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Comment by aixi | Hacker News Reader

Ever since I moved to the 'first world' I've been scared of this disease. We don't have it where I come from and the long term effects sound straight up terrible.

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It's nothing compared to the other tick disease: tick borne encephalitis. Thankfully there's a vaccine against that

Though it's not available in the US.

From the Wikipedia article about that disease [1] it seams the disease isn't prevent in the US, so it wouldn't make sense to get vaccinated against it there (like European people who aren't vaccinated against yellow fever by default).

[1]: https://en.wikipedia.org/wiki/Tick-borne_encephalitis

Lyme disease is not the same as tick-borne encephalitis. Lymerix was a vaccine approved by FDA in US in 1998 because lyme is pretty common in Appalachia, but it was taken off the market. Dogs are recommended to receive a lyme vaccine here, but it's not available to people.

The FDA has licensed a vaccine for tick-borne encephalitis:

https://wwwnc.cdc.gov/travel/diseases/tickborne-encephalitis

The disease appears to be a problem mainly in Europe and Asia, but if you're planning a camping trip in those areas it looks like you can ask a doctor for the vaccine. You also can get the disease from unpasteurized dairy products.

Is that the one that makes you deathly allergic to beef or something?

Nope, you are thinking about alpha-gal allergy there.

https://en.wikipedia.org/wiki/Alpha-gal_allergy

They are talking about TBE (also known as "FSME" in german speaking countries) instead:

https://en.wikipedia.org/wiki/Tick-borne_encephalitis

Thank you :)

What joke is this?

I am vaccinated against this form of tick born disease but of course I am not allergic to beef.

Not the vaccine. Some ticks now transmit the allergen and cause the allergy in humans:

https://en.wikipedia.org/wiki/Alpha-gal_allergy

It's super easy to treat if caught early. But that's where the good ends. Vast majority of cases present the infamous circle. But some don't. And if you got the circle in a hard-to-notice spot, it's easy to miss it (it will a month or two into infection) too.

First precaution is to check your legs (and possibly torso/hands) for ticks after passing through high grass. And whole body after coming from the woods. The nasty bit is you may bring ticks home, they stay active for a while and they may bite someone else.

If you get a rash in a weird spot and you've been out in the woods in the past 48 hours, check it out thoroughly. You may have a tick there. I've had countless ticks hiding in weird places that I found due to weird itchy-rashy feeling.

Once you get the tick, remove it in a safe manner asap. Lyme is transferred after the tick is done feeding and about to take off. Which is ~48 hours.

Personally Lyme Encephalitis is much scarier. Not as common, but long term effects are much more likely and even worse. On the bright side, there's a vaccine for it.

And Lyme nephritis.

Should we assume we are safe if we go hiking in a place where we never brushed against any plants or grass or twigs? In other words we went through woods but only stayed on wide open trails. I assume ticks don’t “fly” in the air ?

Ticks don't fly and they generally dislike sunlit or dry places. They will mostly lurk in darker, wetter places, up to 3 feet from the ground. So a shady tree patch with overgrown grass at the edge of a swamp or creek is much more likely to be thoroughly infested than other places.

Use a repelent, wear some light-colored clothes to spot a crawling tick easily, tuck the (long!) trousers into your hiking shoes and you should be OK.

> Use a repelent

AFAIK permethrin is the only available repellent for ticks but please be aware that it provokes blindness in cats.

'Deet' is also available as repellent against ticks, although less effective. Permethrin is (also) extremely toxic to fish and aquatic life.

They like to crawl up and can do so from your ankles/feet, so it’s not a safe assumption. I spray my hiking boots and socks with deet. If I am going to get into brush, I wear permethrin-laced hiking pants and I tuck the cuffs into my socks. Then I take a shower after coming in from outside.

Deer ticks can be tiny, much smaller than wood/dog ticks so just checking yourself isn’t a great form of protection.

Ticks jump quite a distance. I wouldn't use that as the sole basis for assuming I was safe.

The short answer is "no." You should still do a check. And maybe spray some pemethrin on shoes/socks/trousers

The longer answer is that they're much more likely to get on you if you're walking through tall grass. They're bad this summer and I've mostly gotten them when walking through grass (on a trail I've actually been avoiding). But I have gotten 2 or 3 others.

Mostly good advice, except for the one comment:

>Vast majority of cases present the infamous circle. But some don't.

I believe it's actually the other way around, only 20-30% of cases show the "typical" bullseye.

IIRC 20-30% is for the picturesque classic bullseye. A small amount of cases have no skin indication at all. And the rest get various other rashes. Maybe circley without gradient, maybe bullseye-ish square, maybe just a random redness. Itchiness may or may not be there too.

Personally I had Lyme twice. Neither was 100% bullseye. The first that I let stay for a while before realising what is going on had little bullseye-ish gradient and was a perfect circle. It took some time to develop the gradient. Next time I realised what is going on very early and all I had was a red patch. I don't know if it would have developed the pattern if I didn't take antibiotics literally the next day after little redness appeared at the tick bite location.

Just don't go meandering in backwoods. You're not going to get it in any urban environment.

Me too, and with Zika and Covid I feel like I've gone back to the dark ages of diseases.

That's the cost of fast international travel without health screenings or true quarantines.

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