Lyme Disease: Prevention

To prevent Lyme disease, attention must be paid to reducing risk factors. Behavioral risk factors

• Staying in wooded areas with inappropriate clothing such as short pants.

Risk groups

• Foresters, forest workers
• Children in the forest kindergarten
• People
  • Between the ages of 60 and 69 – apparently spend more time in wooded areas than other groups.
  • With contact with infected wild and domestic animals.

After having been through Lyme disease, which was first treated at a relatively high stage, there is protection against reinfection for several years.

Tips for protection against tick bites

Observe the following rules of dress or behavior:

• Wearing light-colored clothing, so that ticks can be easily seen on it and removed even before a bite.
• Ticks prefer thin and warm areas of the skin. Therefore, you must thoroughly protect your arms (including armpits), back of the knees, neck and head, as well as yourself in the crotch (including groin region).
• The skin should be covered, ie sturdy shoes, long pants and shirts with long sleeves.
• Put on long socks, or even better, pull socks over the legs of the pants.
• Use forest paths and do not go through the bushes or undergrowth.
• After a hike, immediately check your clothes for ticks and preferably change them completely.
• Tick check in the evening and the following morning: children should always be checked for ticks during the tick months (May to September) after playing outdoors in the evening and the following morning. In children, the ticks are mostly located in the head area, while in adults it is mainly the legs that are affected. Other favorite places are the armpits, backs of the knees and the pores/fold.The risk of transmission of Borrelia increases with the duration of the tick’s sucking period; only in rare cases is transmission observed within the first 12 hours. Note: Infection can occur from March to October, rarely earlier or later, depending on weather conditions.
• The injection site should be followed up for six weeks.

Use insecticides (insect repellents). Caution. These do not provide reliable protection against ticks.

• There are three types of insecticides:
  • Natural agents based on essential oils; the effect is based on interfering with prey detection.
    • Protective effect: usually only a few hours
    • Side effects: Skin irritation and allergies are possible (increased after sun exposure).
    • Contraindications: none
  • chemical agents for the skin:
    • DEET (diethyltoluamide), a chemical insect repellent; it works by repelling insects directly from the smell of the substance, or DEET reduces sensitivity to endogenous substances that attract insects [it is considered the gold standard in prevention against insect bites].
      • Effective spectrum: horseflies, flies, mosquitoes, ticks.
      • Protective effect: 8 hours against mosquitoes and up to 4 hours against ticks.
      • Effective strength: highly effective, suitable for tropical use only products > 20% DEET
      • Side effects: DEET has the disadvantage that it enters the body transdermally (through the skin) and can develop neurotoxic (“toxic” to the nervous system) effects (e.g., paresthesia/numbness and tingling), with large-area application also encephalopathy/brain damage and seizures; in rare cases also cardiotoxic (heart-damaging) effects and hypotension (low blood pressure); Cave: attacks plastics; allergies are possible.
      • Contraindications: pregnant and lactating women and infants and young children (children under 6 years).
    • Icaridin, a repellent (scaring agent); the animal perceives this active ingredient through the sense of smell and is scared off without being killed
      • Effective spectrum: horseflies, flies, mosquitoes, ticks.
      • Protective effect: up to eight hours
      • Effective strength: comparable to DEET, also in terms of application in the tropics.
      • Side effects: none known
      • Contraindications: none
  • chemical agents for clothing:
    • Pyrethroids (e.g., permethrin); these are synthetic insecticides (insect poisons); they act as contact and feeding poisons
      • Effective spectrum: almost all insects
      • Protective effect: long-term protection (wearing time).
      • Side effects: absorbed pyrethroids are largely degraded in the body within a few hours or days; accumulation in fatty tissue is possible, where the half-life for degradation is up to 30 days; it is not clear whether they have a mutagenic (mutagenic), carcinogenic (cancer-causing) or immunotoxic (“toxic” to the body’s defenses) effect
      • Contraindications: pregnant and lactating women and children under 3 years.
      • There are outdoor clothing impregnated (treated) with such agents and provide long-term protection