Dear Doc,

My kids and spouse are outside all the time in the woods by our house on base. I worry about them getting bitten and infected by ticks, and there are a lot of them during the summer months. I need some tips to prevent tick-borne infection. What do we do if we find one of the creepy bugs on me, a family member, our pets, or while on-duty in the field?

-- U.S. Marine Sgt. “Woody” Woods

Sgt. Woody,

You’re right to be concerned about ticks. They’re everywhere, and ticks can cause disease, such as Lyme disease or babesiosis. The latter is a parasitic infection, so antibiotics won’t work, but a combination of an antiparasitic agent and antibiotic does. Checking for ticks and getting seen by a doctor if you’re bitten is more important than ever.

I found an expert bug scientist, or entomologist, at the Defense Health Agency-Public Health in Aberdeen, Maryland. Robyn Nadolny holds a doctorate in ecological sciences, runs a molecular biology laboratory, and is chief of the vector-borne disease branch. She has answers to your questions and offers her advice.

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Now is the season to check for ticks after you or a loved one have been outdoors. It’s also the time to check yourself and your battle buddy for ticks during field exercises.

Ticks can situate themselves anywhere on your body but are often found in hard-to-see areas such as the groin, armpits, and scalp.

Military field exercises and deployments put service members at higher risk for tick-borne diseases, such as Lyme disease, Rocky Mountain spotted fever, and a host of other infections. Pets can be at risk, too.

Lyme disease is the most common vector-transmitted disease in the United States, according to the Centers for Disease Control and Prevention.

Most humans are infected with Lyme disease when immature blacklegged ticks, called nymphs, bite them. Nymphs are tiny—about the size of a poppy seed—and difficult to see; they feed during the spring and summer months. Adults and nymphs of other tick species are also usually abundant in the spring and summer, but ticks can bite at any time of the year as long as it’s above freezing.

In most cases, the infected tick must be attached to a human for 36 to 48 hours or more before the Lyme disease bacterium can be transmitted. Other pathogenic organisms can be transmitted more quickly, so it’s a best practice to remove the tick as soon as it’s discovered.

Adult ticks can also transmit Lyme disease bacteria, but they are larger (sesame seed-sized), and people who are bitten are more likely to discover and remove the ticks before they have had time to transmit the bacteria.

Babesiosis is a parasitic infection transmitted primarily by blacklegged ticks. The number of cases of the disease has increased in recent years, especially in the mid-Atlantic. The blacklegged tick is more common in the Northeast and upper Midwest but is present across most of the Eastern U.S.

Tick Checks

Here are some good tips for your tick checks:

• Self-check or buddy check after leaving the tick-infested area. This is the best fail-safe strategy.
• Use tape to catch ticks crawling on your uniform or clothes.
• Re-treat footwear with a pyrethroid insect repellant spray several times throughout the season.
• Check yourself in front of a mirror after being outdoors or take a shower as soon as you can.

The Department of Defense’s Insect Repellent System is a safe and proven method to reduce disease and the annoyance level associated with insects. The system incorporates:

• Permethrin on the uniform (factory or field-treatment methods)
• DOD-approved DEET or Picaridin insect repellent on exposed skin
• A properly worn uniform
• Permethrin-treated bed nets when relevant

Other useful tips include:

• Look frequently for freckles or small specks of moving dirt that may be ticks.
• Tuck pants into your boots and button your sleeves down fully.
• Toss your clothes into the dryer for 10 minutes on high after you get home. This will kill ticks crawling on your clothing.
• Remove ticks promptly and properly by pulling the head straight out with sharp tweezers to lessen the chances of the tick rupturing and having infected fluid come in contact with a bite.
• Keep dead ticks that have bitten you in a sealed plastic bag in the freezer for a few weeks in case you develop symptoms.
• Treat civilian clothes with permethrin spray that lasts through multiple washes.
• Report tick bites immediately to a health care provider.

MilTICK Service Helps You Identify Ticks and Infection

MilTICK is a free testing and identification service for ticks removed from DOD personnel, their dependents, retirees, contractors, and civilian employees. DHA-Public Health provides the service, and those eligible can save their ticks and mail them into MilTICK directly or through a military hospital or clinic.

MilTICK tests for the most commonly occurring pathogens within a 30-day turnaround time, usually much quicker. This enables the person bitten by the tick to seek medical advice in a timely manner if the tick is found positive for a human disease.

MilTICK Surveillance for Understudied, Rare, and Emerging Pathogens, or SURE Path, is a service that began in December 2023 to expand testing for rare and emerging tick-borne diseases.

“MilTICK SURE Path uses tick specimens already submitted and subjects them to additional testing for rare pathogens at the end of each calendar year. This allows the vector-borne disease team to better understand emerging tick-borne threats to military communities and notify installations and individuals if rare pathogens are discovered.

If you’d like to see the tick risks at your installation, check out the MilTICK CAC-enabled data dashboard, which is updated monthly with the latest MilTICK data.

It’s much easier to find germs in a tick than it is to diagnose a person with a disease, so tick testing can serve as a valuable tool in the diagnostic toolbox.

If you find a tick attached, send it to the MilTICK team right away. Not only will you get results to hopefully put your mind at ease, but you’ll also be providing data tick scientists can use to better protect the rest of the community.

Thanks for your questions. I hope I’ve given you enough information about ticks to protect you, your family, your four-legged family, and your battle buddies. Vigilance and tick checks are increasingly important given that ticks are now found year-round and pretty much worldwide due to climate change and are continually expanding their territories.

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Marine,

Our military bug scientist had a lot of useful information to share about ticks and the diseases they carry. Always look for those nasties after being outdoors, apply repellant every time you might be in a tick-rich environment, and reapply as directed. Check your kids and pets, too.

There are a number of CAC-enabled MilTICK tick submission kits and other resources. Hope this helps, and remember, stay safe out there.