How to Prevent Lyme Disease

Lyme disease is the most common tick-borne disorder in the United States. It can affect your joints, nervous system, heart, skin, and eyes. It's transmitted through the bites of certain species of ticks known as black-legged or deer ticks. Adult deer ticks are about the size of sesame seeds and nymphal (baby) ticks can be the size of the period at the end of this sentence.

Reducing exposure to ticks is your best defense against contracting Lyme disease. There are a variety of methods you can use to prevent and control Lyme disease.

Avoid Tick Infested Areas

Although generally only about 1 percent of all deer ticks are infected with Lyme disease bacteria, in some areas more than half of them harbor the germs. More people with Lyme disease become infected during May through July, when immature ticks are most prevalent. In warm climates, deer ticks thrive and bite during the winter months as well.

Deer ticks are most often found in wooded and bushy areas with tall grass and leaf litter, as well as nearby shady grasslands, and are especially common where the two areas merge. They can also inhabit lawns and gardens, especially at the edges of woodlands and near older stone walls.

Because adult ticks feed on deer, areas where deer are frequently seen are likely to harbor large numbers of deer ticks. When you do enter tick areas, walk in the middle of trails to avoid contact with overgrown grass, bushes, and leaf litter. A local park service or health department can tell you which areas are tick infested.

Dress Appropriately

Wearing certain clothing can also help you avoid ticks. Consider these tips:

  • Wear long pants, long-sleeve shirts, and long socks to keep ticks off your skin.
  • Wear white or light-colored clothing to make it easier to spot ticks.
  • Wear a hat.
  • Tie back long hair.
  • Wear shoes (no bare feet or sandals).
  • Tuck pant legs into socks or boots and tuck shirts into pants to help keep ticks out of clothing.
  • Tape the area where your pants and socks meet to prevent ticks from crawling under clothing.
  • Don't sit directly on the ground or near stone walls.

Use Tick Repellents

Spray tick repellent on clothes and shoes before entering areas infested with ticks. Use a repellent with 20 percent to 50 percent DEET (N,N-diethyl-meta-toluamide) on adult skin and clothes to help prevent tick bites. Although highly effective, repellents can cause some serious side effects, particularly when you use high concentrations repeatedly on your skin. Infants and children especially may suffer from bad reactions to DEET. If you repeatedly apply insect repellents with concentrations of DEET higher than 15 percent, you should wash your skin with soap and water, and wash any clothing worn as well.

Permethrin is another type of repellent that kills ticks on contact. It can be found at stores that carry outdoor gear and products. One application to clothing and shoes is typically effective through several washes. Permethrin should not be applied directly to the skin.

Apply Pesticides (Acaricides)

A pesticide designed to kill ticks called an acaricide can be effective in reducing tick populations around your home. If properly timed, a single application at the end of May or beginning of June (and optionally in September to control adult ticks) can reduce tick populations significantly. Spraying on a large scale, however, may not be economically feasible and may prompt environmental or health concerns.

You may also want to consider safeguarding your home with bait boxes that treat wild rodents with acaricide. Properly used, these devices have been shown to reduce ticks around homes by more than 50 percent. The unit does not harm the rodents. The treatment is similar to products used to control fleas and ticks on pets. Bait boxes are now available from licensed pest control companies in many states.

Studies are also being done on the effectiveness of topically applied acaricides to deer at feeding stations. As deer eat, they brush against rollers holding the acaricide. So far, the results have been encouraging.

Check With Local Health Officials

The Environmental Protection Agency (EPA) and your state regulate pesticides. Check with local health officials about the best time to apply acaricide in your area, as well as any rules and regulations related to a pesticide application on residential properties. You can also contact a professional pesticide company to apply pesticides at your home.

