Prevention and Control

Avoid tick habitats: Whenever possible, avoid entering areas that are likely to be infested with ticks, particularly in spring and summer when nymphal ticks feed. Ticks favor a moist, shaded environment, especially areas with leaf litter and low-lying vegetation in wooded, brushy or overgrown grassy habitat. Both deer and rodent hosts must be abundant to maintain the enzootic cycle of B. burgdorferi. Sources for information on the distribution of ticks in an area include state and local health departments, park personnel, and agricultural extension services.

Tuck pants into socks to protect yourself from the bites of ticks and other vectors.

Use personal protection measures:
If you are going to be in areas that are tick infested, wear light-colored clothing so that ticks can be spotted more easily and removed before becoming attached. Wearing long-sleeved shirts and tucking pants into socks or boot tops may help keep ticks from reaching your skin. Ticks are usually located close to the ground, so wearing high rubber boots may provide additional protection.

The risk of tick attachment can also be reduced by applying insect repellents containing DEET (n,n-diethyl-m toluamide) to clothes and exposed skin, and applying permethrin (which kills ticks on contact) to clothes. DEET can be used safely on children and adults but should be applied according to Environmental Protection Agency (EPA) guidelines to reduce the possibility of toxicity.

Use tweezers to remove ticks.

Perform a tick check and remove attached ticks: The transmission of B. burgdorferi (the bacteria that causes Lyme disease) from an infected tick is unlikely to occur before 36 hours of tick attachment. For this reason, daily checks for ticks and promptly removing any attached tick that you find will help prevent infection. Embedded ticks should be removed using fine-tipped tweezers. DO NOT use petroleum jelly, a hot match, nail polish, or other products. Grasp the tick firmly and as closely to the skin as possible. With a steady motion, pull the tick's body away from the skin. The tick's mouthparts may remain in the skin, but do not be alarmed. The bacteria that cause Lyme disease are contained in the tick's midgut or salivary glands. Cleanse the area with an antiseptic.

Taking preventive antibiotics after a tick bite: The relative cost-effectiveness of post-exposure treatment of tick bites to avoid Lyme disease in endemic areas (areas where the disease is known to occur regularly) is dependent on the probability of B. burgdorferi infection after a tick bite. In most circumstances, treating persons who only have a tick bite is not recommended. Individuals who are bitten by a deer tick should remove the tick promptly, and may wish to consult with their health care provider. Persons should promptly seek medical attention if they develop any signs and symptoms of early Lyme disease, ehrlichiosis, or babesiosis.

Strategies to reduce tick abundance: The number of ticks in endemic residential areas may be reduced by removing leaf litter, brush- and wood-piles around houses and at the edges of yards, and by clearing trees and brush to admit more sunlight and reduce the amount of suitable habitat for deer, rodents, and ticks. Tick populations have also been effectively suppressed through the application of pesticides to residential properties. Community-based interventions to reduce deer populations or to kill ticks on deer and rodents have not been extensively implemented, but may be effective in reducing the community-wide risk of Lyme disease. New approaches such as deer feeding stations equipped with pesticide applicators to kill ticks on deer, and baited devices to kill ticks on rodents, are currently under evaluation.

Early diagnosis and treatment: The early diagnosis and proper antibiotic treatment of Lyme disease are important strategies to avoid the costs and complications of infection and late-stage illness.

Lyme disease vaccine: As of February 25, 2002 the manufacturer announced that the LYMErix™ Lyme disease vaccine will no longer be commercially available.

Return to top of page

References:

Prevention and Control:

Brown M, Hebert AA. Insect repellents: an overview. J Am Acad Dermatol 1997;36:243-249.

Curran KL, Fish D, Piesman J. Reduction of nymphal Ixodes dammini (Acari:Ixodidae) in a residential suburban landscape by area application of insecticides. J Med Entomol. 1993;30:107-113.

Dennis DT, Meltzer MI. Antibiotic prophylaxis after tick bites. Lancet 1997;350:1191-1192.

Hayes EB, Maupin GO, Mount GA, Piesman J. Assessing the effectiveness of local Lyme disease control. Journal of Public Health Management. Journal of Public Health Management Practices 1999;5:86-94.

