It's tick season. Here's how to protect yourself.

More than 31 million people in the United States get bitten by ticks each year, and some of those ticks carry diseases such as Lyme disease, according to the CDC. In this episode of Life Kit, we cover where you might encounter ticks this summer, how to protect yourself against them and what to do if you get bitten. A previous version of this episode incorrectly called ticks insects. They are arachnids, which are not insects. Learn more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Speaker names marked ? are inferred from speaking time and the show’s known hosts — they are not voice-verified.

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• 0:16Marielle Segarra?

  You're listening to Life Kit from NPR. Hey, it's Marielle. You know, I try to be understanding when it comes to bugs. Just because they look scary doesn't mean they are. And just because they annoy me or interrupt my life in some way doesn't mean they shouldn't exist. I draw the line at ticks, though. Ticks can leave me alone. They are jumpy, crawly, biting arachnids that want to suck your blood. And they can cause Lyme disease and lots of other problems for people. On this episode of Life Kit, how to deal with ticks. I talked to NPR health correspondent Ping Huang about where ticks live,

• 0:57Marielle Segarra?

  how to avoid them, and what to do if you find one on you.

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• 2:15Marielle Segarra?

  Hi Ping.

• 2:16Speaker 05

  Hey Marielle.

• 2:17Marielle Segarra?

  All right, so ticks, what are they?

• 2:20Speaker 05

  So ticks are this kind of flat-bodied bug. There's a bunch of different kinds that are in the US, like more than 80 of them. But there's only about a dozen that actually cause health problems in people. So generally speaking, ticks go through this life cycle where they hatch from eggs, they crawl around as larvae, they become nymphs, and then they become adults that mate and lay more eggs. And one critical thing for humans is that they need a full blood meal to get to each of their next stages.

• 2:49Marielle Segarra?

  A full blood meal? Does that mean... What does that mean? Is that all they eat, blood?

• 2:55Speaker 05

  I mean, they definitely need what's in blood to sort of like get them to mature through their life cycle. And so that's why they bite us. Although, people who research ticks actually say that humans are not what they're looking for. We are not their most preferred blood meal. They tend to prefer deer, dogs, mice, other rodents, other animals in general. But they're also not that picky, so if humans happen to be in the way, we're gonna get bit.

• 3:23Marielle Segarra?

  Wow, now I feel a little insulted, but okay.

• 3:26Speaker 05

  Well, you and maybe around 31 million people a year in the US who do get bit by ticks. That's according to the CDC. But, you know, in terms of what we're talking about, in terms of diseases, what's also useful to know is that not every tick bite causes problems, but some of them do cause serious ones. So it helps to know like what to do when you do get a tick bite and also when to worry about them.

• 3:48Marielle Segarra?

  Yeah, what do we need to worry about when it comes to ticks? What diseases do they carry?

• 3:53Speaker 05

  So here in the US, Lyme disease is the big one. That's the most common and well-known of the tick diseases. There's almost 90,000 cases that get reported each year, although actually that's probably underreported. There's probably more like half a million cases each year. So Lyme disease is a disease that's caused by a bacteria. And, you know, a lot of people can get treated with antibiotics and recover pretty quickly. But some people do experience prolonged chronic symptoms like fatigue and body aches and brain fog that can last for quite a long time. It varies with different people, but it can be quite awful. And the ticks carry a bunch of different pathogens. They carry toxins, bacteria, parasites, viruses, you know,

• 4:38Speaker 05

  anything from Rocky Mountain spotted fever to anaplasmosis, Powassan virus, and even alpha-gal syndrome, which is an allergy. It makes you allergic to red meat. And these problems can range from like, pretty mild to pretty serious. And generally speaking, together, they form a pretty big public health problem.

• 4:58Marielle Segarra?

  Takeaway one, at least 31 million people are bitten by ticks in the US every year. And unfortunately, ticks can cause a wide range of medical issues when they attach to us and feed on our blood, most commonly Lyme disease. Okay, so where do we have to be worried about exposure to ticks?

