How to Reduce the Risk of Lyme Disease

Richard Krieger, MD, chairman of the Infection Control Committee at Chilton Medical Center, and infectious disease physician at ID care, recommends how to reduce the risk of Lyme disease.

Interview Transcript (slightly modified for readability)

“The recommendations to reduce tick-borne diseases are pretty well laid out; there are a lot of websites where it’s described. The [Centers for Disease Control and Prevention] CDC, I know has it, for instance, and probably a lot of outdoors [websites]; I’m not even talking about medical websites, you know, if you go to these outdoors camping websites, [they’ll] basically talk about mosquito, or I should say, insect, repellant; ticks are not insects [so] technically arthropod repellants. Things that you use to repel insects would repel ticks to some degree.

I always thought that these recommendations are very nice except they’re very impractical. I mean, if you’re out in the summer hiking on a 90-degree day, you’re not going to wear long sleeves, long pants, wear socks, and tuck the pants legs into the socks, but those are the recommendations. Obviously the more exposed skin you have, the more likely [it is] for a tick to land on you and bite you.

The problem with tick bites is they are painless and the ticks that spread Lyme disease are particularly tiny. So people have looked directly at a place, like an arm or a leg or something where they have a tick attached, and they don’t even realize it at first. It’s not unusual for someone to say, ‘Well I looked down and I thought I had a little mole there and then I realized that the mole had legs and it was wiggling, and I said, oh. I guess that’s not a mole.' That’s a problem. But on the other hand, what we have to our advantage with the bites, is it’s not like mosquito-borne illnesses where if a mosquito carrying Zika virus bites you, within a matter of seconds you could get infected. A tick has to be attached for approximately 24 hours or more in order to spread the infection with Lyme disease.

If somebody is out hiking in the woods or out gardening or playing football in a field or something, if they come in a couple of hours later and get undressed and shower, if they just look themselves over, even if it’s not a few hours, if it’s in the morning and they go to sleep at night and they’re showering before they go to sleep, if they just inspect their bod[ies] (and obviously with children if the parents do it with the children, because children aren’t going to be responsible enough to do that, but if parents inspect their kids) if they don’t see ticks then that’s a pretty good sign. The one caution is to look in areas where you wouldn’t ordinarily think to wash or to look: in the hair, because if there’s ticks in the hair, they may go missed, you know, because they’re not readily seen. Also, certain other places like body creases. People frequently say they pulled a tick out of their groin, because you won’t see it there, even if you go in the shower and you’re washing up, these are small, so if it’s in the crease in the body or under the arm is another place, they may get missed. [An if they're] on the back of the neck, [you] won’t see it [yourself], so you have to ask someone to look, but vigilance is the biggest thing. If you come in- having been outside- and you shower right away, that also helps, because a lot of times ticks are crawling and haven’t attached yet.”