Tickborne and Mosquitoborne Illness

• Wear light colored clothing to make ticks easier to see.
• Wear long-sleeved shirts and long pants tucked into socks to deprive ticks of attachment sites.
• Wear closed-toe shoes, not sandals.
• When hiking, biking, or walking, stay in the center of trails to avoid grass and brush.
• Check for ticks AT LEAST once per day; particularly along waistbands, in the armpits, and groin area. Don’t forget the back and the scalp!
• Use a tick repellent with DEET on skin and clothing according to the directions.
• Use a tick repellent with permethrin ON CLOTHING ONLY as directed by the label.

Once bitten by a tick, it is important to remove the tick appropriately. Since the risk of contracting a tickborne illness increases the longer the tick stays attached; ticks should be removed as quickly as possible. Sometimes a small red welt may be present on the skin where the tick was attached. This is generally due to localized irritation from the tick’s saliva and can be expected to resolve in 1-2 days. The following tick removal tips will help you safely remove a tick and reduce your risk of developing a tickborne illness. Note: it is also important to follow these recommendations when removing ticks from your pets. 

• Use tweezers, or fingers wrapped in tissue, to grasp the tick as close to the surface of the skin as possible.
• Use gentle, steady pressure to pull the tick from the skin, try not to twist or jerk the tick as you pull.
• DO NOT squeeze the body of the tick at any time while it is attached – you can release disease-causing bacteria into the bite wound.
• DO NOT squeeze the body of the tick to kill it after it has been removed – you can force disease-causing organisms out of the tick and onto/into your skin.
• Wash your hands with warm soapy water when finished removing the tick.
• DO NOT use matches, gasoline, nail polish remover, or other ointments as methods of tick removal.
• Inspect your body for additional ticks - don’t forget the back and the scalp.
• Note the date of tick removal and report any symptoms consistent with tickborne illnesses to your physician immediately.

Be aware of peak exposure times and places. Exposure to mosquito and tick bites may be reduced by modifying patterns of activity or behavior. Although mosquitoes may bite at any time of day, peak biting activity for mosquitoes carrying some diseases (such as dengue and chikungunya) is during daylight hours. Mosquitoes carrying other diseases (such as malaria) are most active in twilight periods (dawn and dusk) or in the evening after dark. Avoiding the outdoors or focusing prevention activities during peak hours may reduce risk. Place also matters; ticks are often found in grasses and other vegetated areas.

Wear appropriate clothing. When weather permits, people can minimize areas of exposed skin by wearing long-sleeved shirts, long pants, boots, and hats. Tucking in shirts, tucking pants into socks, and wearing closed shoes instead of sandals may reduce risk. Insect repellents, such as permethrin, can be applied to clothing and gear for added protection.

Check for ticks after being outdoors. Conduct a full body check upon return from potentially tick-infested areas, which even includes your back yard.  Prompt removal of attached ticks can prevent some infections.

Optimum protection can be provided by applying insect repellents to clothing and exposed skin. Products containing the following active ingredients typically provide reasonably long-lasting protection.

• DEET
• Picaridin (KBR 3023)
• Oil of lemon eucalyptus (OLE) or PMD.  This recommendation refers to EPA-registered repellent products containing the active ingredient OLE (or PMD). “Pure” oil of lemon eucalyptus (essential oil) is not the same product; it has not undergone similar, validated testing for safety and efficacy, is not registered with EPA as an insect repellent, and is not covered by this recommendation.
• IR3535
• 2-undecanone

Published data indicate that repellent efficacy and duration of protection vary considerably among products and among mosquito species. Product efficacy and duration of protection are also markedly affected by ambient temperature, level of activity, amount of perspiration, exposure to water, abrasive removal, and other factors. In general, higher concentrations of active ingredient provide longer duration of protection, regardless of the active ingredient. Products with <10% active ingredient may offer only limited protection, often 1–2 hours. The concentration of different active ingredients cannot be directly compared (that is, 10% concentration of one product doesn’t mean it works exactly the same as 10% concentration of another product). Studies suggest that concentrations of DEET above approximately 50% do not offer a marked increase in protection time against mosquitoes. Regardless of what product is used, if people start to get insect bites they should reapply the repellent according to the label instructions, try a different product, or, if possible, leave the area with biting insects.  Also, choose a repellent that provides protection for the amount of time that you will be outdoors.  Search for a repellent that is right for you by clicking here.

• Apply repellents only to exposed skin or clothing, as directed on the product label.
• Do not use repellents under clothing.
• Never use repellents over cuts, wounds, or irritated skin.
• Do not apply repellents to eyes or mouth, and apply sparingly around ears.
• When using sprays, do not spray directly on face—spray on hands first and then apply to face.
• Do not spray in enclosed areas, avoid breathing a spray product, and do not use it near food.
• Wash hands after application to avoid accidental exposure to eyes. Children should not handle repellents. Instead, adults should apply repellents to their own hands, and then gently spread on the child’s exposed skin. Avoid applying directly to children’s hands.
• Use just enough repellent to cover exposed skin or clothing. Heavy application and saturation are generally unnecessary for effectiveness. If biting insects do not respond to a thin film of repellent, apply a bit more.
• After returning indoors, wash treated skin with soap and water or bathe. This is particularly important when repellents are used repeatedly in a day or on consecutive days.
• Wash treated clothing before wearing it again. This precaution may vary with different repellents—check the product label.