• 5:16Speaker 05

  Ticks tend to prefer tall grasses, the edges of forests, like piles of leaves or wood, stone walls, things like that. They've been found all over the US and every state. You know, they've been found in urban parks in Texas, around beach shrubs in California, under porches in Arizona. And they tend to prefer like shaded areas with high humidity.

• 5:39Marielle Segarra?

  Even at the beach? I didn't realize that.

• 5:42Speaker 05

  Yeah, they have found them, you know, in the sort of scrub brush around the edges of the beach in California, for sure.

• 5:47Marielle Segarra?

  And then what about around the country? Geographically, which are the regions that tend to have more ticks?

• 5:54Speaker 05

  Yeah, so the CDC kind of breaks it down into three regions, like the north, the south, and the west. And the north is definitely the place where there are the most tick bites. That encompasses the northeast, the mid-Atlantic, and the upper Midwest. And it's a high-risk area for Lyme. About one in five people in the north get tick bites every year. You know, it's also a place where the ticks tend to carry- A lot of the bacteria that causes Lyme disease. So that's carried by black-legged ticks, which are also called deer ticks. And around 60% of adults in the north and the northeast area carry the bacteria that causes Lyme disease.

• 6:32Marielle Segarra?

  And then what about the south?

• 6:33Speaker 05

  So this is the area that encompasses like the central and the southeast US. And this is second to the north. More like 1 in 10 people report tick bites each year in this area. And Lyme is much less common here, although there are still some cases. One interesting thing that I learned in my conversations was that one of the reasons that there might be this regional difference between the north and the south is actually that the ticks themselves behave differently in these areas. So in the north, you've got like the same species of ticks, but they tend to climb to the top of like a leaf pile or tall grass. Like they tend to kind of get up there and sort of reach their arms towards humans. But the ones in the south actually tend to stay like very close to the ground

• 7:16Speaker 05

  and the soil and the dirt, which makes them less likely to cling onto a human leg or a human arm.

• 7:21Marielle Segarra?

  All right. And then the last region is the west, right? I feel like I haven't heard about too many problems with ticks in the west, or I don't think about it as much when I go there.

• 7:31Speaker 05

  It's a place where tick bites are the least common for sure. You know, they're about like one in every 20 people report getting bitten by a tick each year.

• 7:40Marielle Segarra?

  Takeaway two, you can find ticks in lots of places. Tall grass, piles of leaves, shrub brushes, also piles of wood and structures like stone walls. Most tick bites in the US happen in the northeast, mid-Atlantic and upper Midwest. There are also ticks in the south, but they're less common. And they exist, but are far less common in the west part of the country. So what can we do to try to avoid ticks?

• 8:05Speaker 05

  Yeah, so the first thing that is helpful to think about is prevention. Cause if you can prevent getting a tick bite, you can prevent getting a disease from getting a tick bite. So you're most likely to encounter a tick if you spend time outside. So one of the things you want to think about is the clothes that you're wearing. So it's recommended that you wear long sleeves and long pants. You can Tuck your shirt into your pants and your pants into the socks if you can stand it. And this just gives ticks less exposed skin to get on to. Another thing that the experts highly, highly recommend is having an outdoor outfit that you pre-treat with permethrin. So this is an insecticide that you can spray on your, you know, your hat, your shirt, your pants, your socks, your shoes,

• 8:50Speaker 05

  anything that you're wearing on the outside. And that is really helpful because permethrin actually kills ticks on contact. So that is a very effective way to prevent them. Another thing that's also recommended as a second line of defense is covering any exposed skin that you have with a good EPA recommended bug repellent, something with picardin or DEET in it, that'll cut the risk even more. And then also just sort of being aware of your surroundings. So if you're going hiking, you'll want to stick to the center of the trail instead of the edges where, you know, the ticks are more likely to be hanging out in the grasses and the shrubs along the side.

• 9:24Marielle Segarra?

  Are ticks more prevalent in the summer? Or is this a year-round problem?

