ticks

New Tickborne Illness Clinical Practice Guidelines Are Published

The Wilderness Medical Society has released new clinical practice guidelines for the prevention and management of tickborne illnesses including Lyme disease, anaplasmosis, and spotted fever rickettsiosis, among others.1

Data from the Centers for Disease Control and Prevention show that the incidence of tickborne illness cases has more than doubled within the last 20 years.

While this new evidence-based guideline is similar to other practice guidelines currently available, the expert panel focused on rural and limited-resource settings.

Among the recommendations are:

  • Clothing treated with permethrin may further reduce the risk of tickborne illnesses when used in combination with a skin-based tick repellent.
  • Washing clothing at temperatures higher than 54 °C and drying clothing in high heat for 10 minutes may reduce the risk of tickborne illnesses.
  • Exposing attached ticks to petroleum jelly, fingernail polish, isopropyl alcohol, gasoline, or methylated spirits is not effective and not recommended.
  • Individuals with systemic or high-risk symptoms such as fever, generalized rash, dyspnea, and syncope should receive a higher level of medical care.
  • Individuals with symptoms that suggest Lyme carditis should be screened with an electrocardiography scan as soon as possible and should have a thorough cardiovascular evaluation in an appropriate clinical setting.
  • Educational programs are recommended to change behaviors and lower the rate of tickborne illnesses.

 

“With a changing climate that continues to influence the epidemiology of [tickborne illness], promotion and strict adherence to simple prevention measures is important,” said lead study author Benjamin Ho, MD, in a press release.2 “Despite the limitations of the existing literature, these guidelines provide a starting point for front-line providers to mitigate the transmission and reduce the disease burden of [tickborne illnesses] through education and low-risk interventions.”

 

—Leigh Precopio

References
  1. Ho BM, Davis HE, Forrester JD, et al. Wilderness Medical Society clinical practice guidelines for the prevention and management of tick-borne illness in the United States. Wilderness Environ Med. 2021;32(4):474-494. https://doi.org/10.1016/j.wem.2021.09.001
  2. New Wilderness Medical Society guidelines may help reduce tick-borne illness. News release. Elsevier; December 14, 2021. Accessed December 16, 2021. https://www.elsevier.com/about/press-releases/research-and-journals/new-wilderness-medical-society-guidelines-may-help-reduce-tick-borne-illness