Editor’s Note: INM is grateful to have this guest column on Lyme Disease and prevention from Alexis Chesney MS, ND, LAc is a naturopathic physician, acupuncturist, author and educator. Dr. Chesney is author of the book, Preventing Lyme and Other Tick Borne Diseases.
There are more than 300,000 new cases of Lyme disease diagnosed each year. And while most think of the disease as a summer issue, Lyme disease can occur at any time of the year, which is why being diligent is important year- round, so says the Global Lyme Alliance.
What is Lyme Disease? It is a preventable infectious disease transmitted through a tick bite, although fewer than half of people with Lyme disease actually recall a tick bite. Ticks are biting arachnids that can transmit disease-causing pathogens like the bacteria Borrelia Burgdorferi, which causes Lyme disease, protozoa, or viruses. Prevention is the key
Prevention is one of the six foundational principles of naturopathic medicine. Evaluating and addressing environmental and other external impacts on health is a key component of a naturopathic doctor’s toolkit. To prevent Lyme and tick-borne disease (TBD), there are many proactive strategies to take, including the following:
Addressing tick habitat is paramount. Grass, low-lying shrubs, and leaf litter are common places ticks can thrive. Ticks love high-humidity environments, between grassy and forested areas, wood piles, stone walls, and around the perimeter of buildings surrounded by grass.
Take the following steps to make your land less tick friendly and to address the wildlife, like mice and birds that are common tick hosts:
- Rake and remove leaves.
- Clear brush and debris from grass and gardens.
- Keep grass short.
- Trim shrubs and low branches.
- Create wide, grass-free paths made of wood chips or stone.
- Remove bird feeders or place them on the perimeter of the land.
- Demarcate border areas, where ticks seem to thrive. Consider adding a 3-foot-wide strip of stone or wood chips in places where your lawn meets high-plant growth or any kind of structure, areas that are prime mouse habitat.
- Eliminate or limit wood piles, brush piles, compost piles, stone walls, and rotting wood, places that both capture moisture and are prime mouse habitat.
More on Controlling the Habitat Environment for Ticks
Beyond what is listed above, consider tick control treatment options for the land. The natural fungal spray Metarhizium anisopliae strain F52 (Met52) causes a decrease of nymphal deer ticks by 55 percent on lawns and 85 percent on woodland plots.1 Fungus spores attach and penetrate the outer surface of the tick, then grow inside the tick, causing the tick to die.
This spray does not harm birds, mammals, bees, or aquatic wildlife and is nontoxic to humans. Certain essential oils have also been shown to repel or be toxic to ticks.2 Cedar, rosemary, peppermint, and wintergreen essential oils are among those showing good results. Studies of a commercially available essential oil formulation suggest that high-pressure spray is more effective than a low-pressure spray.
Tick tubes are an excellent intervention to target ticks in areas where mice nest. As Richard Ostfeld who has studied and written extensively on the biology of Lyme Disease explains, “White footed mice are consistently shown to be the most efficient wildlife reservoirs of Borrelia burgdorferi, infecting between 75 and 95 percent of larval blacklegged ticks that feed on them.”3
Place these biodegradable tick tubes filled with permethrin-treated cotton in areas where mice are found. The mice will take the permethrin-treated cotton to build their nests. The permethrin will not harm the mice or other animals, but it will importantly kill ticks at the larval stage. It is the larvae that most often feed on mice, and the permethrin kills them before they have a chance to acquire pathogens from the mice and before they reach the nymph and adult stages, when they might use humans as hosts. Research shows that over an 8-year period, there was on average a 93.6 percent reduction in exposure per hour to infected ticks in treated areas of the Fire Island Pines, New York.4
Here are effective strategies when in tick territory:
- Use personal tick repellent.
- Wear permethrin-treated clothing.
- Wear light-colored clothing.
- Tuck pants into socks and shirts into pants.
- Avoid walking through grass and leaf litter.
- Treat pets with tick-control products, and check them for ticks every few hours while outdoors and when they come indoors.
- When coming in from the outdoors, place clothes directly in the dryer on high heat for 6 minutes to kill ticks.5
- Shower soon after coming indoors. Showering will not wash off attached ticks, but it will aid in spotting them and may wash off crawling ticks.
- Conduct a full-body tick check. Use sight and touch to sense for any ticks crawling on or attached to the body. Ticks are attracted to warmth and moisture, so make sure to search under the arms, behind the knees, between the legs, inside the belly button, between the buttocks, in the genitals, under the bra, around the waist, around and in the ears, on the head, and between the toes. Use a mirror or another set of eyes to check hard-to-see places.
Should One Use Pyrethroids?
The most effective way to kill and repel ticks is to use pyrethroid acaricide, however using pyrethroids on the land has serious environmental consequences because when wet they are toxic to bumble bees, butterflies, and aquatic life, and moderately toxic to birds. To prevent this, the careful use of permethrin (a type of pyrethroid) in treating materials is recommended as an environmentally safe alternative.
