Although ticks can be active any month of the year, depending upon the temperature, May is generally known as Lyme Disease Awareness Month around the world. Unfortunately, with COVID-19 filling the minds of health care professionals, and just about everyone else, very little awareness information has made its way to the public this May.

Ticks can carry a number of illnesses, some of which can be transmitted in a few of minutes. Therefore, awareness and prevention is key in order to top ticks from biting.

I have been hearing from many that it looks like a bad year for ticks, so everyone needs to remember that proper tick bite prevention methods are needed now more than ever, especially as some symptoms can be similar to those of COVID-19. Although some tick bite prevention methods are a personal choice, such as picaridin/icaridin instead of DEET, natural versus chemical, or wearing light coloured clothes with socks tucked in pants, the best defence is a multi-pronged one.

For those that spend a considerable amount of time outdoors in high risk tick areas, permethrin treated clothes should be investigated as an addition to your prevention routine. Unfortunately, we only have a small selection available in Canada thus far (at Mark’s), but some US suppliers will now ship to Canada.

Even with the use of repellents, wearing treated clothing, etc., tick checks are very important and should become a regular part of your daily routine. As ticks like to hide in warm, moist, hard to see, areas you will need help from a partner, or a handheld mirror. Preferably a magnifying mirror, as the ticks can be very small. I also have heard quite frequently from people who found them behind the ears, on the scalp, under the band of a bra or at the waist band of pants.

If you do find an attached tick, don’t panic and pull it off with your fingers. This can force it’s stomach contents into you. Instead, make sure you remove it correctly. Use fine-tipped tweezers, a proper tick removal tool, or even string. There are various YouTube videos showing the proper methods. Do not squeeze the body; spin it around with a Q-tip; smother it with vaseline; etc., as it may cause the tick to regurgitate or break off in your skin.

Once you remove a tick, clean off the bite site with soap and water or an alcohol-based sanitizer. Put the tick in a container, mark the date and the location of the bite on your body, and where you think the tick was picked up. Then put it in your freezer as you may want to have it tested or have the type verified.

Depending upon the type of tick, level of engorgement (how long it has fed), and what area you were in when bitten (high risk?), you may want to have the tick tested. If you request treatment based on any of the above, especially the level of engorgement, I have reservations about the prophylactic treatment that some doctors will prescribe. As with all things Lyme, this treatment is controversial. Some say that it may prevent a rash from forming, but there isn’t sufficient information to confirm that other symptoms will be prevented.

Although the bull’s-eye version of the erythema migrans (EM) Lyme rash is the one that is better known, other types of rashes are actually more common – https://www.cdc.gov/lyme/signs_symptoms/rashes.html. As well, apparently approximately 20% of people will not get a rash. It is also harder to see a rash if you have darker skin. The rash on darker skin may appear more like a bruise. Without any visible signs of infection, such as a rash, it can be harder to obtain a diagnosis and treatment.

Testing can also be problematic. The Lyme ELISA can result in false positives AND false negatives – https://www.canada.ca/en/health-canada/services/drugs-health-products/medeffect-canada/health-product-infowatch/canadian-adverse-reaction-newsletter-volume-22-issue-4-october-2012.html#a1. If you receive a positive ELISA, your blood is sent to the Winnipeg Microbiology Lab so that a Western Blot test can be undertaken. If your test comes back negative, typically nothing further is done. Unfortunately, at this point most doctors will tell you that you do not have Lyme. The reliance on a test, which is not 100% accurate, is very concerning and I believe results in a lot of misdiagnosed, or undiagnosed cases.

Educate yourself as many health care professionals are lacking in this regard.

Prevention is key!