Lyme Disease is Vastly Misunderstood. This Expert Advice Will Keep You and Your Family Safe This Summer

Tempted to think of Lyme disease as something that’s not likely to affect you? The statistics might change your mind. After the disease was discovered in Lyme, Connecticut back in 1982, the Centers for Disease Control and Prevention (CDC) reported a total of 491 cases in 11 states. By 1988, 4,882 cases were reported in 43 states.

Today, approximately 30,000 cases of Lyme disease are reported to the CDC—and even they admit this number doesn’t reflect every case of Lyme disease diagnosed each year. In fact, recent estimates suggest the number is likely closer to 476,000.

To help us understand Lyme disease—and how to protect ourselves and our loved ones this summer—The Sunday Paper sat down with one of the country’s leading tick researchers, Thomas N. Mather, Ph.D, professor and director of the University of Rhode Island Center for Vector-Borne Diseases. Here’s what the man who is lovingly called “the tick guy” by other Lyme disease experts around the country shared with us.

A CONVERSATION WITH THOMAS N. MATHER, PHD

How do we get Lyme disease?
Blacklegged ticks, also known as deer ticks, are the ones that transmit the germ that gives people Lyme disease. The ticks get the germ when they feed on an infected animal. (This is called a blood meal.) Young ticks here in southern New England get their blood meals from white-footed mice and chipmunks, animals that are almost always infected with the Lyme disease germ. When ticks feed on those animals, a good portion get infected. And if that infected tick bites you, it’s possible that it’ll transfer that Lyme disease germ to you.

In California, there are a greater variety of small rodents, and ticks more frequently feed on lizards and anoles (which are like little lizards)—and those animals aren’t carriers of the germ that causes Lyme disease. In fact, their blood kills Lyme disease germs. This is why we see fewer cases of Lyme disease on the west coast.

To that point, we often hear Lyme disease is concentrated in certain areas, like the northeast, but that it’s everywhere in this country. Is this true?
Lyme disease has been reported in every state, but patients don’t contract Lyme in every state. We believe the reason we see it in all states is due to people traveling.

Blacklegged ticks and Western blacklegged ticks, which transmit the germ that gives people Lyme disease, have known areas of concentration: the Northeast, mid-Atlantic states, and the upper Midwest are hot spots. While there are blacklegged ticks in southeast and south central U.S., infection of Lyme disease is much lower there. And on the west coast, you’ll find Western blacklegged ticks, but your risk is lower because the proportion of ticks carrying the germ that causes Lyme disease is lower. (Remember, the lizards those Western blacklegged ticks are feeding on don’t have the germ that causes Lyme.)

When we’re outside this summer, where are we most likely to find ticks?
If you’re hiking along a trail, know that blacklegged ticks are most likely to be on the edges of the trail—not in the center. If you have a grassy yard, they’re more likely to hang out around the edges of the yard as well.

Ticks seek shady, moist areas because they are susceptible to drying out, which is why it’s less likely you’ll find them in the middle of a sunny trail or your yard. They put themselves in the right position to survive and maximize their opportunity to find a host to give them a blood meal. When you know this, you can steer clear of those habitats.  

What are some of the biggest misconceptions about ticks and Lyme disease?
A lot of people think ticks fall out of trees, which is why it’s common to find them on your head around your hairline. Ticks are blind; they don’t climb trees and wait there to jump on a host. They’d never make it. Ticks go to the edges of trails and yards to seek shade—which is also where we go to seek shade. Then, they crawl onto your foot and make their way up your body toward your head. That’s where your skin is thinner, which makes it easier for them to bite you. It’s also where they’re less likely to get groomed off.

Another misnomer is that all ticks transmit the germ that causes Lyme disease. In fact, two-thirds of ticks people find don’t transmit Lyme disease. For example, American dog ticks—yes, the ones you’ll find on your dog—don’t give you Lyme. And again, not all blacklegged ticks will be infected with that germ that causes Lyme disease. On the east coast and upper Midwest, we’re finding about 1 in 3 or 1 in 4 blacklegged ticks are carrying the germ that causes Lyme right now. On the west coast, maybe 1 in 100 ticks are carrying the germ.

