Lyme Disease Prevention

How can I protect myself from Lyme disease?

There are several ways to prevent or reduce contact with ticks when in areas with long grass, shrubs or woods:

  • Apply insect repellents containing DEET or Icaridin to exposed skin and clothes. Follow directions on the package carefully.
  • Wear light colored, long sleeved shirts and pants, closed shoes, and tuck pant legs into socks.
  • Walk on well-traveled paths, avoiding high grass and vegetation.
  • Check yourself, children, and pets after walking in grassy or wooded areas. Check clothing and inspect skin including in and around ears, arm pits, inside belly button, groin, around the waist, and especially in hair and scalp area. When possible, take a bath or shower within two hours of coming indoors. This makes it easier to find ticks and washes away loose ones.
  • Remove ticks as soon as they are found. Carefully grasp ticks with tweezers as close to the skin as possible and pull the tick straight out. Clean and disinfect the area where the tick was attached to the skin.
  • Keep lawns mowed short.
  • Put playground equipment in sunny, dry places, away from wooded areas, yard edges, and trees.
  • To access more information about simple landscaping techniques to reduce the number of blacklegged ticks, please see the Landscape Management Handbook.

Prophylaxis of Lyme disease

  • Adults and children >8 years of age: single dose doxycycline 200 mg po (4.4mg/kg for patients <45kg)

  • There is no effective antibiotic for prophylaxis in children ≤8 years of age. 

Prophylaxis is generally not recommended but may be offered to patients when all criteria are satisfied including:

  1. The attached tick can be reliably identified as an adult or nymphal blacklegged tick that is estimated to have been attached for ≥36 h based on the degree of engorgement or by certainty about the time of tick acquisition.
  2. Prophylaxis can be started within 72 h of tick removal.
  3. Ecologic information indicates that the local rate of infection of these ticks with B. burgdorferi is ≥20%. There is insufficient information to provide a list of all counties in NS that meet this criterion. For the purposes of prophylaxis, physicians may wish to consider higher and medium risk areas to have tick infection rates in this range.
  4. Doxycycline is not contraindicated.
Charlotte Gallant