Lyme Disease is very common in New England.  It is spread by the Blacklegged tick (also known as the deer tick or Ixodes scapularis).  Each year the tick population grows, and more ticks are carrying the bacteria (Borrelia burgdorferi) that causes Lyme Disease, as well as agents causing other diseases (especially Babesia and Anaplasmosis/Ehrlichia). Anyone can be infected, and children are at particularly high risk.   Many aspects of Lyme Disease are controversial, but everyone agrees that prevention is the best strategy, and early diagnosis and treatment are crucial.   Here are some basic steps to follow to protect yourself and your family.  


I.   CHECK YOURSELF AND YOUR CHILDREN EVERY TIME YOU GO OUTDOORS!  Black legged ticks, especially in the baby (nymphal) stages, are small and easy to miss – unless you’re looking!  

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Get naked and check your entire body using your fingers and eyes, especially along the hairline and groin. Nymphal and adult female black legged ticks. Ticks can catch a ride inside on your clothing.  Ticks can be killed by putting clothes in the dryer on hot for an hour. There are many strategies to decrease exposure to ticks.  These range from wearing appropriate clothing and bug repellant, to designing outdoor play areas to minimize tick habitats. The following links provide good information:

Note:  for those of you that cringe at the thought of spraying pesticides on your property or your children, there are botanical alternatives.  Some have been studied with good results.

Ticks are most plentiful in the following areas:

  • where woodlands transition into fields, meadows, or yards.
  • ticks are often found in tall grass, gardens, or mulch beds.
  • deer paths through the woods, leaf litter, wood piles, and rock walls.
  • where deer and/or mice are present, ticks are usually abundant.  
  • when you are in such areas, you need to be particularly vigilant to prevent a tick from attaching to your body.


1.  Remove it promptly and properly:Using fine needle tweezers or a tick removal spoon, grasp the tick on the head as close to the skin as possible, and apply slow, gentle, steady pressure directly perpendicular to the skin (up).  It can take up to a minute for the tick to release its bite.  It is important to remove the head and NOT to squeeze the belly.  Do not burn or suffocate the ticks.  After removal, clean the area with soap and water and apply an antiseptic ointment.Click here for detailed tick removal instructions with a video:  We have tick removal spoons available for free in the office.  Pick some up and have them on hand.  They are also available at  

2.  Identify the tick:Black legged ticks are the only ticks in New England believed to carry Lyme Disease.  (Dog ticks can carry other diseases including Rocky Mountain Spotted Fever).  We have tick identification cards available for free in the office.  There are large pictures available here:http://www.tickencounter.org

3.  Send the tick into the University of Massachusetts Laboratory of Medical Zoology:  They will analyze the tick and tell you what disease causing organisms it carries.  Tests are 99.9% accurate, and cost $50 for a full panel appropriate to the type of tick.  Results are available within 5 business days.  This is a not for profit service, and the only one of its kind available in New England.  Other labs can identify the tick, but not tell you what diseases it carries.  This information is crucial in telling you whether you have been exposed to Lyme Disease as well as the other common co-infections (Babesia, Ehrlichia).  This can guide antibiotic prophylaxis and treatment.  It may also prevent you from having to wait 6 weeks to begin testing for Lyme Disease that can be expensive, and is not always accurate.  www.tickreport.com

4.  If you find an engorged (swollen) deer tick, please call your PCP for advice.  


No.  Many people who develop Lyme Disease never remember getting a tick bite.Sometimes, a “bull’s eye rash” will develop at the site of the tick bite.  If you get this rash, it means you have Early Lyme Disease, and no further testing is necessary.  Treatment in this stage is usually quick and effective.  

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Please see your PCP without delay.  It is helpful to photograph the rash before it changes.

A flu like illness in the summer or fall is another sign of Early Lyme Disease.  It may include:

  • fever and chills
  • fatigue
  • muscle or joint pains
  • headache
  • facial weakness.

If you are concerned about any of these symptoms, please call your Primary Care Provider.