4 things to know about ticks and Lyme

Claire McCarthy, MD

Senior Faculty Editor, Harvard Health Publishing

As the weather gets better and school vacations begin, along with sunburns and water safety there is something else parents need to think about: ticks and Lyme disease.

Lyme disease is spread by the bite of the blacklegged tick. While there are cases in various parts of the country, it’s most common in the Northeast and mid-Atlantic states, as well as around the Great Lakes. The early symptoms of Lyme include fever, body aches, and a bull’s-eye rash. It’s very treatable with antibiotics, but if not caught and left untreated, it can lead to serious health problems.

Here is information from the Centers for Disease Control and Prevention on four things that everyone should know and do:

1.  Prevention is key

As is true with all health problems, preventing them in the first place is always best. Be mindful of where your children play, as brush and tall grasses are where the ticks hang out. As much as possible, try to keep to the center of paths. Use a repellent with DEET (at least 20%), picaridin, or IR3535 on exposed skin (the Environmental Protection Agency has a great online tool that can help you choose the best insect repellent), and spray clothing (including socks and shoes) and gear like backpacks with permethrin.

2. Do tick checks at the end of every day

Even if your kids were just playing outside in the yard, get in the habit of looking them over. Ticks like warm, moist areas like the armpits, groin, and scalp, so you should particularly check there. Be sure to look carefully, because the blacklegged tick often transmits when it’s in the nymph stage, and nymphs are really tiny.

If you find an attached tick, grab it at the base with a tweezer and pull it upward with steady pressure. You can get rid of a live tick by wrapping it tightly in something or flushing it down the toilet.

Along with checking your human family members, be sure to check pets that have been outside, as they can carry ticks inside with them. You should also check clothing. Anything that isn’t going into the wash can be thrown into the dryer for 10 minutes or so (when washing clothes, be aware that if they aren’t washed in hot water, they may need extra time in the dryer to kill any ticks on them).

3. Be on the lookout for symptoms

If you do tick checks at the end of every day you should be fine, because it takes at least 24 hours — more often 36 to 48 hours — for an infected tick to transmit Lyme. This is a really important point that many people don’t know.

The classic rash of Lyme is an expanding bull’s-eye rash at the site of the bite. The rash is present in 70% to 80% of cases. Of course, that means it isn’t present in 20% to 30% of cases, so if someone in your family had a tick on them for more than 24 hours, or if you live in an area where there are many cases of Lyme and there may have been a tick bite, you should call your doctor if the person has a fever, chills, aches and pains for no clear reason, along with swollen lymph nodes or swelling of one or more joints. While having these symptoms doesn’t mean for sure that a person has Lyme, it’s worth getting checked out, as early treatment generally leads to a complete cure.

4. Be a cautious consumer of information when it comes to testing and treatment of Lyme

As with many conditions, there is a lot of misinformation out there about Lyme testing and treatment. It’s important to use laboratories that use evidence-based norms and processes. There are many advertised tests for Lyme disease, but some of them are simply not reliable — and it’s really important to have reliable information when making a diagnosis. It’s also not recommended to do testing for Lyme in someone who does not have clear symptoms of Lyme disease.

Most people recover completely after treatment of Lyme, but there are some people who have chronic symptoms such as fatigue, pain, or joint swelling after Lyme disease. This is called post-treatment Lyme disease syndrome or post-Lyme disease syndrome. The cause of these syndromes is unknown. Prolonged use of antibiotics is not recommended. Studies have shown that it doesn’t help, and there can be serious health problems when antibiotics are taken for prolonged periods of time.

To learn more about Lyme and its treatment and prevention, visit the Lyme disease page on the Centers for Disease Control and Prevention website.

Follow me on Twitter @drClaire


  1. Deb Lyme Mom

    Powassen virus can be transmitted from an attached tick in just 15 minutes. The longer a tick is attached, and depending on how well it is taken off, both influence the chance of infection. Luckily most areas have tick rate infections of less than 30%. That is what is most in our favor when we get a bite. Do not be as relaxed as this article leads you to believe you can be. Lives are being ruined because most doctors are ignorant of the treatments and the protocols and will not test unless you have a target rash, which is stupid, because a target rash is absolutely diagnostic – no test needed.

  2. B. Kim

    If you find a tick on your body, you can send it to the UMass Laboratory of Medical Zoology. Their website is tickreport.com Some towns (mine included) subsidize the cost which was 15.00. Directions for handling and submitting the tick are on their website. They will confirm the type of tick and test results for Lyme and other tick diseases. Quick and worth it!

  3. Apollo

    Prevention indeed is key, in fact there really are no other keys. If you get Lyme disease, your MD won’t test you for it unless the tick is still embedded in your skin and a large rash appears encircling the tick that spells out LYME in big red letters.
    Even then, the test will come back negative unless you have a hypersensitivity to outer surface protein A, so you won’t get treated and the disease will spend years slowly ravaging your body. Even if you win the lottery, and are tested, and test positive, the MD won’t treat you long enough or with the right medications. Doxycycline, the standard choice, has been shown by Johns Hopkins to simply convert the germ into a different, more resilient form of the organism called persister cells.
    So you’ll feel ok for a few weeks, deemed “cured” by your MD, but slowly get sicker and sicker, as the disease starts round 2, which is now called “Post Treatment Lyme Disease Syndrome” by MDs since they have to call it something to get a billing code. This illness, PTLDS, looks and behaves exactly like Lyme Disease and even reacts to antibiotics in the same fashion, but apparently its actually a mass delusion many cured Lyme patients seem to exhibit. MDs still don’t know why most Lyme patients pretend to have Lyme disease after they’ve been cured, but hopefully one day modern science will figure out how a mass delusion in so many heterogeneous patients across the country is indistinguishable to the original disease. If I didn’t know better, I’d think they were still sick from Lyme disease. Call me crazy, I know! Ha ha ha

  4. Chris Fuentes

    Thanks for a great summary on the serious threat of tick-borne diseases and how to prevent being bitten. We launched Ranger Ready Repellents because we live at the epicenter of T-B-D’s. The CDC recommends using an EPA-registered repellent with at least 20% of an active ingredient such as Picaridin 20% found in Ranger Ready. It provides 12 hour tick and mosquito protection without the harmful side effects of DEET. Chris Fuentes Founder | Co-Inventor, Ranger Ready Repellents, South Norwalk, CT.

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