Original Source: NY Times
The mere thought of ticks makes our skin crawl. And the diseases they spread are only getting more common.Since prevention is better than having to seek treatment, we’ve compiled our favorite picks and the advice to keep in mind as you head outdoors this summer.
Prevent a tick bite before going outside
Cover up. Whenever possible, reduce the amount of exposed skin near plants and brush. For hiking, gardening, camping, and the like, wear long pants, a shirt with sleeves, and a hat.
Best for…
For clothing and gear (but not skin), this permethrin repellent is as effective as similar formulas at repelling ticks and mosquitoes, and its trigger spray is easier to control.
Treat your clothing and gear with permethrin. Treating items with the insect repellent permethrin has been shown to help prevent tick bites. Simply spray permethrin on clothing and gear (especially shoes), and then wait for it to dry. Sawyer Products Permethrin Fabric Treatment is a top pick in our guide to the best bug repellents.
Note that permethrin is very dangerous to cats when it’s wet, but it’s not harmful when dry. So keep your furry friends away from any items you spray with permethrin until it dries. For maximum effectiveness, reapply after about six washings or every six weeks.
Buy pretreated garments, or have a professional treat your clothing.Amazon, Insect Shield, L.L.Bean, and REI all sell permethrin-treated clothing. Insect Shield also sells clothing just for kids (and a few things for dogs, too). The treatments last through dozens of washes.
Insect Shield can also treat clothing that you already own. This is the same treatment that the company applies to clothes it sells, under its own brand and others (such as ExOfficio). Insect Shield charges per clothing item, and it also offers bulk discounts; it takes about two to three weeks to get your treated clothing back.
“I wanted to send in my own clothes because I already know what I like to wear when I’m out pulling weeds or camping, ” said writer Liam McCabe, who tested the service. “A few pieces shrank a little bit, and I could feel and smell a mild residue, but it mostly came out in the wash. So far, I’m happy with how it turned out.”
Top pick
This monthly, prescription-only chewable tablet for dogs treats and controls a wide spectrum of parasites, including fleas, hookworm, roundworm, and five kinds of ticks. It also helps prevent heartworm disease.
This prescription topical solution for cats offers a broad spectrum of coverage that lasts for two months. But it can’t be used on kittens who are younger than six months.
Give your pets tick-prevention medication. Ticks can ride along with your pets, so make sure you’re regularly doing tick checks on any animals that go outdoors. In our guide to the best flea treatments for cats and dogs, we have several recommendations to help control ticks on your pets, including Simparica Trio Chewable Tablets for Dogs and Bravecto Plus Topical Solution for Cats.
While you’re outside
Use a picaridin-based bug spray on your skin. Sawyer Products 20% Picaridin Insect Repellent is our top pick because of its wide availability, variety of sizes, and two-cap bottle design (which prevents spillage in a bag). Yet any product with 20% picaridin will do the trick. (We also recommend Proven Mosquito and Tick Spray, Natrapel Tick and Insect Repellent, and others in our guide.) These EPA-approved formulas are deemed effective for up to 12 hours.
Sprays with at least a 25% DEET formula, like Cutter Backwoods Dry Insect Repellent, are also effective. But they’re smellier than picaridin products, and they can also damage any plastics that might be present in items like shoes or watch bands.
Top pick
This EPA-approved picaridin formula is safe and effective. And its bottle sprays more evenly and accurately than competitors’ bottles.
Avoid thick brush. Dense areas of plants and brush tend to harbor ticks, but the deep woods are not the only area of concern. Non-native plants like Japanese barberry can be a hotbed for ticks. Removing those plants and avoiding them when you do see them can help you avoid being bitten.
Once you get back inside
Break out the lint roller. Once you’re at your vehicle or on your doorstep, give your clothing a good brushing with a lint roller, such as the Scotch-Brite Lint Roller, a top pick in our guide to laundry aids. And don’t forget to give your dog’s or cat’s coat a once-over.
Top pick
With just a few swipes, this roller’s sticky paper picks up lint, hair, and dust. It was the least expensive and most effective roller we tried, but we don’t like that its refills cost as much as the roller.
Check your bits. Editor Kalee Thompson’s kids learned this fun song at summer camp in New Hampshire (and it works well for all ages): “Check yer back and yer crack and yer pits and your bits for ticks.”
Those “bits” should definitely include your hairline and behind your ears. The little buggers seem to love it there. Ticks often attach in areas you tend not to pay much attention to, and that makes finding them harder.
Thomas Mather, who goes by @thetickguy on X and is the director of the University of Rhode Island’s Center for Vector-Borne Disease and the TickEncounter Resource Center, suggests doing tick checks fairly regularly, perhaps during one of life’s most intimate moments. “I noticed that I could see a lot if I just paid attention while I was sitting on the toilet,” Mather said. “I can see down the inside of both of my legs and behind my knees by doing a little twisting. I can push my junk to the left and to the right, and I can kind of check it out to see if I see any ticks there.”