• 9:30Speaker 05

  So it depends on where you are, but in the places where there are the most ticks, spring and summer are the times of year where you want to be the most careful. So it's generally considered like April, May, June, July, August are the months where you're going to want to be super careful about getting bitten, especially by the nymphal ticks because of that life cycle. Like I said, the smallest ones are the ones that tend to bite humans and be the hardest to sort of spot and take off. And so people are at like particular risk in those summer months when there are tiny, tiny little ticks that are crawling around and trying to bite you.

• 10:05Marielle Segarra?

  I think a lot of people know to take precautions if they're going on a hike in the summer especially, right? That they should wear those long pants and tuck them in to their shoes. But I guess I just wonder how careful you need to be. I mean, like there are going to be situations where you're out in just shorts and a t-shirt or a bathing suit and you're around grass. But if it's like a mowed lawn, is that less risky?

• 10:30Speaker 05

  It tends to be less risky. Like, I think it's kind of like the wild, like, fields and tall grasses that are probably the most risky. You know, if someone's got a yard that they're maintaining pretty regularly, if they're cutting down the grass, especially if they're spraying their yards with like tick repellent or insect repellent, like, that's really going to cut down your risks there. But, you know, the ticks are kind of wherever they get picked up and dropped off. And so if it's an area where animals are coming through, you know, cats or rodents, there's a chance that there could be ticks there as well.

• 11:03Marielle Segarra?

  Takeaway three: Try to avoid getting bitten by ticks in the first place. One way to do that is to wear long sleeves and long pants and tuck your pants into your socks. Experts also recommend having an outdoor outfit that you pre-treat with the insecticide permethrin. And you can spray any exposed skin with an EPA-recommended bug repellent. Also, avoid frolicking through any tall grass or shrubs. And if you're hiking, stay on the trail.

• 11:32Marielle Segarra?

  Should you be doing a tick check when you get home from being outside? And what does that entail?

• 11:38Speaker 05

  Yeah, absolutely. I mean, this is pretty critical, especially in the spring/summer seasons where ticks are at their height. So, one thing to think about is that ticks tend to kind of start at the bottom and crawl up. And then wherever they hit resistance is where they're most likely to stop and bite. So, you're gonna wanna check your whole body for ticks, you know, especially places where there's a cuff or an elastic, you know, like the bottom of your pants, or the bottom of your shorts, or, you know, where your underwear meets your leg crease, or your arm creases, or a bra strap or something. And so, you just wanna sort of be extra careful around those areas. And you also wanna do this pretty quickly. Generally speaking, like, the longer a tick latches onto your body, the more likely

• 12:20Speaker 05

  it is to spread some diseases. And so, a good rule of thumb, if you wanna sort of think about, you know, coming in from the outside, it might be helpful to, like, A, throw your clothes in the dryer, because putting them on, you know, high heat for 10 minutes will kill any ticks that are kind of still crawling around on them. And then you wanna jump in the shower, which will wash any ticks off you, and also give you a chance to check all those places on your body that might have been covered with clothes that, you know, now you can check for ticks.

• 12:49Marielle Segarra?

  What about in your hair or on your scalp?

• 12:52Speaker 05

  I would think that they could also get stuck in your hair. You know, if they can kind of crawl all the way up your back and into your head, or if they get dropped off of a tree into your hair. So yeah, definitely consider your hair somewhere that, uh, somewhere that you would want to check for ticks.

• 13:06Marielle Segarra?

  I feel like you need a buddy here, a buddy and maybe a handheld mirror.

• 13:12Speaker 05

  Yeah, that would also help you for sure. Um, cause some of those ticks can actually be quite small. Um, and so you want to be super, super careful about, um, where they might be biting you.

• 13:22Marielle Segarra?

  Let's talk about what they look like because when I've done these tick checks, sometimes I'm like, is that a freckle? You know, it's, it's hard to know. I, I, I haven't luckily, I, I actually haven't seen one in real life. So I've been like, are they the size of a pencil eraser? Are they the size of a sesame seed? Like, how big are they or how small do they get?