Of course, while every tick won’t transmit Lyme disease, enough of them do—which means taking smart, preventive steps to avoid being bitten by a tick are really important.

OK, so what are the best ways to stay safe?
If you love spending time outdoors, it’s important to understand there’s a chance you’ll be exposed—but your risk depends on where you go and how you act when you’re there. If you go bushwhacking off the trail, that’s pretty risky. You’ll want to take even more protective measures than the person who saunters down the middle of a gravel trail.

When you’re entering a tick habitat, here are three things to do to stay safe:

1. Think about your clothing choices. Tuck your shirt into your pants and your pants into your socks. Right now, leggings are trendy and that’s a great thing. Tuck those into your socks and you have a great, tight, protective layer. If you’re traveling to an area where Lyme is prevalent, the best protection is to treat your clothes with permethrin, which is an effective tick killer. You can buy clothes pre-treated with this insecticide, which provides long lasting protection through several washes.

2. Know where ticks like to live. If you’re hiking, walk in the middle of the trail because ticks are more likely to be hanging out on the edge of the trail. Also, the moister the environment, the more likely you are to find ticks—which means a pile of damp leaves or stack of firewood in your backyard is a likely place for ticks.

3. Understand what kind of ticks are found in the area you’re going, how risky they are, and the handful of different types of germs they might transmit. Go to TickEncounter for a simple, straightforward explainer with all the key information you need to know.

What’s the best way to scan for ticks on our bodies?
If you encounter an immature tick (and if you haven’t taken precautions like tucking your pants into your socks and your shirt into your pants), it’ll most likely be at ground level, where it’ll find its way onto your foot and crawl up your leg on the inside of your pants. Adult stage ticks wait for their meals a little higher up in vegetation—a couple feet off the ground. If you encounter one of those, they’ll get on your legs at knee level and crawl up the outside of your leg.

A blacklegged tick can get from your foot to your waist in about 5 minutes. The Lonestar tick (which does not carry the germ that transmits Lyme) can crawl from your ankle up your entire body in just a couple minutes. Now, not all ticks travel this fast. Some of them take hours to decide what to do.

Ticks keep crawling up until they reach a restriction, and then they’ll stop. This is why common restrictions are good places to look for ticks: skin folds; the back of your knee; your underwear line (a lot of times ticks get stuck around your waist band); around bra straps. These are spots ticks get hung up on.

On younger kids, ticks will often crawl to the hairline. One example we see all the time on TickSpotters: Lift up long hair on little girl and a tick will be in the middle of the back of her neck, right where the hair starts.

What should we do if we find a tick?
If you find a tick, don’t throw it out! Remove it by grasping the tick close to your skin and slowly pull it straight out, like you would a splinter. Try to avoid squeezing its body and do not attempt to burn the tick off, which could cause it to release infected fluids into your skin. Trying to wash it off your skin also won’t work and worse, the soap will make the tick harder to grasp with those tweezers.

Next, place the tick in a zip-close bag and take a picture of it. You can then upload that picture to the TickSpotters section of our site and we’ll give you accurate tick identification information, as well as science-based risk assessments tailored to the type of tick you found. We get back to everyone within 24 hours to help people understand what kind of tick they found and whether it may be carrying the germ that causes Lyme disease. The site has empowered thousands of people to be more educated and engaged about tick prevention.

If you’ve been bitten by a tick and go to the doctor, make sure you go armed with information.

We did a study of health care professionals to gauge how well they were able to identify ticks, and we found almost all of them scored about 30 percent (out of 100) on tick Identification. I think most physicians would be grateful to know what type of tick you found; it makes it much easier to follow the treatment guidelines.

Many patients are convinced they need antibiotics when they’ve been bitten by a tick, but that’s not true across the board. That said, you don’t want a doctor taking a wait-and-see approach when there’s strong evidence that you’ve been bitten by a blacklegged tick. One bite can really change your life, which is why knowledge and prevention is key.

Dr. Mather is the director of URI’s Center for Vector-Borne Disease and its TickEncounter Resource Center, which has received local, national, and even international recognition. His research focus is on tick ecology, area-wide tick control strategies, tick-bite protection, and tickborne disease prevention.