Prevention of Lyme disease depends on 4 factors: preventing tick bites, removing the ticks and prophylactic treatment with antibiotics if you have been bitten by a tick and finally it is important to maintain a healthy immune system.
Wear Protective Clothing
Prevention of Lyme disease involves efforts to prevent tick bites. If walking or tramping in endemic areas, it is important to wear protective clothing such as long-sleeved shirts, hats, and long pants tucked into long socks and/or tramping boots. Check carefully for ticks not only when you get home but frequently while still outside.
Have a Shower and Change Clothes
My sister and brother-in-law, who live in a high-risk Lyme-bearing tick area in California, advise their visitors to have a shower and wash their hair ASAP after a walk or hike or other activities on their land or in their area. They live on a rural block in Salmon Creek where deer roam widely.
They also advise that you check for ticks regularly and to have someone check your back for ticks. Don't put same clothing on after shower because ticks can hide in the fabric. They recommend washing your clothes worn on the hike including underwear because ticks can hide in the clothing and bite later.
Either wash clothes or at least put them through a drier because ticks are intolerant to being dried out.
Insecticides
Also, apply insecticides on the skin and/or on the outside of clothing to prevent ticks attaching. For example permethrin or DEET, a slightly yellow oil intended to be applied to the skin or clothing, provides protection against all sorts of biting insects including ticks. For a more natural insecticide use oil of lemon eucalyptus which also repel ticks
Pesticides
Pesticides can also be used to reduce tick numbers in scrub in endemic areas. Products meant for widespread application such as permethrin and its derivatives are preferred. They are available as a liquid concentrate and as granules. If liquid insecticides are used, application should be by fogging, not by coarse sprays. Apply these products in a strip a few feet wide at the perimeter of the lawn at any areas adjacent to woods and underbrush. Also treat any ornamental shrubs near the house that may serve as a habitat for small animals. The best time to apply these products is in late spring and early fall. In every case, professional application is recommended.
Keep the area around your home clear of rubbish
At home remove wood piles, rock walls, and bird feeders as these attract tick-carrying small animals and can increase the risk of acquiring Lyme
Ensure live-stock and pets are treated for ticks as well. Check that pets don’t bring ticks into the house by examining them for ticks if they have been to an endemic area. If you live in the bush, fence off an area around your home so that deer etc. cannot roam too close and ensure you have a suitable rodent eradication program.
Reduce the Natural Reservoir
A community can reduce the incidence of endemic Lyme disease by reducing the numbers of the animals which act as a natural reservoir on which the ticks depend, such as rodents, other small mammals, and deer. Even though deer ticks acquire Lyme disease pathogens from rodents rather than from the deer themselves, Lyme and all other deer tick-borne diseases can be prevented on a regional level by reducing the deer population on which the ticks depend on for their reproductive life cycle.
Ticks must be removed as soon as you notice a bite because the risk of transmission of Lyme disease increases with the duration of tick attachment. Remember, the sooner the tick is removed, the less likely it is that you will develop and infection.
Most publications suggest that for Lyme disease to be transmitted the tick needs to be attached for 36 to 48 so that the infectious agent has time to travel from within the tick into its salivary glands. Ticks that have been attached that long will be engorged and full of blood. Some say that if a tick is attached for less than 24 hours, infection is unlikely.
However ILADS suggests that transmission may take place in as little as 4 hours of attachment.
The problem is that many people do not realise they have been bitten due to the small size of the nymphs and the analgesic effect of the bite itself, so removal is not an option. The tick eventually drops off after feeding is completed.
Ticks can be removed with tweezers. The best method is to pull the tick out with tweezers as close to the skin as possible. DO NOT twist, crush or squeeze the body of the tick as this may cause the tick to inject more bacteria into the wound. Also be careful not to accidently remove the body leaving the head still attached. It is a good idea to apply a local antiseptic to the area once the tick is removed.
Tape the tick to a card and record the date and location of the bite so it can be used later in diagnoses.
Warning: The Australian Society of Clinical Immunology warns of the dangers of using tweezers especially in people who are allergic to tick bites because you may cause the allergen containing and/or pathogen containing saliva to be injected into the bite. They say the tick should be killed and removed by a medical professional.
There is controversy about prophylactic treatment with antibiotics. Some schools say that if you have removed a blood filled tick then a single dose of doxycycline administered within the 72 hours after removal may reduce the risk of Lyme disease. It is not generally recommended by this school, however, as development of infection is rare. They say that about 50 people would have to be treated this way to prevent one case of infection. Others have a more rigid approach.
IDSA Recommendations
Although routine preventive antibiotic administration is not recommended for individuals with tick bites and no symptoms of disease, the IDSA’s preventative treatment recommendation is that some selected, high-risk tick bites may be treated with a single dose of the antibiotic doxycycline for people who are eligible for the drug. Eligibility criteria for preventive Lyme disease treatment with doxycycline include:
- The attached tick can be reliably identified as an Ixodes scapularis tick that is estimated to have been attached for 36 hours or longer
- Preventive treatment can be started within 72 hours of the time the tick was removed
- Ecologic information indicates that the local rate of infection of these ticks with Borrelia burgdorferi bacteria is 20 percent or greater
ILADS Recommendations
ILADS advises that prophylactic antibiotic treatment (full dose) upon a known tick bite is recommended for those people who fit the following categories:
- People at higher health risk bitten by an unknown type of tick or tick capable of transmitting Borrelia burgdorferi, e.g., pregnant women, babies and young children, people with serious health problems, and those who are immune-deficient.
- Persons bitten in an area highly endemic for Lyme Borreliosis by an unidentified tick or tick capable of transmitting B. burgdorferi.
- Persons bitten by a tick capable of transmitting B. burgdorferi, where the tick is engorged, or the attachment duration of the tick is greater than four hours, and/or the tick was improperly removed. This means when the body of the tick is squeezed upon removal, irritated with toxic chemicals in an effort to get it to back out, or disrupted in such a way that its contents were allowed to contact the bite wound. Such practices increase the risk of disease transmission.
- A patient, when bitten by a known tick, clearly requests oral prophylaxis and understands the risks. This is a case-by-case decision.
Note: The physician cannot rely on a laboratory test or clinical finding at the time of the bite to definitely rule in or rule out Lyme disease infection, so must use clinical judgment as to whether to use antibiotic prophylaxis. Testing
the tick itself for the presence of the spirochete, even with PCR technology, is helpful but not 100% reliable.
ILADS believe that an established infection by B. burgdorferi can have serious, long-standing or permanent, and painful medical consequences, and be expensive to treat. Since the likelihood of harm arising from prophylactically administered anti-spirochete antibiotics is low, and since treatment is inexpensive and painless, it follows that the risk benefit ratio favors tick bite prophylaxis.
The key to preventing Lyme disease from becoming chronic is having a strong immune system. People with a healthy immune system generally have minimal symptoms at initial infection and never develop chronic disease. Have a good diet, plenty of sleep and exercise.
Find out more about "What Is Lyme Disease"
