The best way to steer clear of ehrlichiosis is to avoid tick bites.
Most ticks attach themselves to your lower legs and feet as you walk or work in grassy, wooded areas or overgrown fields. After a tick attaches to your body, it usually crawls upward to find a location to burrow into your skin. You may find a tick on the back of your knees, groin, underarms, ears, back of your neck and elsewhere.
If you remove a tick in the first 24 hours after attachment, you reduce your risk of infection. While you may not be able to avoid going into areas where ticks are present, the following tips can make it easier to discover and remove ticks before they attach to your skin:
Aug. 29, 2012
- Wear light-colored clothing. Ticks are dark colored. Light clothing helps you and others notice ticks on your clothing before they can attach themselves to your skin.
- Avoid open-toed shoes or sandals. Ticks generally live in grassy areas or fields and can attach themselves to your feet and legs when you brush by. Wearing open-toed shoes or sandals increases the risk of a tick attaching to your bare skin and working its way under your clothes, out of sight from detection.
- Apply repellent. Products containing DEET (Off! Deep Woods, Repel) or permethrin (Repel Permanone) often repel ticks. You can use DEET on your skin or clothing, but follow recommendations on the label. For children, use a DEET repellent containing less than 30 percent DEET, and use the product with caution. Don't use DEET on your or on children's hands or faces. Permethrin is for use on clothing only.
- Wear long pants and a long-sleeved shirt. The less skin you expose, the less area a tick has to bite. For added protection, wear shirts, pants and socks with permethrin impregnated in the fabric.
- Tuck your shirt into your pants and your pants into your socks. By doing this, ticks will be less able to crawl onto exposed skin. However, be aware that if ticks get on your clothing, they'll climb upward until they reach exposed skin. Check your clothing often while you're outdoors.
- Stay on clear trails whenever possible. Ticks prefer grassy areas and may be less common on well-beaten paths.
- Pull back long hair. Ticks may attach to dangling hair and work their way to your neck or scalp. Pulling back long hair helps you see ticks better on your neck and limits the chance of them attaching in the first place.
Inspect your body. Do a complete visual inspection of your body. Be sure to check your head and neck because ticks will continue to climb upward until they find a suitable burrowing site. Use your hands to feel through your hair and in areas you can't see when you return from your outing or garden.
Ticks can be as small as a strawberry seed, and they usually attach to hidden skin. Be sure to check all the possibilities. A shower alone will rarely dislodge attached ticks from your head and body.
- Inspect your clothes and gear. Check your clothes, backpacks and other gear when you get home to look for ticks that hitched a ride. Spinning your clothes in the dryer for 20 minutes will kill any ticks you missed.
- Don't forget your pets. Do a daily inspection for ticks on any pet that spends time outdoors.
- Ehrlichiosis. Centers for Disease Control and Prevention. http://www.cdc.gov/ehrlichiosis. Accessed May 3, 2012.
- Other tick-borne diseases. American Lyme Disease Foundation. http://www.aldf.com/Ehrlichiosis.shtml. Accessed May 3, 2012.
- Hay WW, et al. Current Diagnosis & Treatment: Pediatrics. 20th ed. New York, N.Y.: The McGraw-Hill Companies; 2011. http://www.accessmedicine.com/content.aspx?aID=6589902. Accessed May 3, 2012.
- Longo DL, et al. Harrison's Online. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2012. http://www.accessmedicine.com/content.aspx?aID=9102446. Accessed May 3, 2012.
- Graham J, et al. Tick-borne illnesses: CME update. Pediatric Emergency Care. 2011;27:141.
- Ismail N, et al. Human ehrlichiosis and anaplasmosis. Clinical Laboratory Medicine. 2012;30:261.
- Lyme disease. American Lyme Disease Foundation. http://www.aldf.com/lyme.shtml#removal. Accessed May 4, 2012.
- Preventing tick bites. Centers for Disease Control and Prevention. http://www.cdc.gov/ticks/avoid/on_people.html. Accessed May 4, 2012.
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