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Here’s What You Need to Know About This Summer’s Lyme ‘Outbreak’

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As the weather heats up this summer, outdoor activities like hikes and picnics beckon. But before heading out, you’d be wise to heed the advice of scientists and experts, who warn that the risk of getting bit by a tick is particularly worrisome this summer.

A tick bite can transmit several infectious diseases, including Lyme disease and co-infections like babesiosis and bartonella. You may have seen articles published this year claiming a Lyme “outbreak” is imminent. Since there’s so much misinformation that tends to surround Lyme disease, we spoke with three experts to separate fact from fiction and find out what you can do this summer to protect yourself.

First, should we really be concerned about ticks this summer? In short, yes. Of course, people should always be aware of the possibility of tick-borne diseases, cautioned Dorothy Leland, the vice president of But Dr. Marina Makous, who treats patients with tick-borne infections and various complications at her practice in Exton, Pennsylvania, said it is true that there’s an especially high number of ticks out this summer. That’s due partially to a large crop of acorns produced this year, which sustains high populations of rodents that in turn are responsible for spreading ticks.

Climate change, too, has been a factor. “It’s been significantly wetter and ticks thrive in humid, wet conditions. They don’t like dry heat and we’ve had very wet years,” said Makous, who completed a two-year fellowship in Lyme disease and neuroinflammatory disorders at Columbia University Medical Center before opening her practice.

Dr. Mark Soloski, co-director for basic research at the Johns Hopkins Lyme Disease Research Center agreed that this does seem to be a high-risk year, explaining that investigators who “drag” or sample for ticks are seeing more ticks earlier, especially nymphs, the most aggressive form of the black-legged tick — the most common transmitter of tick-borne diseases.

“Time will tell,” Soloski said, “but at our Center here at Hopkins we’ve seen more cases than usual in May.”

So where exactly should people be concerned about encountering a tick? Certain geographical areas pose a greater risk, including the Eastern seaboard, West Coast and upper Midwest, said Makous. However, she cautioned that Lyme disease has been found in every county in the U.S.

Be careful among wooded areas, long grass, underbrush, and even under wooden picnic tables and benches. The edge of woods that transition to open grassy spaces, such as parks, athletic fields and homes that border wooded areas can also be risky, said Soloski.

How can you protect yourself? First, start with your clothes. Wear long pants tucked into socks, long sleeves and a hat in light colors so you can see any ticks. Check yourself periodically and brush off any ticks on your clothing. Leland also recommended keeping an eye on your pets, who can bring ticks into the house and can contract tick-borne diseases themselves.

Next, consider an insect repellent. Use Deet on your skin, and treat your clothes with permethrin. You can use a permethrin spray, or dilute a permethrin concentrate with one part concentrate to 10 to 15 ounces of water, and soak or spray your clothes and shoes. Makous said this can keep your clothes protected for 40 days or about six washes. “I’ve had patients who have said they saw a tick get on and then off,” Makous said.

After returning home, take a shower to wash away any unattached ticks — though Leland said showering won’t remove any that have already latched on. Showering is also a great opportunity to examine your body carefully.

Run soapy hands over every inch of your body, feeling for bumps that didn’t use to be there. Pay special attention to folds of skin and hidden places — scalp, neckline, underarms, belly button, groin area, behind the knees,” Leland said.

Now, here’s the tricky part — how do you know if you’ve been bitten by a tick? If you actually see a tick on you, get it off as soon as possible. Leland recommended using fine-point tweezers or a tick-removing tool to grasp the tick as close to the skin as possible and pull up with a steady, even pressure. “Don’t squeeze, twist or squash it. Don’t burn it with a match or cover it with Vaseline,” she cautioned.

Soloski also recommended swabbing the bite with alcohol or warm water and soap and being aware of your health; if you notice flu-like symptoms in a few days, see a doctor who will likely prescribe a course of doxycycline, an antibiotic that is the standard of care.

However, you may not ever see a tick. You also may not see the standard “bullseye rash” that can accompany a tick bite. In fact, Makous said the classic bullseye rash occurs in the minority of Lyme rashes.

“More commonly it’s a slightly itchy or slightly painful red spot that is not necessarily round — like oval, longer. The hallmark is that it starts to spread and grow,” Makous said. “Sometimes it can have a purplish center, or look like a pimple or a spider bite.”

Keep an eye out for flu-like symptoms within three to 15 or 30 days as well as any sudden onset of fatigue, headaches or neurological symptoms. Kids might become cranky and show personality changes or experience sleep disturbances.

“If you have no upper respiratory symptoms or diarrhea, doesn’t appear to be food poisoning and sinus infections are unusual in the summer, that makes me think Lyme,” Makous said.

If you’re concerned, seek out medical care immediately — early treatment of Lyme is key. You can find a Lyme-literate doctor in your area on the International Lyme and Associated Diseases Society (ILADS) website. Lyme tests are not always accurate, so it’s important to find a doctor well-versed in Lyme, who knows how it presents itself.

Having said all that, a fear of ticks doesn’t have to keep you inside all summer. The risks are there, and Lyme disease and other tick-borne infections are serious and not to be taken lightly. However, it is possible to avoid tick bites this season.

Not every tick bite will cause Lyme disease, most often it does not. Studies have shown that transmitting the Lyme bacterium is a complex process and the tick needs to stay attached 24 to 48 hours,” Soloski said. (Though, Leland notes that research indicates it’s possible for tick-borne diseases to be transmitted in a much shorter time, even within minutes, so it’s important for patients not to get a false sense of security and for doctors to not discount the possibility of Lyme if the tick was attached for a shorter amount of time). “Enjoy the beautiful outdoors, dress practically and if you find a tick on you, don’t panic!”

Thinkstock photo by Schlegelfotos

Originally published: June 14, 2017
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