Create a Tick-Safe Zone

Ticks that transmit Lyme disease thrive in humid wooded areas. They die quickly in sunny and dry environments. According to the American Lyme Disease Foundation (ALDF), deer ticks cannot jump or fly, and do not drop from above onto a passing animal. Potential hosts (which include all wild birds and mammals, domestic animals, and humans) acquire ticks only by direct contact with them.

Following these landscaping techniques can help reduce tick populations around your home, garden, or yard:

  • Remove leaf litter and clear out brush and grass around homes and at the edges of lawns.
  • Place wood chips or gravel between lawns and wooded areas to restrict tick migration to recreational areas.
  • Mow the lawn and clear brush and leaf litter frequently.
  • Keep the ground under bird feeders clean.
  • Stack wood neatly and in dry areas.
  • Keep playground equipment, decks, and patios away from yard edges and trees.

Discourage Deer

There are several actions you can take that may help reduce deer populations around your home in an effort to help prevent Lyme disease, including:

  • Don't feed deer on your property. It may be necessary to remove bird feeders and clean up spilled birdseed.
  • Construct physical barriers (deer fencing) to discourage deer from entering your yard.
  • Help control deer with deer-resistant or deer-proof plants.

Check for Ticks

The ALDF says that your best line of defense against contracting Lyme disease is to examine yourself at least once daily and remove any ticks before they become engorged (swollen) with blood. Perform daily tick checks after being outdoors, even in your own yard. Carefully inspect all parts of your clothing, skin, and body, especially in moist areas, including:

  • Armpits
  • Backs of the knees
  • Nape of the neck
  • Navel area
  • Scalp
  • Groin area
  • Buttocks
  • Waist

Remove Ticks Promptly

If you do find a tick embedded in your skin, do not panic. Not all ticks are infected. Furthermore, according to ALDF, studies have shown that infected ticks normally cannot begin transmitting the spirochete (the bacterium that causes Lyme disease infection) until it has been attached for about 36 to 48 hours.

Keep in mind, if you do find a deer tick attached to your skin that has not yet become engorged, it likely has not been there long enough to transmit a Lyme disease infection.

Remove the tick immediately using these tools:

  • Small-tipped tweezers
  • Glasses or magnifying glass (if helpful/needed)
  • Gloves or tissue

Take care to follow each of these important steps:

  1. Safety first: Follow universal precautions and wear personal protective equipment, if you have it.
  2. Grasp the tick with the tweezers very close to the skin.
  3. Pull with gentle, constant pressure. Pulling too hard will tear the tick and leave some behind. Take your time. The tick is trying to hold on, but you will win. 
  4. Examine the tick to make sure all of it has been removed. Make sure the tick's mouth parts are intact; it has angled jaws and an arrow-shaped head.
  5. If any of the tick is missing (if anything is, it's usually the head), seek medical attention immediately to decrease your risk of a potential infection. Don't call 911, but do go to the urgent care clinic for a same-day appointment.
  6. Save the tick in an airtight container (do not touch it with bare hands). It's carrying bacteria that can make you sick, even if it doesn't bite you again.
  7. Watch the patient (or yourself) for several days. If signs of Lyme disease are seen, seek medical help immediately. The first and most telltale sign of Lyme disease is the bullseye rash, known as erythema migrans.

    What Not to Do When Removing a Tick

    Improper tick removal increases the chance of the tick transmitting infection. Keep these tips in mind:

    • Do not twist, crush, squish, or pull the tick. You run the risk of detaching its head.
    • Do not try to burn the tick. When you heat up a tick with a match, it will probably regurgitate all of your blood (and some bacteria) into your body in an effort to make itself smaller so it can back out. Though you may have more easily gotten rid of the pest, you'll be more likely to get Lyme disease.
    • Do not try to smother the tick with petroleum jelly, mineral oil, nail polish, or other products.
    • Do not touch the tick with bare skin. It may make you sick.

