Introduction

Lyme disease is caused by bacteria carried by ticks that spread to humans from a tick bite. Although a rare disease, it is the most common human tick-borne infectious disease in the Northern Hemisphere, so it is essential that you are aware of it if you are a frequent visitor of forests and wooded areas.¹ 

There are approximately 1500 confirmed cases of Lyme disease a year in England and Wales, with another 1,000 - 2,000 cases being diagnosed on clinical assessment instead of confirming with laboratory testing.² While not all tick bites can result in Lyme disease knowing how to prevent tick bites should be the number one precaution anyone enjoying the outdoors should take.

In this article, we will examine ticks, where they can be found, and how we can prevent them from biting us.

Ticks and where to find them

It is important to note that not all ticks carry the Lyme disease bacteria, Borrelia burgdorferi, but it is important to know what to look for after you have been in the ticks' habitat.

Ticks feed on wild mammals such as birds, squirrels, rodents, deer, and sheep. They can be found in areas where these animals live, such as moorland, wooded, or forested areas with long grass. Infected ticks have been found in urban parks, so it is always best to keep an eye out for them after hiking, cycling, etc. in grassy areas.

Ticks cannot fly. After feeding, they drop off from the animal and wait in the long grass until they latch onto another mammal that passes by, using hooks on their legs. They are normally more active in spring through autumn but can be active all year round if the winters are mild. 

What do ticks look like? 

Ticks are small reddish/brownish spider-like creatures and have been described as looking like a poppy seed before they have been fed. They can vary in size, ranging from 1mm to 1 cm, with 6 or 8 legs. 

Checking for ticks

When returning from an outdoor activity in a tick habitat, it is always best to check yourself and any dogs that have accompanied you for ticks. The most common areas where you can find a tick are the groin, armpit, hairline and behind the knees, although they can be found anywhere on the body. You would be looking for a black speck that can sometimes can be mistaken for a mole. If unsure, take a picture with your phone and zoom in on the picture to see if your mole has legs!

A detailed map of the prime spots where ticks like to hide.

How to prevent tick bites

The best form of protection against any tick-borne infectious diseases is prevention using the following methods: 

Clothing

• Wear long-sleeved tops and long trousers when out in areas of woodland, long grass, or where you know wild mammals present
• Light clothes can make spotting ticks easier
• Tucking your trousers into your socks stops ticks from crawling up your trouser legs

Insect repellent

• For clothes, use Permethrin, which is an insecticide that can be used to treat walking boots, clothing and camping gear. Pre-treated clothing is available for those who do not want to spray their own
• DEET or Icaridin can be used on the skin to deter ticks from staying on your body if they do jump on. As ticks can crawl to an area that is not treated with a repellent it is advised to spray on the skin before dressing

Environment

• Try to avoid long grass as much as possible
• Maintain your property if you live in an area where ticks or their hosts are present. Keeping lawns short, removing leaf litter, and having a physical barrier (i.e. a fence) around your garden to stop animals from entering. Ticks don't like lavender, marigolds or rosemary, so you could try planting these in your garden³ 
• Try not to leave food waste around as this could encourage rodents (carriers of Lyme disease), which can carry ticks into your garden⁴

Awareness

• Familiarise yourself with habitats where ticks are found
• Do tick checks on return from your activity
• Shake your clothing out after you have been outside when in tick habitats
• Shower within 2 hours of being outdoors. This can help remove ticks that have not attached themselves to you
• Check your dog for ticks if they have accompanied you

What should I do if I find a tick on me?

If you find a tick on you, it must be removed as soon as you discover it. Lyme disease is transmitted the longer the tick is feeding, which is normally 24 hours.⁵

They burrow their heads into your skin and have hooks that keep them attached. So when removing, you must ensure you pull straight up, not twisting, as you may leave the head in, as this can cause the site to become infected.

The correct technique for tick removal.

People often ask what to do with the tick when it is removed. Some will squash it or kill it in another way and discard the tick. Countries where ticks are present have a surveillance scheme to monitor how many ticks are infected with tick-borne diseases. In the UK, you can send your ticks to such a scheme run by the UKHSA.

Summary

Lyme disease, transmitted by ticks, is the most common tick-borne infectious disease in the Northern Hemisphere. Although rare, it's important to be aware of it, especially for frequent visitors of forests and wooded areas. Ticks thrive in areas where wild mammals reside, such as moorlands and wooded regions.

These small reddish/brownish creatures, resembling poppy seeds before feeding, latch onto passing mammals using their leg hooks. Always check for ticks after outdoor activities, focusing on areas like the groin, armpits, and hairline. Preventing tick bites is key and involves wearing protective clothing like long-sleeved tops and trousers, using insect repellents, and avoiding long grass.

Environmental measures include property maintenance, planting tick-repelling plants like lavender, and minimising food waste to deter rodents, which carry ticks. Awareness of tick habitats, regular tick checks, and prompt tick removal within two hours are crucial to prevent and manage them.