Permethrin-treated clothing and gear is highly effective against tick bites and safe for use. In one study, researchers reported that “subjects wearing permethrin-treated sneakers and socks were 73.6 times less likely to have a tick bite than subjects wearing untreated footwear.”6 When treating clothing with permethrin, efficacy lasts for six weeks before requiring further treatment.
One can buy clothes that have already been treated with permethrin and there are companies that will treat clothing for people. There are factory-based techniques for long-lasting permethrin impregnation of clothing that allows for clothes to hold pesticidal activity against Ixodes scapularis (deer ticks) for 70 washes.7 A study conducted on workers from the North Carolina Division of Water Quality wearing clothing treated by this technique found a 99 percent decrease in the rate of tick bites acquired during work hours and a 93 percent decrease in the total incidence of tick bites.8
While Lyme and other tick-borne diseases are on the rise, one can be well-equipped with these environmental tick control and personal tick bite prevention tactics. Prevention is the best medicine. Implementing strategies to protect oneself from tick bites and therefore from Lyme disease instills confidence in safely enjoying the outdoors .
More on the topic of Lyme Disease and ticks from Dr. Chesney.
Alexis Chesney MS, ND, LAc is a naturopathic physician, acupuncturist, author and educator. She works full-time at Sojourns Community Health Clinic and has a small part-time private practice. She enjoys getting to the root cause of complex chronic illness and partnering with patients to find wellness and balance in their lives. Her book Preventing Lyme and Other Tick-Borne Diseases, published by Storey Publishing, was released in March 2020. Dr. Chesney is passionate about education and speaks on the topics of prevention, diagnosis and treatment of Lyme and tick-borne diseases at medical conferences and to the general public. She also enjoys mentoring other medical practitioners.
This article is provided by the Institute for Natural Medicine, a non-profit 501(c)(3) organization, partnered with the American Association of Naturopathic Physicians. INM’s mission is to transform healthcare in America by increasing both public awareness of naturopathic medicine and access to naturopathic doctors for patients. INM believes that naturopathic medicine, with its unique principles and practices, has the potential to reverse the tide of chronic illness that overwhelms existing health care systems and to empower people to achieve and maintain their optimal lifelong health. INM strives to achieve this mission through the following initiatives:
- Education – Reveal the unique benefits and outcomes of naturopathic medicine
- Access – Connect patients to licensed naturopathic doctors
- Research – Expand quality research of this complex and comprehensive system of medicine
- Kirby C. Stafford and Sandra A. Allan, “Field Applications of Entomopathogenic Fungi Beauveria bassiana and Metarhizium anisopliae F52 (Hypocreales: Clavicipitaceae) for the Control of Ixodes scapularis (Acari: Ixodidae),” Journal of Medical Entomology 47, no. 6 (November 2010): 1107–15, doi:10.1603/me10019.
- Catherine Regnault-Roger, “The Potential of Botanical Essential Oils for Insect Pest Control,” Integrated Pest Management Reviews 2, no. 1 (February 1997): 25–34, doi:10.1016/j. jep.2016.11.002.
- Richard S. Ostfeld, Lyme Disease: The Ecology of a Complex System (New York: Oxford University Press, 2012).
- “Damminix Tick Tubes Test Results on Fire Island, N.Y.,” Ecohealth Inc., www.ticktubes .com/downloads/ticktubes_fire_island_study.pdf. Accessed March 11, 2018.
- Christina A. Nelson, et al., “The Heat Is On: Killing Blacklegged Ticks in Residential Washers and Dryers to Prevent Tickborne Diseases,” Ticks and Tick-Borne Diseases 7, no. 5 (2016): 958–63, doi:10.1016/j.ttbdis.2016.04.016.
- Nathan J. Miller, Erin E. Rainone, Megan C. Dyer, and Liliana Gonzalez, “Tick Bite Protection with Permethrin-Treated Summer-Weight Clothing,” Journal of Medical Entomology 48, no. 2 (January 2011): 327–33, doi:10.1603/me10158.
- Meagan F. Vaughn and Steven R. Meshnick, “Pilot Study Assessing the Effectiveness of Long- Lasting Permethrin-Impregnated Clothing for the Prevention of Tick Bites,” Vector-Borne and Zoonotic Diseases 11, no. 7 (July 2011): 869–75, doi:10.1089/vbz.2010.0158.
- Sullivan, Kristin M. Sullivan, Alison Poffley, Sheana Funkhouser, et al., “Bioabsorption and Effectiveness of Long-Lasting Permethrin-Treated Uniforms over Three Months among North Carolina Outdoor Workers,” Parasites & Vectors 12, no. 1 (January 23, 2019): 52, doi:10.1186/ s13071-019-3314-1.
- Chesney, Alexes, ND, Lac, Excerpted from Preventing Lyme and Other Tick-Borne Diseases. Used with permission from Storey Publishing (2020).
INM's team is made up of naturopathic doctors and health journalists.