Don't you love the spring? The tulips are blooming, the trees are leafing, and the young ticks are... feeding. OK, that part isn't so great, particularly since cases of tick-borne Lyme disease continue to rise. But you can take steps to minimize your risk.

More than a dozen illnesses are transmitted by ticks in the United States, and Lyme disease is the most common. The infection is carried by blacklegged ticks, which live in wooded, brushy areas. If an infected tick attaches to your skin to feed, the bacteria that cause Lyme disease can get into your body and make you ill.

Most cases of Lyme disease happen in the late spring and summer when young ticks are active and people are spending more time outdoors. Cases have been steadily rising in the United States, tripling from 10,000 reported cases in 1992 to around 30,000 in 2009. The disease is most common in the Northeast, Mid-Atlantic, and North Central states, which account for nearly 95 percent of reported cases.

The good news is that you can take steps to reduce your risk of being bitten by an infected tick. The Centers for Disease Control and Prevention (CDC) offers these tips:
• If you can, avoid areas with ticks, particularly during peak tick season (late spring to early fall). These include wooded and brushy areas with high grasses and leaf litter.

• If spending time in a tick-infested area, wear long sleeves, long pants, and long socks. Also, consider wearing light-colored clothing, which can make ticks easier to see and remove. Tucking your pants into your boots or socks, and your shirt into your pants, can keep ticks on the outside of your clothing.

• Apply an insect repellent with DEET to your clothes or exposed skin. You can also use an insecticide called permethrin on your clothes, but this shouldn't be sprayed on skin.

• After being outdoors, check for ticks, especially in skin folds such as in the armpits, in the groin, and behind the ears. Be sure to check both yourself and your children. Young ticks are tiny—about the size of a poppy seed—so they can be difficult to spot.

• Make sure that ticks are not brought home on clothes. It's a good idea to wash clothes in hot water and dry them on high heat for at least an hour.

• Use tick medicines or collars on cats and dogs. Check pets frequently for ticks.

• Create a tick-safe zone if you live in an area with ticks. Remove leaf litter and brush around your home and at the edges of your lawn. Put wood chips or gravel between lawns and wooded areas, and keep your lawn mowed. Place playground equipment, decks, and patios away from the yard edge and trees. You might also apply a pesticide to your yard. One application at the end of May or beginning of June can reduce tick populations by 68 percent to 100 percent.

A tick usually has to stay attached to your skin for at least 24 hours before there's much risk of it making you ill. The most common symptom is a rash spreading out from the bite, usually after one to two weeks. The rash may look like a bull's eye, and it can become very large (about the size of a dinner plate). But not everyone gets a rash. You may also have flu-like symptoms, such as fatigue, chills, fever, headaches, and muscle and joint aches.

Although most people recover from Lyme disease, the infection can cause serious health problems, such as severe joint pain and long-term nerve damage. However, your chances of these problems are low if you're treated early with antibiotics.

Bottom line. As cases of Lyme disease continue to rise, it's important to take precautions to avoid ticks. And if you develop a rash or flu-like symptoms after being in an area with ticks, be sure to see your doctor. Read more on how to safely remove a tick.

Sources
Lyme disease [Centers for Disease Control and Prevention]

Critical needs and gaps in understanding prevention, amelioration, and resolution of Lyme and other tick-borne diseases: the short-term and long-term outcomes - workshop report [Institute of Medicine]

—Sophie Ramsey, BMJ Group

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