Up Your Game: Take More Precautions Against Ticks this Summer

Experts are predicting a longer, more severe tick season this summer, which may trigger an outbreak of tick-borne illnesses. In particular, researchers are worried about an uptick in Lyme disease and Powassan virus, a rare condition that  can cause brain inflammation. 

While Lyme disease has grown more common—there were more than 28,000 cases in 2015, according to the Centers for Disease Control and Prevention—the Powassan virus is still rare. Only 75 cases have been reported over the last 10 year in the United States, according to the U.S. Centers for Disease Control and Prevention (CDC). But this season’s conditions are ripe for an increase.

Like Lyme disease, Powassan is carried by white-footed mice (also known as wood mice) and transmitted to humans via deer tick bites. It’s also more prevalent in the Northeast and Great Lakes regions—just like Lyme disease. However, Powassan’s transmission to humans is quicker than Lyme disease and tends to be more fatal. 

Many people bitten by Powassan-infected ticks do not develop obvious or immediate symptoms. Others may experience flu-like symptoms, a mild rash, fever and headache. 

In some cases, the virus can affect the central nervous system and lead to encephalitis (inflammation of the brain) and meningitis (inflammation of the membranes the surround the brain and spinal cord), causing symptoms such as fever, headache, vomiting, weakness, confusion, loss of coordination, speech difficulties, seizures and loss of consciousness. These begin appearing a week to one month after being infected. Currently, there aren’t any medications are to treat Powassan or vaccines to prevent it. 

Warm winters have improved conditions for ticks because they have improved conditions for mice and deer, the animals ticks typically infest. A greater number of insects survived the cold temperatures, and this year’s early spring awakened dormant insects sooner.

How do you protect yourself from tick-borne illness like Powassan and Lyme disease? Here’s what you can do:

Before going outside:
  • Dress in long sleeves, long pants and socks.
  • Wear insect-repellent clothing.
  • Use permethrin (medication to treat scabies and lice) as an insecticide and spray it on your clothing and shoes.
  • Apply insect repellent to your skin. Generally, products with DEET and picaridin are effective. If you prefer natural ingredients over chemicals, the CDC suggests products that contain garlic oil, 2-undecanone, nootkatone and/or mixed essential oils (rosemary, lemongrass, cedar, peppermint, thyme and geraniol).    
While outside:
  • Stay away from brush areas and piles of leaves.
  • Check for ticks while you’re outside. They can be as small as poppy seeds, so thoroughly check your skin, shoes and clothing.
After coming home:
  • Run your clothing through a dryer for about 10 minutes.
  • Take a hot shower and scan your body for unexplained bumps and spots.
If you find a tick on you, the safest way to remove it is to grip it with tweezers as close to your skin as possible. Old wives’ tales of using cigarettes, household products or nail polish remover to smother the tick only irritate the insect, causing it to inject its bodily fluids into the wound, according to UpToDate.