• 13:43Speaker 05

  Yeah. Lucky you, I have found ticks on myself and it is not the best. But they are, they tend to be like really, really small, flat oval bugs. They don't have wings. And the nymphs and adults that are the most likely to bite you, they each have eight legs. And, you know, the size of them, it really depends on what stage they're at. So Becky Eisen, who's a tick biologist at CDC, told me this.

• 14:10Speaker 06

  People are often surprised by how small these critters are. So if you can picture an everything bagel, an adult is about the size of a sesame seed. So the little white seeds on there. And then the, um, the nymphs are about the size of a poppy seed. So those tiny little black seeds. So they're often difficult to find, particularly those really small nymphs, which is probably helps to explain why so many human infections are associated with nympho bites.

• 14:41Speaker 05

  Becky is specifically talking about deer ticks, which are the ones that carry Lyme. But Lone Star ticks can be a little bit bigger and dog ticks can be much bigger than that.

• 14:50Marielle Segarra?

  A poppy seed, though. I don't like that.

• 14:52Speaker 05

  Mm-mm. The thing with ticks, at least with most ticks, is that they need to crawl onto you, latch onto your skin. And in many cases, they actually need to eat a while, like maybe a few hours to even a few days before they can, as one expert described it to me, spit enough of an infectious dose into you to make you sick. There's a couple of exceptions to that. Things like poisson virus can be transmitted very quickly. But with something like Lyme, it can actually take maybe one to two full days of feeding before they can actually get you sick. So one of the main things that experts about this say is that if you find a tick on you, don't panic. Just get it off as soon as you can. Don't wait to go to the hospital or the ER. Just grab a pair of tweezers.

• 15:35Speaker 05

  If you have them, grab the tick as close to your skin as you can and just pull it straight out and make sure that you get the mouth parts of the tick out too. That's the part where it's latching on to you.

• 15:47Marielle Segarra?

  Takeaway four: If you're spending time outdoors in nature, do a tick check the same day. You're looking for a small, flat bug that could be as small as a poppy seed. Pay special attention to the areas where the tick might have met resistance as it crawled up from the ground. So things like pant creases and cuffs. And then check the parts of your body that were covered, too. Use a handheld mirror to get a better view. And ask a friend to check your scalp, moving your hair aside to look. If you do find a tick on your body, don't panic. Grab a pair of tweezers and remove the full bug from your skin. Make sure to get its mouth pincers, too. Okay, and then what do you do with it?

• 16:26Speaker 05

  Well, you should not flush it or throw it out right away, as gross as it might be to find that tick on you because there's some information that it would help you to collect in order to sort of understand what your risk is. So you can try to take a really clear picture of it. You can submit that to some experts to get some consult. Try to figure out what kind of tick is it? What life stage is it in? And that information will help you and also a doctor if you actually do seek some medical Care, figure out what your risks are.

• 16:53Marielle Segarra?

  Yeah. How would you figure that stuff out if you're not seeing a doctor?

• 16:57Speaker 05

  Yeah. So there are some really good resources online. There's one called Tic Encounter from the University of Rhode Island, which has this field guide on their website where there's pictures of tics at different stages. And also, if you kind of look at that and you're like, I'm not sure what this is, you get stuck, you can actually submit a picture and they'll consult with you and tell you what they see in terms of like, what kind of tick it is, how long it's been feeding on you. And, you know, depending on where you picked it up, what you might be at risk at. And then the CDC also has this thing called the Tic Bite Bot on their website, which will walk you through a couple of questions, like, how long was it feeding on you? What symptoms do you have? And that can also help you figure out whether you should go see a doctor or not.

• 17:39Marielle Segarra?

  How do you know if you should go to the doctor after you find a tick and you pull it off of you?

