Is the thought of Lyme disease making you feel you'd be safer in the comfort of your room rather than the great outdoors? Before you head out for a summer-long supply of video games, here's some information to help you estimate if you are at risk of getting Lyme disease.

Location

More than 28,000 cases of Lyme disease were reported in 2008, making it the leading tick-borne (carried by ticks) disease in the United States. Experts think that the number of Lyme disease cases may be even higher, though, because sometimes people don't know that they have it.

Nearly all cases of Lyme disease (95%) in the United States happen in the Northeast, upper Midwest, and Pacific coastal states. Some cases of Lyme disease have also been reported in other states, but the states that have been the hardest hit are:

• Connecticut
• Delaware
• Maine
• Massachusetts
• Maryland
• Minnesota
• New Hampshire
• New Jersey
• New York
• Pennsylvania
• Wisconsin

Some cases have also been reported in parts of Canada as well as in northern and southern Europe and even in Asia.

Outdoor Activities and Pets

Besides living in one of these areas, other factors that might increase your Lyme disease risk include:

• spending a lot of time outdoors in tall grass, brush, shrubs, or wooded areas
• having pets that may carry ticks indoors
• participating in activities such as yardwork, hiking, camping, fishing, or hunting in tick-infested areas

Safety Tips

So you got a job as a landscaper this summer and you're planning a big camping trip. Does that mean Lyme disease is in your future? No. But it's still a good idea to take these precautions to protect yourself:

• Wear enclosed shoes or boots, long-sleeved shirts, and long pants.
• Tuck your pants into shoes or boots to prevent ticks from crawling up your legs.
• Use an insect repellant containing 10% to 30% DEET (N,N-diethyl-meta-toluamide).
• Wear light-colored clothing to help you see ticks easily.
• Keep long hair pulled back or placed in a cap for added protection.
• When outside, don't sit on the ground.
• While outdoors, frequently check yourself for ticks.
• After each outing, check yourself and your pet for ticks. Wash all clothes after leaving tick-infested areas, and thoroughly shampoo your hair to eliminate any unseen ticks.

If you use insect repellents containing DEET, follow the recommendations on the product's label and don't overapply it. (Using more product than you need won't increase your protection.)

Place DEET on shirt collars and sleeves and pants cuffs, and only use it directly on exposed areas of skin. Be sure to wash it off when you go back indoors. Don't spray aerosol or pump products containing DEET directly onto your face; instead, spray it on your hands and rub it into your face.

Removing a Tick

You should know how to remove a tick just in case one lands on you or a friend.

First, don't panic. Your risk of developing Lyme disease after being bitten by a tick is low. Only 1% to 3% of people who are bitten by a tick are at risk for getting the disease. It takes at least 24-48 hours for the tick to transmit the bacteria that causes Lyme disease. To be safe, though, you'll want to remove the tick as soon as possible.

If you find a tick:

• Call your doctor, who may want you to save the tick after removal so that the tick can later be identified as the type that may carry Lyme disease. You can put the tick in a jar of alcohol to kill it.
• Use tweezers to grasp the tick firmly at its head or mouth, next to your skin.
• Pull firmly and steadily on the tick until it lets go of the skin. If part of the tick stays in your skin, don't worry. It will eventually come out — although you should call your doctor if you notice any irritation in the area or symptoms of Lyme disease.
• Swab the bite site with alcohol.

One note of caution: don't use "folk remedies" like petroleum jelly or a lit match to kill a tick. They don't get the tick off your skin quickly enough, and may just cause the insect to burrow deeper into your skin.

Reviewed by: Stephen C. Eppes, MD
Date reviewed: August 2011