After it’s been removed, note characteristics like size, color and shape. This can help identify which type of tick bit you and the viruses that may be associated with it. Share this information with your MDVIP-affiliated physician if symptoms begin appearing. Don’t have an MDVIP-affiliated doctor? Find one near you by clicking here »
18 Comments
Nancy Bennett
Jun 30th, 2017
I'll ask the same question that was in an earlier comment: Any advice on Alpha gal and the lone star tick? It's far more prevalent than Powassan and it can be fatal. I went into anaphylactic shock one morning and was later diagnosed with the 'meat allergy.' Are any clinical trials being conducted?
1 Reply
MDVIP
Jun 30th, 2017
Greetings Nancy. Both Alpha Gal and Lone Star ticks are associated with an alpha-gal allergy, which is an allergic reaction to beef, lamb, pork, goat, whale and/or seal. Milder symptoms include nasal congestion, nausea, skin rash, while more serious symptoms may be extreme dehydration and breathing difficulties. Lone Star ticks are reddish-brown, quite small and usually found in shaded, wooded areas. They tend to live in West central Texas northward to northern Missouri and eastward from Maine to the southern tip of Florida. Take the same precautions to avoid Lone Star ticks, as you would with other types of ticks. For more information on ticks, refer to University of Rhode Island’s Tick Encounter Resource Center http://www.tickencounter.org. In good health, MDVIP
David
Jun 30th, 2017
I live in Mississippi on the coast. I was diagnosted with lyme disease in 2007. Unfortunatly it took a year to come to the conclusion I had Lyme since the doctors in the south can't believe Lyme infected ticks live here. They do. I have 2 friends who live an hour north of the coast with Lyme also. And another friend who lives in pensacola, Fl. With Lyme also. Be aware none of us had the bulls eye they say to look for. It was January when I contracted Lyme, working under my house. Do the best you can at ALL times to protect yourself and family from tick bites. This disease is life changing and different in each person. The ticks also are known to carry a parasite that can do much more damage as well. The Dr. I found in Mobile, Al has hundreds of Lyme patients from the south. And warned me that 10 times the number of Lyme cases go misdiagnosed or no diagnosed at all. So I tell any and all my symtoms and advise to get treatment asap.
1 Reply
MDVIP
Jun 30th, 2017
Greetings David. We’re sorry to hear that you contracted Lyme disease and that it took so long to get diagnosed and treated. You’re right; tick-borne diseases are considered a public health issue in the Northwest and Midwest. However, ticks move around, spreading viruses throughout the country. Thank you very much for sharing your experience. We hope no one else goes undiagnosed and untreated as long as you did. In good health, MDVIP.
Doug
Jun 29th, 2017
I picked up two ticks while traveling in AR last summer. The locals recommended shaving cream to get the tick to back out. I had never heard of this method, but it worked quickly both times.
1 Reply
MDVIP
Jun 30th, 2017
Greetings Doug. Thank you for sharing your tip. In good health, MDVIP
Bob Moore
Jun 29th, 2017
Thank you for the information. Any advice for Alpha-Gal & Lone Star ticks? My allergist says that she has more than 300 cases in her practice alone (in North Alabama). She advises that permethrin is effective while DEET is not. Thanks again!
1 Reply
MDVIP
Jun 30th, 2017
Greetings Bob. Both Alpha Gal and Lone Star ticks are associated with an alpha-gal allergy, which is an allergic reaction to beef, lamb, pork, goat, whale and/or seal. Milder symptoms include nasal congestion, nausea, skin rash, while more serious symptoms may be extreme dehydration and breathing difficulties. Lone Star ticks are reddish-brown, quite small and usually found in shaded, wooded areas. They tend to live in West central Texas northward to northern Missouri and eastward from Maine to the southern tip of Florida. Take the same precautions to avoid Lone Star ticks, as you would with other types of ticks. For more information on ticks, refer to University of Rhode Island’s Tick Encounter Resource Center http://www.tickencounter.org. In good health, MDVIP

Ray Salemme
Jun 28th, 2017
All of the compounds you discuss to repel ticks are chemicals. Some are natural compounds (like heroin and strychnine), some are synthetics. Generally, the synthetics like DEET work much better at repelling ticks. So, if we are talking kids and Lyme disease (not to mention Powassan and brain inflammation -Yikes!), we (living in Bucks PA) as PhD biochemists, choose to go with what works-DEET.
1 Reply
MDVIP
Jun 28th, 2017
Greetings Ray. Thank you for your suggestions. We agree that DEET-based products are effective and we mention using them and picaridin. For people who prefer natural products, we suggested using repellents that contain garlic oil, 2-undecanone, nootkatone and/or mixed essential oils (e.g., rosemary, lemongrass, cedar, peppermint, thyme and geraniol). However, the American Academy of Pediatrics (AAP) cautions parents about applying DEET-based products to children. It also suggests that permethrin-based products should only be applied to their clothing. Picaridin and essential oils products are considered safer but the AAP also warns that more studies are needed. In good health, MDVIP
Jim Smith
Jun 28th, 2017
MDVIP: While I believe you are trying to help, I agree with others that you may be mis informing a little, especially with reference to removal and what to do after a bite. Thank you for your article and your efforts to warn others. You are spot on with your efforts. I have a family of 4 living in Massachusetts, and 3 of the 4 of us have been bitten and diagnosed with Lyme. We are extremely vigilant against ticks, but we live near the woods and there is only so much one can do.

Here are our thoughts:

1. When you find a tick embedded, use a TICK REMOVAL TOOL to get it off. It is similar to tweasers, but designed specifically for removal of ticks. They are about $2. Get a few to have around the house. Do not use your fingers or a match, and be careful if you must use your fingers, as you can force the disease into you you.

2. When you discover you have been bitten, Immediatly put it in a folded wet paper towel, put it in a ziplock bag, and mail it to UMASS for testing. Anytone in the USA can do this. Look up UMASS zoological tick testing. If you dont mail your tick in, you are essentially winging it and may not notice the symptoms until it is long overdue and you have long term Lyme, and you will be forced to take months of antibiotics. Im not a Dr, this is my opinion. I agree with Dr Kaplan above.