    Dealing With Tick-Infested Skin, Hair, and Clothes

    For tick-infested hair and skin, showering and a vigorous shampoo may help dislodge any crawling ticks, though ALDF says this is only somewhat effective. As for clothing, unfortunately, simply washing your clothes will not kill ticks. Tick-infested clothing should be run through a clothes dryer at a high temperature for 30 minutes or more. Drying your clothes may also kill any unseen ticks left on your clothing.

    Check Your Pets

    Check pets for ticks before letting them in the house, since pets can carry them in. These ticks could fall off without biting your pet and then attach to and bite people. Plus, pets can develop symptoms of Lyme disease too.

    Monitor Tick Bites

    If a tick is attached to your skin for less than 24 hours, your chance of getting Lyme disease is extremely small. But just to be safe, monitor your health closely after a tick bite and be alert for any signs and symptoms of tick-borne illness. ALDF advises that you monitor the site of the bite for the appearance of a rash that looks like a bullseye for three to 30 days after the bite. If a rash or other early symptoms develop, see a physician immediately. Though you may have already missed the window for preventing a Lyme disease infection, early diagnosis can help you get early treatment.

    Talk to Your Doctor

    If you answer "yes" to the following questions, discuss the possibilities of taking antibiotics with your doctor or healthcare provider:

    • Were you in an area where Lyme disease is common when you acquired the tick bite?
    • Was the tick attached for at least one full day?
    • Has it been less than three days since you removed the tick or since it fell off of you?

    Although taking antibiotics after a tick bite is not routinely recommended, it may be beneficial for some people in areas where Lyme disease is common. Your healthcare provider must determine whether the advantages of prescribing antibiotics after a tick bite outweigh the disadvantages. The risk of developing Lyme disease from a tick bite is small, even in heavily infested areas, so most healthcare providers prefer not to use antibiotics to treat people bitten by ticks unless they develop symptoms of Lyme disease.

    On-the-Horizon Strategies

    According to the CDC, other methods for controlling ticks currently under evaluation include:

    • Vegetation and habitat modifications
    • Fungal agents for biological control
    • Natural extracts that safely repel ticks
    • A vaccine to protect against Lyme disease

    The Lyme Disease Vaccine

    In December 1998, the FDA approved a vaccine against Lyme disease, LYMErix, which was produced by SmithKline Beecham. In February 2002, the maker of LYMErix announced that production of the controversial vaccine was being stopped, citing an insufficient consumer demand. CDC reports the protection provided by this vaccine diminishes over time. Therefore, if you received this Lyme disease vaccine before 2002, you are probably no longer protected against Lyme disease.

    However, in July 2017, the Food and Drug Administration (FDA) granted fast-track designation to a new Lyme disease vaccine candidate called VLA15. Fast-track designation means that the review of the vaccine will be expedited, with an eye toward earlier availability to the general public. This vaccine was fast-tracked to fight the rapidly growing problem of Lyme disease, which can result in considerable disability and long-term suffering in some.

    VLA15 is a multivalent vaccine, which means that it confers protection against more than one strain of Borrelia, the bacteria that causes Lyme disease. More specifically, VLA15 targets outer surface protein A (OspA), which is the most dominant protein in Borrelia transferred by ticks. Because it targets six different types of OspA—representing six different strains of Borrelia—this vaccine has the potential to protect against Lyme disease spread in the United States, Europe, and worldwide.

    In light of the vaccine’s fast-track designation, Valneva, the company that manufactures VLA15, has stepped up phase II clinical trials. According to a July 2017 press release, phase I clinical trials involve 180 participants from three sites, two in the United States and one in Belgium.

    In this partially randomized study, the researchers are evaluating the safety and tolerability of various doses and formulations of the VLA15 vaccine. The researchers will determine immunogenicity, or the ability of the vaccine to provoke an immune response, by measuring immunoglobulin G (IgG) antibody levels against the six most common strains of Lyme borreliosis in the United States and Europe.

    IgG antibodies represent about 80 percent of the antibodies in the body. These antibodies are needed to fend off bacterial and viral infections.

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