manufacturers in these columns so as not to be construed as endorsing anyone, but a company called Insect Shield makes a line of permethrin-infused clothes. (“We have you covered.”) There could be others as well, but this was the one whose apparel was used in the CDC testing linked above.
Does it work? Consumer Reports says permethrin-treated clothing “may” prevent tick bites. So the recommendation would be to wear such clothing in addition to the standard prevention techniques, but not think that such clothing provides a magic shield allowing you to forage for berries in shorts.
Yard tick repellents have the same issue. There are many options, discussed at length in this article. But once again, not a magic shield. Rather, a yard tick repellent should be just part of an intergrated strategy to avoid ticks, with vigilance still #1 on the list of strategic imperatives.
(2) Bullseye rashes are highly overrated as indicators of tickborne disease
Many cases of Lyme Disease don’t start with a bullseye rash. And there are about 15 other tickborne illnesses that don’t involve a rash at all. For instance, babesiosis, the fastest-growing tickborne illness, is caused by a parasite, not a bacterium.
So you can’t assume that your COVID-like symptoms are not due to a tick, just because you don’t see a rash and test negative for COVID and/or have been vaccinated.
Further, Lyme Disease is the most misdiagnosed common disease in the US. This is true in both directions. Some people are told they have it, but they don’t. Others who have it are told they don’t. So always get a second or even third opinion. You can google on the phrase “Lyme-literate” to find doctors who promote their knowledge of Lyme Disease, but there is no guarantee they will be right.
(3) Keep the tick, in case you get sick
That rhyme is an easy memory device. Don’t flush it. Don’t squish it. Resist the urge to send it to that kid who used to steal your lunch money. Keep it in a jar with a couple of small air holes and a leaf.
Two reasons for that precaution. First, while many people can distinguish a wood tick from a deer tick just by size, a smaller example of the large wood tick on the left is not easily distinguishable from a large deer tick, on the right.
It makes a huge difference which type of tick it is. Those two types of ticks carry different diseases that require different medicines. Wood ticks are quite unlikely to make you sick in the first place, other than a local infection at the site.
The second reason is that it is possible in some cases to figure out which tickborne illness you have by sending the tick itself to a lab. Many labs are listed here but other things equal, the closer ones will have more experience with local ticks.
Knowing which illness is being treated might allow a more targeted therapy. Smaller doses of the correct antibiotic carry less risk and will be more effective than large doses of a “broad-spectrum” antibiotic. The latter, being more powerful, carries more potential for risks and side effects, especially over the three-week course, that being the duration which is often recommended. (If you link to the aforementioned babesiosis article, you'll see how treatment is dramatically different than for Lyme Disease.)
Don’t send a tick to a lab until you really think you are sick, and even then only in consultation with your doctor. The cost adds up, and comparatively few tick bites cause disease. The labs may be wrong, too. For instance, they may find one germ (“pathogen”) that causes disease and assume that’s the one causing yours, while overlooking the right one.
It's also possible that you got bitten and infected by a different tick than the one you found and kept.
The turnaround time may be too long, as well. For that reason, a doctor might recommend starting on one therapy for the most likely culprit, until and unless "proven" wrong by the lab.
(4) Buy special tick tweezers to get the tick out
If you just try squeezing it out with your fingers or a regular tweezers, you are likely to squeeze whatever is inside the tick back into you. Other urban legends: you can’t smother it with Vaseline. And ticks are no exception to the general rule of thumb that very few of life's problems are solvable by holding a match to your skin.
(5) However you remove the tick, do it from the head
If you don’t have a special tick tweezers, keep in mind that the important thing in removing the tick is to get under it, as in the illustration. If you don't have the right tweezers, a credit card or even two might help to lift it out from below.
(6) Tick checks should be done every day you are out in any field or on any path
Ticks can’t jump, and they don’t swoop down on you from trees, but it is amazing how easy it is to pick one up when they are seeking a host, even if you think you are avoiding their habitat.
You also expect to find them on your legs, since that’s the height of the grass, but most ticks will crawl up your body before you notice them. You should feel your scalp and behind your ears. That is where your skin is thinnest, and hence where ticks prefer. Behind your ears is also slightly moist, which they prefer. They also like other moist places that we can't mention here in our family-friendly forum.
With the possible exception of heartburn (so many avoidance and management tips that it’s covered not once but rather in two previous blog posts), tickborne illness is the easiest G-rated medical condition to prevent. Taking all these precautions should reduce your risk of tickborne illness this summer to near-zero.
(7) New for 2022: Ticks can make you allergic to red meat
Yep. You heard it here first. The Lone Star tick, shown below, can transmit something called alpha-gal syndrome. The allergy to red meat and possibly other mammal products can be severe and possibly permanent. The Lone Star tick is mostly now found in the Midwest and East, but is spreading north and west. All the more reason for the other tick avoidance recommendations above, since this condition is not treatable.
If you are a Quizzify customer, ask us to post our Summer Hazards quiz for you. That quiz can be made very tick-centric for those of you in tick-heavy areas, while others of you can substitute other questions specific to your own geographic hazards.
We can also write articles like this for your company newsletters.
Not a Quizzify customer? Now's your chance. Somewhere between 1 in 1000 and 1 in 300 of your employees will get a tick bite this summer or fall. That may seem like a small percentage but it's far more than your heart attacks and hospitalizations for diabetes combined...and think how much effort goes into the much harder task of attempting to prevent those.
Comments