3. Have your yard sprayed monthly with Tick deterrent. We use a natural company, so it is not harmful chemicals, but it works. We pay about $70 per month in the summer, and we do not do it in the winter. We also have chickens that we got for the purpose of finding and eating ticks around the yard. Mow your yard and clear brush.

4.Tick check your small kids (and yourself) every single time you come in the house. Check yourself before you come in, and try to remove clothing before you eneter the main zone of your house, as you may drop one without knowing it. We typically do this after yard work and etc.

5.Use mousetraps everywhere. Basement, Garage, Shed. Get rid of the mice, who can carry up to 100 ticks PER MOUSE and drop them around your house.

6.Consider removing bird feeders, as they also can carry and drop ticks in your yard.

7.Stay aware. Tell your friends. Lyme is a horrible disease and is going to reach epidemic levels.

Good luck folks!
1 Reply
MDVIP
Jun 28th, 2017
Greetings Jim. Thank you for your suggestions. In good health, MDVIP
Pamela Ecker
Jun 28th, 2017
I am very surprised to see your advice on removing ticks. You left out some very important parts of the CDC article. For example, If you use regular tweezers you are simply pulling on the body and squeezing (possibly forcing more saliva into the bite). This can leave the mouth parts imbedded. The CDC recommends using fine ended tweezers that can get under the tick without squeezing, similar to fine jeweler's tweezers.

When pulling out a tick (without proper tweezers) you can use your fingernails to get under the head and gently pull. You know you have done it correctly if a small bit of skin comes with it. I realize this sounds disgusting but it is thorough. For those who are sqeamish, there is a handy little tool called a tick-key that does the same thing. I keep one in each first-aid kit and several around the house. They are flat and small, easy to carry around. After removal be sure to wash everything including the site and your hands.

Something else to know; if you get the tick out correctly with it's head still attatched, THEY CAN STILL JUMP AWAY. It is important to kill it immediately, as it can go into hiding again until it needs to feed. Fully fed ones can go dormant for months and then reappear.

I would recommend that readers see the full article on the CDC's site and also check out forestry and hiking health guides for further advice. Mine came from a dermatologist specializing in animal born skin disease and a thorough research into the subject -having been a lifelong hiker and camper.
1 Reply
MDVIP
Jun 28th, 2017
Greetings Pamela. Thank you very much for you suggestions. In good health, MDVIP
Lynne Brown
Jun 23rd, 2017
Hello: I live in Central Georgia and years ago I found a very small tick attached to my stomach that had turned grey because it was full. I pulled it off with a tweezer and watched the bite within three days of the bite the area turned red and a big red ring formed around the bite like a bulls eye. I went immediately to my doctor who diagnosed lymes disease and he put me on antibiotics. For two weeks I was sick with fever shaking aching in my joints but as soon as I finished the antibiotics
the symptoms went away. I later had my blood tested for lymes and it came back normal. The trick is to catch it right away so if you have a small tick on you check the bite site for at least three days to make sure the bullseye doesn't appear if it does go to your doctor immediately...
1 Reply
MDVIP
Jun 30th, 2017
Greetings Lynne. We’re glad to read that you’re feeling better. We’re also grateful that you shared your experience with our readers. Your story may help someone else bitten by a tick. In good health, MDVIP
RICK WATKINS
Jun 23rd, 2017
Spring turkey hunters almost always pick up ticks in the spring. I have used a 3M lint roller that I roll myself with all over, clothes and skin. It's amazing the ticks I pick up that I haven't seen or felt.
1 Reply
MDVIP
Jun 23rd, 2017
Greetings Rick. Thank you very much for sharing your tips with our readers. In good health, MDVIP
Roger Johnson
Jun 22nd, 2017
Don't allow medical personnel to discount the presence of tick borne disease in your state. Tennessee is one state where a large number of doctors deny the presence of tick borne diseases here. I think perhaps because it can be so difficult to diagnose and treat and then there is the outdoors economy.
Janet
Jun 22nd, 2017
Regarding the products that you had mentioned, are they safe for young children, toddlers & infants?
1 Reply
MDVIP
Jun 23rd, 2017
Greetings Janet. Check with your pediatrician before using any insect repellent. If you prefer it to be professionally-made versus homemade, the American Academy of Pediatrics considers Bite Blocker herbal lotion as a safe, natural insect repellent for children and pregnant women. This article from Parents magazine can provide you with more information. http://www.parents.com/health/bug-bites/guide-to-bug-repellent-for-kids/ In good health, MDVIP

