Lyme disease

"When? Is it above 45 degrees Fahrenheit, or roughly 7 Celsius? If so, ticks will be out. Climate change, by the way, is making the onset of Lyme season earlier each year, and making the season last longer.

What to wear? Basically, long sleeves and long pants. Dr. Delaney recommends tucking your pants into your socks so ticks can’t crawl up your legs. Wearing light colored clothing is a good idea, so dark ticks show up easily. She also recommends you spray your clothes, shoes, and socks with the insecticide permethrin, which kills ticks on contact.

Permethrin shouldn’t be sprayed on skin. Instead, treat exposed skin with DEET or a chemical called IR3535, which she says is more commonly used in Europe, and has an excellent safety record. If you are taking bags out for outdoor sports, like tennis, spray your bags too.

Where to hike? Stay on the path. Stepping off the trail puts you directly into the leaves and brushy area that ticks love. 

When you get home: Inspect your clothes and body for ticks. If you find one on your skin, remove it immediately and consult your doctor. She might put you on prophylactic antibiotics to prevent a Lyme infection.

Common symptoms include fever, a dry cough, fatigue and difficulty breathing or shortness of breath. Some of these symptoms overlap with those of the flu, making detection difficult, but runny noses and stuffy sinuses are less common for Lyme. The C.D.C. has also added chills, muscle pain, sore throat, headache and a new loss of the sense of taste or smell as symptoms to look out for. Most people fall ill five to seven days after exposure, but symptoms may appear in as few as two days or as many as 14 days.

Quick removal is important. The bacteria that causes Lyme disease, by far the most common tick-borne illness in North America, is believed to transmit after the tick has been attached for at least 24 hours (though other tick-borne diseases can transmit much faster).

You should save the tick, because you can (and should) send it to a commercial lab for analysis. It’s helpful to understand which, if any, of the many tick-borne illnesses you were exposed to if you develop symptoms later.

Lyme symptoms can show up any time between two days and three weeks after a bite. Fever, fatigue and malaise are hallmark Lyme symptoms, and are also among the symptoms of a coronavirus infection. “But the one major difference is presentation of respiratory symptoms,” Dr. Delaney said. That means if you’re coughing, it’s probably not Lyme.

It’s crucial to tell your doctor about any recent hikes or outdoor activity. The sooner you get treated for tick-borne illness, the better the outcome tends to be."