Arthritis Self-Management

Preventing Lyme Disease

by David W. Golann

Lyme disease is a hazard of the summer months in many rural and suburban parts of the United States. It is caused by the Borrelia burgdorferi bacterium, which is transmitted to humans by blacklegged ticks. These ticks, which live mainly in wooded areas, spread the bacterium by latching on to people and biting them.

Symptoms of Lyme disease include headache, fever, fatigue, and a skin rash. If left untreated, Lyme disease can affect the heart and the nervous system. It can also cause joint pain — a condition known as Lyme arthritis.

You can help protect yourself from Lyme disease by learning how to reduce the risk of being bitten by a tick and how to remove a tick if one does get on you. It is also important to know how to identify the early signs of Lyme disease so you can be treated promptly. Use the information that follows to help keep Lyme disease at bay this summer.

Where ticks live

Lyme disease was first recognized in 1975 in the town of Lyme, Connecticut. Today it is most prevalent in the Northeastern and mid-Atlantic states, though it is also common in some states of the upper Midwest. According to data collected by the Centers for Disease Control and Prevention (CDC) from 2003 to 2005, 10 states account for 93% of Lyme disease cases in the United States. These states are Connecticut, Delaware, Maryland, Massachusetts, Minnesota, New Jersey, New York, Pennsylvania, Rhode Island, and Wisconsin.

The ticks that carry Borrelia burgdorferi live in wooded areas, tall grass, brush, and leaf piles. They thrive in moist environments such as rotting logs and stone walls. A manicured lawn, on the other hand, will harbor few ticks, except along its perimeter.

Ticks often come into areas on the backs of deer and rely on deer as well as mice and other rodents to survive. Tick populations are thus higher in areas with high deer and rodent populations.

Prevention 101

Knowing where ticks live is only half the battle. The next step is knowing how to avoid them. The following are a few strategies for preventing ticks from getting under your skin.

Make your environment less tick-friendly. In general, a sunny, dry environment is least hospitable to ticks. Clear brush and leaves from your yard, mow your lawn regularly, and keep woodpiles in sunny areas. The perimeter of a lawn — where it is adjacent to brush or woods — is often a tick hotspot. Putting down gravel or woodchips along this perimeter can keep ticks from migrating onto your lawn.

Try to limit the population of rodents and deer on your property. Because trash can attract deer and rodents, remove litter from your yard and around your house. Removing bird feeders that attract deer or putting up fences that keep deer out are other ideas.

There are also chemicals that some people use on their property to reduce the tick population. These may be in the form of sprays or pesticide-treated rodent and deer feeders. Check with your local health department about what’s best to use, and make sure you follow local laws about applying pesticides.

Keep away from ticks. When walking through the woods, keep to the center of trails and keep away, if possible, from brush and tall grass. Avoid sitting directly on the ground, on woodpiles, or on stone walls. If you have children who play outside, create a safe play area for them, away from the perimeter of the lawn.

Dress appropriately. If you know you will be in an area where ticks live, wear close-toed shoes, long socks, long pants, and long-sleeved, light-colored shirts. (Ticks are easier to spot on light-colored fabric.) Tucking your pants into your socks or boots helps prevent ticks from finding bare skin.

Spray yourself. Spray exposed skin and clothing with bug repellent before going into an area with ticks. Use a spray that has a 20%–30% concentration of the chemical DEET (this includes many common store brands). DEET-based sprays are safe for most people, though children may have to use extra caution (check the label for specific instructions).

A chemical called permethrin does not repel ticks, like DEET, but kills them on contact. Never apply permethrin to the skin. Instead, apply it to your clothes. If you spray your clothes with permethrin, do so outdoors and set them out to dry before you wear them. The chemical will remain effective for about two weeks. You can buy spray bottles of permethrin at lawn-care and sporting goods stores.

Check yourself. Performing a thorough tick check on yourself and your children is probably the best way to prevent Lyme disease. After you have been out in an area with ticks, examine your body for ticks. Ticks often attach to people at the legs, but they can climb anywhere on a person’s body in search of a good place to settle down. In the armpits, around the waist, in the groin, and on the scalp are just a few common sites. Tick bites are usually painless, so you may not be able to feel them. (To learn what to do if you find a tick on you, see “If you find a tick on yourself” below.)

Last Reviewed on July 21, 2010

David W. Golann is an Associate Editor at Arthritis Self-Management.

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