Barbara Coppola
Jun 22nd, 2017
I think it's wise to avoid ticks and to remove them but how and what tests should we be given after a tick bite. I understand that you will not always see the target rash or get symptoms right away.
If you have many ticks that have been removed, like almost daily here in Ct. what would be the recommendation for testing and what test?
1 Reply
MDVIP
Jun 22nd, 2017
Greetings Barbara. Unfortunately, there aren’t home testing kits for tick-borne diseases. If you notice a tick on you, remove it and note its characteristics such as size, color and shape. If you have your phone handy, you could also take a photo. Share all of this information with your doctor to help him/her identify its type and if it bit you. He/She will decide if you need tests, and what kinds, before symptoms begin appearing. In good health, MDVIP

Maxine Harris
Jun 22nd, 2017
Your article mentioned a greater possibility of tick bites in the Northeast and Great Lakes regions. What are the chances of getting tick bites in the Northwest regions, from the Midwest to Washington and Oregon? Thank you.
1 Reply
MDVIP
Jun 22nd, 2017
Greetings Maxine. Tick-borne diseases are rising across the U.S. The Pacific Northwest has different species of ticks than the Eastern seaboard, Midwest and southern U.S.; as such, the risk of more well known viruses like Rocky Mountain Spotted Fever and Lyme disease are rather low. Oregon didn’t publish its number of Rocky Mountain Spotted Fever cases, possibly because there weren’t any. However, 41 cases of Lyme disease were reported in 2015--10 in Clackamas County. Washington State annually reports zero to three cases of both Rocky Mountain Spotted Fever and Lyme disease. Pacific Northwest residents face some risk of tick-borne viruses specific to the region such as relapsing fever and anaplasmosis. Midwesterners are at risk Heartland virus, as well as viruses affecting the upper Midwest like Lyme and Powassan. Powassan is more of an issue there because of the proximity to its origination, Powassan, Ontario. Unfortunately, six different species of ticks can carry Powassan. And since ticks can migrate throughout the United States and Canada, they’re able to spread diseases to different regions. Below is a link to the Tick-Borne Diseases reference guide produced by the U.S. Centers for Disease Control and Prevention (CDC). It can provide you with more information. https://www.cdc.gov/lyme/resources/tickbornediseases.pdf In good health, MDVIP
Brian Klee
Jun 21st, 2017
To remove an imbedded tick, light a stick match, immediately blow it out, and quickly put the hot match head on the tick's body. Repeat until the tick withdraws from the skin.
1 Reply
MDVIP
Jun 22nd, 2017
Greetings Brian. Thank you for sharing your tick removal tips with our readers. In good health, MDVIP

Ivan Waldman
Jun 21st, 2017
I am extremely disappointed in your article. You are supposed to be an authoritative source, and yet there were immediate suggestions for better tick removal methods. Unfortunately, when I attempted to view the YouTube video I received the following error message:
"You HAVE to learn this tick..." The YouTube account associated with this video has been terminated due to multiple third-party notifications of copyright infringement.

It would be helpful if you put more effort into verifying the information you post that is purported to be medically authoritative. Why should we have to individually verify everything you publish? That is worse than you publishing nothing at all.
1 Reply
MDVIP
Jun 22nd, 2017
Greetings Ivan. There are several ways you can remove ticks. We mentioned tweezers because the U.S. Centers for Disease Control and Prevention (CDC) recommend this method. Unfortunately, we can’t help you regarding the video, as there isn’t one associated with our blog. In good health, MDVIP

Howard Kaplan
Jun 21st, 2017
A good discussion of the disease as well as pictures of the infected areas and the tick vectors may be found on WebMD: http://www.webmd.com/arthritis/ss/slideshow-lyme-disease
1 Reply
MDVIP
Jun 21st, 2017
Greetings Howard. Thank you for sharing the WebMD link with other readers. In good health, MDVIP

David Kaplan Ph D
Jun 21st, 2017
Using tweezers to remove ticks runs the high risk of leaving mouth parts in your skin that can become quite irritating...and can harbor bacteria.... See the following link for a more effective approach.... If you have been bitten for a period of time, you may want to store the tick in a plastic bag in refrigerator should further testing be required.

http://www.uprootinglyme.com/understanding-lyme/best-way-to-remove-a-tick/
1 Reply
MDVIP
Jun 21st, 2017
Greetings David. Thank you for sharing another approach to removing ticks. In good health, MDVIP

Mike Schwartz
Jun 19th, 2017
I looked up the word "nootkatone".
If you are interested, there are lots of links "from" (and, some info "in") this Wikipedia article: https://en.wikipedia.org/wiki/Nootkatone
Enjoy . . .
1 Reply
MDVIP
Jun 21st, 2017
Greetings Mike. Thank you for sharing information on Nootkatone, a compound used in natural insect repellants. In good health, MDVIP

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