Bloodsucking parasites are having a great year. This spring, the Centers for Disease Control and Prevention reported that emergency room visits for tick bites were up more than 25% from the previous April and had reached the highest level since 2017.
Nationally, about 31 million people get tick bites every year, and 476,000 people are treated for Lyme disease.
Worse, regions in the United States that were once considered safe from ticks or carried only mild risks have become increasingly likely areas where you could contract tick-borne illnesses such as Lyme disease, alpha-gal syndrome, and Powassan virus.
“Tick precautions aren’t just for the classic hot spots anymore,” says Marina Tonial, who has a master’s in public health and is a Certified Health Education Specialist.
As the climate warms, ticks are establishing themselves farther north and at higher elevations than before. Right now, ticks are particularly gnarly in New England and the Midwest, which is experiencing one of its worst seasons in more than a decade.
Fortunately, there are easy steps you can take to mitigate the risk of bites and treat them if they occur.
Tonial, who works with the Barnstable County Department of Health and Environment on Cape Cod in Massachusetts, shared with us some practical steps you can take this summer—and throughout the year—to stay safe while enjoying the outdoors.
Know the risk in your area.
In the U.S., the Northeast consistently has the highest tick-bite rates, followed by the Midwest and Southeast. About 90% of Lyme cases come from roughly 15 states, mostly in the Northeast, mid-Atlantic, and upper Midwest.
Check state and local health department websites for helpful, up-to-date information about the risk of tick-borne disease in the destinations you’ll be visiting. The CDC also publishes useful data on national trends.
No matter where you are, it’s important to know you don’t need to be thru-hiking in deep wilderness to encounter the nasty little buggers. Ticks thrive in backyards and on grassy beach dunes just as well as in forests.
“On the Cape, we’ve found lone star ticks right in the dune grass along the shoreline,” says Tonial.
Anywhere with grass, leaf litter, or brush should be seen as a hazard.
Know when ticks are most active.
Young deer ticks are active any time the temperature rises above 40 F. Late spring and early summer are prime time for the young deer ticks that cause most Lyme cases.
Because they dry out easily, deer ticks tend to quiet down during the hottest weeks of summer as the arachnids retreat into cool, shaded leaf litter. Then they climb grass and become active again in the fall.
Lone star ticks and dog ticks, on the other hand, stay active right through the heat—and young lone star ticks often come out in large numbers in late summer.
Bottom line: Tick awareness should be a year-round habit.
Know what to look for on your skin—and where to look.
The classic bull’s-eye rash associated with Lyme disease is a clear indicator of a bite, but many bitten people don’t get a rash at all. The young ticks that spread most disease are the size of a poppy seed and easy to miss.
Wearing light-colored clothing and checking your body after spending time outdoors makes it easier to catch ticks before they wreak havoc on your long-term health.
Common areas for bites include the scalp, behind the ears, underarms, the belly button, groin, behind the knees, and between toes.
Act quickly to treat potential infections.
Doctors can often diagnose Lyme on sight if you were likely exposed. Otherwise, the CDC recommends a two-step blood test: an initial screening test followed by a second test on the same sample to confirm the diagnosis.
“For certain bites, a single preventive dose of antibiotics within 72 hours can help head off Lyme,” says Tonial. “It’s not right for every bite, so it’s a quick conversation to have [with a medical professional] soon after.”
Note, however, that testing early won’t always give you a clear answer. The antibodies that tests detect take time to make, so false negatives are possible within the first 4 to 6 weeks after exposure.
Other illnesses have their own tests—the malaria-like babesiosis and the often flu-like anaplasmosis are usually confirmed with specialized bloodwork. Rare viral infections like Powassan are typically diagnosed at hospital or state public-health labs.
Alpha-gal syndrome, which is now so prominent it has its own conference, is diagnosed with a specific blood test plus signs of delayed allergic reactions after eating red meat, dairy, gelatin, and even some medications made with mammal-derived ingredients.
And while it’s no replacement for seeing a provider, getting the tick that bit you tested might tell you what pathogens it was carrying. Some local or state health departments and university extension programs offer tick testing, sometimes at reduced cost.
Use different repellants for your skin and clothes.
On skin, bug sprays and lotions that contain DEET, picaridin, IR3535, oil of lemon eucalyptus (also called PMD after its active ingredient), and 2-Undecanone are proven effective against ticks. The Environmental Protection Agency’s website has a useful interactive guide for finding registered products that suit your needs.
Because little kids often touch their eyes and mouths, don’t spray or apply repellant onto children’s hands. Instead, coat your own hands and apply it for the child. Don’t use oil of lemon eucalyptus on children under the age of 3.
On clothing and gear, use a 0.5% permethrin spray and reapply every 6 weeks or six washes, allowing the item to dry fully before putting it on. You can also purchase clothes that come pretreated with permethrin.
Found a tick? Don’t squish it!
If you find a tick on your body, don’t panic. Use a pair of pointy tweezers to pull the tick from its mouth straight up and away from your skin.
Be gentle. Avoid yanking or squishing the tick’s body, as that may spread infection you might have otherwise avoided.
After the tick is removed, clean the area with soap and water and apply rubbing alcohol. Keep an eye out for tick-borne disease symptoms like fever, fatigue, rash, and headaches.
Your dryer is your friend.
Washing machines are ineffective against killing ticks. The dryer, on the other hand, can save the day. Tumble your clothes on high heat for at least 10 minutes to eliminate any critters that may have hitched a ride home with you.