Mather did note that it’s hard to see your own butt, and you might still need help in that area. “But if I do that once or twice a day, I’m doing a pretty reasonable tick check just while I’m multitasking.”
If you find an embedded tick, don’t panic
It’s important to remove the insect relatively quickly, but stay calm.
After a tick crawls onto your body, it can take hours before it attaches itself to you and then another 48 hours until it starts transmitting disease. An exception: A study on mice showed it took only 15 minutes for black-legged ticks to transmit Powassan virus — yikes! Remember, when black-legged ticks are nymphs, they’re tiny — about the size of a poppy seed (thank you for ruining all poppy-seed things forever, CDC). So they can be hard to see.
Sharp, pointy tips are ideal for digging out foreign objects, and these tweezers come with free sharpening.
We haven’t formally tested tick-removal devices, yet members of our staff have used Tick Key, Tick Nipper, and Ticked Off, with mixed results. Of the products they’ve tried, they’ve had the best luck with the Tick Nipper. Experts recommend fine-tipped tweezers as the tool of choice. The Tweezerman Ingrown Hair/Splintertweeze pair is our pick in our guide to the best tweezers.
The CDC has a helpful interactive Tick Bite Bot quiz that will walk you through removal and infection risk.
To remove an embedded tick:
- Take deep breaths.
- Position a pair of pointy tweezers under the tick’s body, as close to your skin as possible. Do not squeeze the tick.
- Pull the tick straight out. The goal is to remove the whole tick, intact. If the head remains in your body, leave it there. Digging around your skin for the detached head is not ideal because the wound could get infected.
- Seal the tick in a plastic zip-top bag (if the tick is still alive, double-bag it, just in case).
- Rub the bite with alcohol, and wash your hands.
- Take more deep breaths.
Identify the tick and seek treatment (if necessary)
A hotly debated topic among experts is whether you should get the tick tested by a lab to see which diseases it carries.
Some experts, including those at the CDC, do not recommend tick testing. A highly sensitive PCR (polymerase chain reaction) test is performed on the tick. If the PCR test detects a small amount of bacteria sufficient to trigger a positive result, it doesn’t mean the tick was feeding long or had enough bacteria to infect you. Such a result could cause undue worry.
“There is a pretty high chance of a false positive and no real oversight in the labs,” Kaitlin McDonald, a PhD student in the Ecology, Evolution, Environment, and Society program in the Department of Biological Sciences at Dartmouth College, said in an email interview.
Only about a quarter of nymphal-stage ticks (the ones most likely to transmit Lyme disease) are infected, and they need to feed for 48 hours or longer to transmit the infection. Most people who recognize a tick bite remove it in less than 48 hours.
But other experts say that identifying and testing ticks is beneficial. The TickSpotters program, led by Mather, can help determine the type of tick and give you a risk assessment, if you send in a clear picture. “If the tick is a risky tick, attached long enough to transmit any germ they might be carrying, then we suggest that people might want to have the tick tested … and to have more information to pass along to their primary care or veterinary care provider,” Mather said.
Knowing which diseases your tick was carrying will help you zero in on medical care before symptoms start. Up to 5% of nymphal ticks carry a co-infection, according to the National Institute of Allergy and Infectious Diseases, and some of the symptoms are similar. Anaplasmosis, for example, is an emerging and dangerous infection spread by black-legged and western black-legged ticks, and it has symptoms similar to those of Lyme disease. Doxycycline is effective against many tick-borne illnesses, but you may need to go on a different antibiotic if you have the parasite babesia or the rare but increasing Powassan virus.
If you do opt to get a tick tested, Mather recommends several companies that perform the service for less than $100, including Ticknology, TickCheck, TickReport, and Eco Laboratory (the latter two are “prevention partners” with Mather’s free TickSpotters program). Your state’s health department may also have a tick-testing lab. For instance, Connecticut, where Lyme disease was first identified, has a free program for its residents.
As the co-authors of this story, we have both experienced the exhaustion of Lyme disease, plus the no-picnic treatment of the three- to four-week doxycycline antibiotic cycle (which comes with a host of potential side effects). We think that testing can be good for peace of mind and can promote vigilance in watching for symptoms and getting early treatment. A few years ago, Annemarie’s husband was bitten by a tick shortly after she was diagnosed with Lyme. When the tick came back from the lab negative for the tested diseases, no further action was necessary. There was no worrying or watching for symptoms to appear. What a huge relief!
If you experience symptoms such as fever, aches and pains, or a rash, see your doctor, and ask for full-panel bloodwork (not just for Lyme disease) to help identify co-infections.
We know this discussion ranks among the worst of the creepy-crawly topics, but common tick-borne illnesses, like Lyme disease, are treatable if they’re caught early. Get outside. Enjoy your summer.