Five Questions With:
Dr. Timothy Flanigan

Dr. Timothy Flanigan is a physician with Brown Medicine’s Division of
Infectious Diseases at
Brown Physicians Inc. He treats patients for a variety of infectious diseases at Rhode Island Hospital and The Miriam Hospital, also serving as a professor of medicine and a professor of health services, policy and practice at the Warren Alpert Medical School of Brown University.

With the population of ticks and cases of tick-borne illness on the rise, Flanigan was interviewed by Providence Business News about preventative measures that can help people enjoy the summer safely at the height of tick season.

PBN: Is a warming climate increasing the tick population or the types of
ticks New Englanders need to look out for nowadays?

FLANIGAN: Tick populations around Rhode Island and most of New England are increasing. This is primarily because ticks enjoy the same environments that we do during the summer months. By turning areas of the woods where ticks inhabit into landscapes and hiking paths, we increased our exposure to these ticks by environmentally altering the areas in which ticks thrive.

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PBN: What diseases besides Lyme should people be wary of this summer?

FLANIGAN: Lyme disease might be the first tick-borne illness that comes to mind when talking about ticks, but there are other diseases that ticks carry that can be viral or bacterial. Babesia, for example, is a parasite that is an emerging threat that is transmitted by the same tick species that transmits Lyme disease. Symptoms of Babesia microti might include flu-like symptoms such as a fever, chills, sweats and body aches, but many people may not feel symptoms at all. Babesia could lead to serious health conditions for people with compromised immune systems and other health conditions.

PBN: What is the best nontoxic insect repellent to use against ticks?

FLANIGAN: There are several products that the Centers for Disease Control and Prevention recommends for protecting against ticks, but most infectious-disease doctors suggest adopting comprehensive tick avoidance and prevention precautions. In addition to reading the recommendations by the CDC, people can find incredibly useful information on the Tick Encounter and Tick Report websites.

Nevertheless, if you are heading to wooded areas or plan to walk through trails, I would recommend that individuals wear long pants and use permethrin on their boots, pants and shirts. When you get home, check your skin to see if any bite marks are present. Also, if you spot a tick, try to remove it before it attaches.

PBN: How should a person remove a tick if they’ve found one attached to them?

FLANIGAN: Removing a tick should be handled carefully and requires the use of tweezers. Ideally, you would grip the tick right near the skin, wiggle it sideways, and dispose of it when it is off.

Most often, people will go to the bathroom to take a shower or bath after a trip outdoors and they might see a tick crawling around. There is no risk of the transmission of Lyme disease or other tick-borne illnesses if the tick has not bitten you, which is why it is crucial to remove it immediately and dispose of it in the toilet.

If you have been bitten by a deer tick, also known as the black-legged tick, individuals have the choice of requesting two doses of doxycycline, one time. This is a preventative measure, not a treatment, that can reduce the odds of contracting Lyme disease by 80%. It is not recommended for children under 8 years old and you cannot take doxycycline if you are pregnant.

PBN: What is a common misconception about the risk of tick-borne diseases?

FLANIGAN: Many people think that they may never recover from a tick-borne illness, but most will feel better over time. Our own immune system can fight tick-borne illness, and antibiotics and other treatments provide additional help. Having a positive Lyme antibody test does not mean you have an active disease. It may indicate that you have successfully fought off the infection. There are better diagnostic tests and vaccines against Lyme being developed on the horizon.

Rob Borkowski is a contributing PBN writer.