How do I prevent tick bites?

According to a recent publication of the CDC tick and mosquito infections are on the rise. Climate change, increased travel, increased surveillance and lack of vaccines are mentioned as reasons for the rise of these infections.

It becomes increasingly important to be aware of the risks of insect borne illnesses. Not just Lyme disease is on the rise: Ehrlichia/Anaplasma, Babesia, Rickettsia and Powassan virus infections are also spread by ticks and the infection numbers are climbing.

Then there is the case of Bartonella. It is an emerging infectious disease and only a handful of doctors and scientists appreciate this group of bacteria as an emerging health threat.

Bartonella is possibly carried by ticks but pets can also carry this infection and transmit it to humans through a scratch or bite. While the acute manifestation of infection with Bartonella is considered a benign and self limiting disease, some of these cases result in a chronic debilitating disease.

It becomes increasingly important to protect ourselves against these infections that are transmitted by insects.

Protect yourself

Ticks are most active during spring, summer and early fall but adult female ticks can also infect individuals during the winter.

Insect repellents

You can put permethrin on your clothes and 50% DEET on your skin to protect yourself against ticks.

Ticks in urban area

You are not safe in urban area. In the Netherlands 30% of the patients contract Lyme disease within urban area and a recent study in the United Kingdom showed that ticks in four London parks carry Lyme disease.

Parks and suburbs are the perfect size to sustain mice but are not quite large enough to sustain small predators such as foxes. Mice can run rampant without natural predators and with mice come ticks. So check for ticks daily.


You can place a deer fence to prevent deer and small animals from entering your yard. Keep the grass in your yard short and spray regularly with pesticides. Another great tip that comes from the patient community is placing tick tubes.

Tick check

After you have been outdoors:

  • Check your clothing for ticks Ticks can be carried into the house on clothing. Remove the ticks. You can also put your clothes in the dryer on high heat for 10 minutes to kill ticks on dry clothes. Damp clothes possibly require extra time. Wash your clothes on a hot temperature because ticks will survive cold and medium temperature water.
  • Examine pets Ticks can come into the house by hitchhiking on your pet. Carefully examine your pet. Using tick and flea repellents on your pets is very important and it is probably not a good idea to let pets in the bedroom or sleep in your bed. Insect repellent is not only important to protect against ticks, fleas can also carry and transmit Bartonella species.
  • Shower soon after being outdoors Showering may help washing off unattached ticks and it is a good opportunity to do a tick check.
  • Check your body for ticks Do a full body check after you have visited tick invested areas (which can include your backyard). Use a handheld mirror to check body parts that are difficult to examine.
    • Under the arms
    • In and around the ears
    • Inside belly button
    • Back of the knees
    • In and around the hair
    • Between legs
    • Around the waist

When you do get bitten

  • Remove the tick correctly
  • When you get symptoms go to your doctor
  • Not all Lyme patients get an erythema migrans, but when you do get one it is diagnostic in and of itself
  • Antibody tests such as the Elisa and Western Blot miss early Lyme infections 50% of the time
  • You could have contracted other tick borne infections alone or alongside Lyme disease

Attachment time

It is thought that the Lyme disease spirochete needs some time to be transmitted from the tick to a host. The spirochete needs to make changes to its appearance before it can infect a vertebrate host. Then it needs to disseminate into the saliva glands of the tick before it is inoculated in the skin of the host. These developmental changes take approximately 24-48 hours to complete.

However, Willy Burgdorfer, the discoverer of Borrelia burgdorferi, was not convinced about this transmission model. He found that ticks could be systemically infected which included the saliva glands and it was his expert opinion that ticks could transmit the Lyme disease spirochete within 24 hours.

The claims that removal of ticks within 24 hours or 48 hours of attachment will effectively prevent Lyme disease are not supported by all the published data, and the minimum tick attachment time for transmission of Lyme disease in humans has never been established. Therefore, Lyme infection can never be excluded after a tick bite, irrespective of the estimated duration of attachment time.