Let's Not Forget Protecting Ourselves from Tickbites!

Protection from insects and ticks is not just a matter of personal comfort, it is a matter of your health and well being. Between

mosquitoes and ticks, some of the diseases you can be exposed to include: Lyme disease, ehrlichiosis, babesiosis, Rocky Mountain Spotted Fever, encephalitis, yellow fever,dengue, malaria, filariasis, newly discovered viruses, and others. Treatments for all of these illnesses are not 100%, and so it is worth taking the time to review protective measures both for property and your person from ticks.

First and foremost is being able to recognize and identify ticks, and second is being able to properly remove ticks. These two issues are covered well in numerous publications, articles and books on Lyme disease and tick-borne diseases, and more information is easily obtained from helpful sources such as the Lyme Alliance of South Central Michigan, Lyme disease support groups in Ohio and other states, the Lyme Disease Foundation, the Lyme Disease Resource Center, and elsewhere.

To reduce the number of ticks around your house and on your property, there are a number of things to do. Clearing brush, mowing grass, and removing leaf litter all help to lower the ground humidity, leaving the ticks more susceptible to dehydration. Fencing the property and removing animal attractions lessens the number of host animals on the property. Allow small children to play in tick safe enclosures with wide paths and trails for them to come and go safely. Researchers in California, including Dr. Bob Lane, have successfully used bate tubes to lure rodents into permethrin soaked areas, thus transferring the chemical to their fur, and then allowing them to go back home. This ensures that the nests, and subsequently the general population of those rodents, have a lowered or eliminated population of ticks on them. Some of the same researchers are looking at "Borreliasedal factors" in such animals as western fence lizards. In addition, the direct application of tick killing chemicals known as acaricides can provide some measure of protection if used in and around your dwelling, if you so choose to use chemicals.

Ultimately, some of the newer and as yet theoretical control measures may come into widespread application. One such idea involves changing the genetics of other bacteria that live inside the ticks, or introducing transformed bacteria into the ticks, which might reduce or eliminate Borrelia burgdorferi in the tick. To date, this is only a theory, however some testing is being attempted in "simulated field environments." Less theoretical, and to some extent now being tested and tried, are various types of genetically altered insects that have been developed. Some day we may have altered ticks. It also may someday be possible to reduce or eliminate the tick's capacity to carry the disease producing bacteria - that is, to decrease its vector competence.

Personal protection takes on many forms. Although it sounds almost silly, the most important technique to reduce your chances of a tick bite is to avoid tick infected areas!

Since that is not always possible or desired, wear light colored clothing so ticks might be seen more easily. At a recent outing to hunt for ticks and fence lizards by scientists in northern California, as a side trip during a three day disease conference, only three of more than twenty participant used any type of meaningful personal clothing protection techniques while walking through oak tree leaf litter. We must do better than that for our patients!

Avoid sitting directly on the ground, especially in or around leaf litter. Wear long sleeves and long pants. Tuck in shirts, and tuck pants into your socks to reduce skin exposed areas. And do frequent tick checks. Adult will check each other willingly and daily when they understand the risk of Lyme disease. Children, however, are less concerned, and it becomes the parent's responsibility to ensure tick free skin on their children.

Since we are not yet, and may not in the near future, be able to rely on a Lyme disease vaccine or on retroviral vectors or genetically engineered ticks, we are still dependent on chemicals for efficient personal tick protection. If used properly and judiciously, these chemicals offer relatively safe and quite adequate tick protection.

Diethyltoluamide (DEET) comes in lotions, solutions, creams, sticks and sprays. The higher concentrations of DEET have longer duration of action and are generally more effective, but only have up to a 50% concentration. No increased benefit is conferred by a 100% concentration, you just get more side effects. A new slow-release formulation of DEET named Editar is as yet not available, but promises a longer duration of action and greater acceptability at a lower concentration.

Avon Skin-So-Soft, which is sold as a bath oil, has been noted to be good at reducing the mosquito that transmits yellow fever. Although used widely, is has no proven benefit for tick protection.

Citronella, also used for flying insects, is derived from tropical grasses found in Asia. It smells good in low concentrations, and can be quite powerful if used heavily, but has little use in effective tick protection plans.

Permethrin is a contact repellent (an insecticide) rather than a repellent. For scabies a 5% cream known as Elimite is used directly on the skin. For lice, a 1% lotion, Nix, is also applied directly to the body, with very specific instructions for its use and removal.

Permethrin products have a long history of use, and when compared to DEET we observe the following: A spray of 0.5% (1/2%) permethrin confers 100% protection against ticks, as compared with 85% protection using a 20% concentration of DEET, and a 90% protection using 30% DEET. Permethrin not only repels ticks, but also works against lice, fleas, mites, mosquitoes, and blackflies.

Interestingly, and rather usefully, the combination of DEET on exposed skin and permethrin on clothing provides superior protection than either agent alone. Not, however, without some, at least theoretical, risk. DEET and permethrin combined may increase neurotoxicity. In fact, it is postulated that the triple combination of DEET, permethrin, and pyridostigmine (an anti-nerve gas agent) further increases neurotoxicity, and may explain some of the signs and symptoms of the "Gulf War Syndrome."

Some of the common or trade names for products with DEET include: Cutter, OFF!, Skintastick, Repel, and Muskol.

Permethrin products include: Permanone, Coulston's, and Duranon.

The one area of the Lyme story where YOU are able to make a meaningful difference is in the techniques you use to avoid ticks and protect yourself from exposure to ticks.

Please, for your own good health and for the health of those around you and those you love, practice and teach tick safety.