Herrington JE, Campbell GL, Bailey RE, et al. Predisposing factors for individuals' Lyme disease prevention practices: Connecticut, Maine, and Montana. Am J Public Health. 1997;87:2035-2038.

Magid D, Schwartz B, Craft J, Schwartz JS. Prevention of Lyme disease after tick bites: a cost-effectiveness analysis. N Engl J Med 1992;327:534-541.

Piesman J, Mather TN, Sinsky RJ, Spielman A. Duration of tick attachment and Borrelia burgdorferi transmission. J Clin Microbiol 1987;25:557-558.

Schulze TL, Jordan RA, Hung RW. Suppression of subadult Ixodes scapularis (Acari: Ixodidae) following removal of leaf litter. J Med Entomol 1995;32:730-733.

Schulze TL, Jordan RA, Vasvary LM, et al. Suppression of Ixodes scapularis (Acari:Ixodidae) nymphs in a large residential community. J Med Entomol 1994;31:206-211.

Return to top of page

Vaccine:

Akin E, McHugh GL, Flavell RA, et al. The immunoglobulin (IgG) antibody response to OspA and OspB correlates with severe and prolonged Lyme arthritis and the IgG response to p35 correlates with mild and brief arthritis. Infect Immun 1999;173-181.

Alpert B, Esin J, Sivak SL, et al. Incidence and prevalence of Lyme disease in a suburban Westchester County community. New York State Journal of Medicine 1992;92:5-8.

DeSilva AM, Telford SR, Brunet LR, et al. Borrelia burgdorferi OspA is an arthropod-specific transmission-blocking Lyme disease vaccine. J Exp Med 1996;183:271-275.

Gross DM, Forsthuber T, Tary-Lehmann M, et al. Identification of LFA-1 as a candidate autoantigen in treatment-resistant Lyme arthritis. Science 1998;281:703-706.

Hanrahan JP, Benach JL, Coleman JL, et al. Incidence and cumulative frequency of Lyme disease in a community. J Infect Dis 1984;150:489-496.

Lastavica CC, Wilson M, Berardi VP, et al. Rapid emergence of a focal epidemic of Lyme disease in coastal Massachusetts. N Engl J Med 1989;320:133-137.

Maes E, Lecomte P, Ray N. A cost-of-illness study of Lyme disease in the United States. Clin Ther 1998;20:993-1008.

Meltzer MI, Dennis DT, Orloski KA. 1999 Cost-effectiveness of a vaccine against Lyme disease in humans. Emerging Infect Dis 1999;5:1-8.

Schoen RT, Meurice F, Brunet CM, et al. Safety and immunogenicity of an outer surface protein A vaccine in subjects with previous Lyme disease. J Infect Dis 1995;172:1324-1329.

Schwan TG, Piesman J, Golde WT, et al. Induction of an outer surface protein on Borrelia burgdorferi during tick feeding. Proc Natl Acad Sci USA 1995;92:2909-2913.

Sigal HL, Zahradnik JM, Levin P, et al. A vaccine consisting of recombinant Borrelia burgdorferi outer-surface protein A to prevent Lyme disease. N Engl J Med 1998;339:216-222.

Steere AC, Sikand VK, Meurice F, et al. Vaccination against Lyme disease with recombinant Borrelia burgdorferi outer-surface lipoprotein A with adjuvant. N Engl J Med 1998;339:209-216.

Steere AC, Taylor E, Wilson ML, et al. Longitudinal assessment of the clinical and epidemiologic features of Lyme disease in a defined population. J Infect Dis 1986;154:295-300.

Zhang YQ, Mathiesen D, Kolbert CP, et al. Borrelia burgdorferi enzyme-linked immunosorbent assay for discrimination of OspA vaccination from spirochete infection. J Clin Microbiol 1997;35:233-238.

Return to top of page

| CDC Home | Search | Health Topics A-Z |

This page last reviewed November 18, 2003

| Division of Vector-Borne Infectious Diseases |
| National Center for Infectious Diseases |
| Centers for Disease Control and Prevention |
P.O. Box 2087
Fort Collins, Colorado 80522

| CDC Privacy Policy | Accessibility |