• 17:44Speaker 05

  In one specific case, it will be useful to seek a doctor pretty quickly. And that's if you are in an area where Lyme disease is prevalent, and you find a deer tick that's been feeding on you for a while, so it's engorged. So in that specific instance, you can get antibiotics that will help prevent the disease. So you would want to go see a doctor as soon as you can after you find that tick on you, preferably within 72 hours of getting a bite, and get a dose of post-exposure prophylaxis. So just some antibiotics that'll help reduce your chance of actually getting Lyme disease. But otherwise, you should wait and see if you have symptoms. So generally speaking, like tic-borne diseases don't show up right

• 18:27Speaker 05

  away. So if there's a little bit of redness on your skin after a bite, that's just a hypersensitivity reaction. The CDC says that wouldn't actually require a visit to the doctor. But if over the next couple of days and weeks, you start getting some symptoms like, you know, aches, or pains, or fever, or especially a rash, you'd want to go see a healthcare provider right away. And then it would be helpful at that point to tell them that you got a tick bite and where you were when you got it. And again, that'll help them figure out what you might be at risk of and what tests they want to run on you.

• 19:03Marielle Segarra?

  Takeaway five: If you remove a tick from your body, take a good photo of it and consider holding on to it to show a doctor. And if you're looking for help identifying a bug, like, is this actually a tick? And what kind is it? You can submit a photo to the University of Rhode Island's Tick Encounter website. They also have field guides with photos you can use as a reference. If you are in an area where Lyme disease is prevalent and you find an engorged deer tick feeding on you, see a doctor within 72 hours so you can take an antibiotic. Otherwise, you're going to wait and see if you have symptoms. Those can include aches and pains, fever, a rash, fatigue, and swollen lymph nodes, among other things.

• 19:44Marielle Segarra?

  I mean, given that it's peak tick season and people can get bitten without realizing it, should you also see a doctor if you develop symptoms like this and bring up? You know, I just went hiking.

• 19:57Speaker 05

  Yeah, you should, because, you know, if you don't find a tick on you, there's still a chance that it bit you, it fed on you, and it just kind of dropped off without you noticing. So it's very possible to get a tick-borne disease without even realizing that you were bitten.

• 20:11Marielle Segarra?

  All right, well, Ping, thank you so much for this. I found it super helpful.

• 20:14Speaker 05

  Yeah, you're welcome. Hope you never get a tick bite in your life.

• 20:18Marielle Segarra?

  Same.

• 20:21Marielle Segarra?

  All right, it's time for a recap. Takeaway one: Ticks feed on our blood, and unfortunately, they can cause a wide range of medical issues when they attach to us, most commonly Lyme disease. Takeaway two: You can find ticks in lots of places, including tall grass, piles of leaves, shrub brushes, piles of wood, and structures like stone walls. Most tick bites in the US happen in the Northeast, Mid-Atlantic, and Upper Midwest, but they can happen all over the country. Takeaway three: One way to protect yourself from ticks is to wear long sleeves and long pants while you're out in nature. Experts also recommend having an outdoor outfit that you pre-treat with the insecticide permethrin.

• 21:03Marielle Segarra?

  And you can spray any exposed skin with an EPA-recommended bug repellent. Takeaway four: If you're spending time outdoors in nature, do a tick check. You're looking for a tiny bug with eight legs. And takeaway five, if you do pluck a tick from your body, take a good photo of it and consider holding on to it to show to a doctor. If you're in an area where there's a lot of Lyme disease and you find an engorged deer tick on you, see a doctor within 72 hours to get that antibiotic. Otherwise, wait to see if you have symptoms. If you do have symptoms and you haven't found a tick on you, talk to a doctor, especially if you've been hiking recently or spending a lot of time in tall grass. For more Life Kit, check out our other episodes. We have one on how to learn how to swim as an adult

• 21:47Marielle Segarra?

  and another on how to have more fun. You can find those at npr.org/lifekit. And if you love Life Kit and want even more, subscribe to our newsletter at npr.org/lifekitnewsletter. Also, we love hearing from you, so if you have episode ideas or feedback you want to share, email us at [email protected]. This episode of Life Kit was produced by Claire Marie Schneider. Our visuals editor is Beck Harlan, and our digital editor is Malika Gharib. Megan Cain is our senior supervising editor, and Beth Donovan is our executive producer. Our production team also includes Andy Tagle, Margaret Serino, and Sylvie Douglas. Engineering support comes from Kwesi Lee. I'm Marielle Segarra. Thanks for listening.

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