Playing It Safe
Our latest hiking policy applies to our arrival at a new venue, which is “Shoot now, ask questions later” or really, “Spritz now with repellent, then find out if ticks are a problem." ‘Cause darn it anyway, we were hours into Day 2 of our planned 13 day SW Coast Path walk in England when we encountered a small, temporary, water damaged sign in the middle of the forest warning about ticks and the Lyme disease the local ticks were transmitting. We were horrified, but there was little to do but to press on to meet our luggage at our B&B for the night. 

In hindsight, Bill could have tucked his pants into his socks but I was wearing sandals. The moral of the story for us was to now always assume that there are ticks until we establish otherwise. OK, maybe not when hiking in the desert but, as our English hostess exclaimed when we arrived that night “They are everywhere”. I thought she was unnecessarily vague and dramatic, but I was soon less critical of her comment. We quickly learned that talking to owners walking their dogs on our trail was the best way to assess the current risk in our precise location, but they weren’t often available.

But the "Ticks are everywhere!” was seemingly too true. A few days later, we were in an urban area on a warm, sunny day about noon when Bill discreetly stepped off the sidewalk to pee in the bushes. I jokingly said “Be sure to check yourself for ticks” and shockingly, he spotted one on his pants when he looked down. It had been a joke, after all. Indeed “everywhere”—this was a couple of minutes from the town center.

A few weeks later when we arrived in Italy, we revised our plan again: we would routinely use tick repellent on our ankles and calves (under our long pants) whenever we hiked. We began to understand how very difficult it was to assess tick risk because they can be just about anywhere there is undergrowth. We were unexpectedly encountering tall, wet grass on segments of lower elevation, unfamiliar trails. And in Italy, dogs and their owners are rarely seen on the trails, unlike in England.

Damp & Dark
The “everywhere” in tick infestations is particularly in damp grass, especially tall grass, and in shaded, humid areas. I have yet to read why damp grass is so much more appealing to ticks than dry grass but face to face conversations and online reading all concurred that ‘damp’ is an important part of the tick equation. “Leaf litter” is another rarely mentioned, high-risk situation that we believe was the source of our most aggressive hitchhikers.

When assessing tick risk, it’s important to know that ticks don’t hop or fly or drop from trees, they only crawl. Their favorite mode of transport is being catapulted from a tall, dewy blade of grass or bracken fern onto the passerby that set the greenery in motion. If they don’t like where they landed, they drop off, crawl up another catapult, and try again. Once on board, they generally start crawling upwards in search of a blood meal. As one local British dog owner said, they are “Looking for the tender bits”, like the belly of her dog. The groin area is a favorite destination on humans though all of our ticks stopped earlier and burrowed in our legs.

Come Prepared For Ticks
Come to England prepared for ticks! We didn’t, and deeply regretted it after digging ticks out of our skin and needing to obtain prescription oral antibiotics to treat an infection.

I personally recommend bringing and using a tick repellent with 20% Icaridin or Picaridin, like Autan. According to one source, it is more effective against ticks than DEET. DEET also has the nasty quality of dissolving the plastic lenses on watch faces and in prescription glasses as well as damaging some synthetic fabrics. Both can be disagreeable on the skin but a light application of Autan worked for us in the past in the Columbia River Gorge in the US Pacific NW—our friends without repellent weren’t so lucky. And an Autan product specifically for ticks that I bought while transiting through the Munich airport in June 2017 was more pleasant on our skin than the less expensive and more readily available tropical formulation.

Our enhanced collection of tick tools.
Carry a tick removal tool with you when you hike in lush lands. Should you be looking for one in the UK, seek out veterinary supply stores or clinics, they are easier to locate than hiking stores. 

Long sleeves and long pants with pants tucked into your socks are the standard, mechanical, repellent. We always wear long sleeved shirts and full length pants when outdoors for sun protection, so that recommendation isn’t a hardship for us. However, wearing socks with my sandals isn’t practical, so having to switch to shoes and socks for a tick barrier is very uncomfortable for me.

And of course, no holes or threadbare socks allowed for this job. After some consideration, I switched from my cooler, lighter weight socks to a denser knit pair, just to be sure. Light colored pants are always advised so you can see the little buggers but really, on an all day hike, how much time can you devote to inspecting your clothes? And light colored pants can be a looser in mud for a traveler.  

Good Years & Bad Years
Yes, even ticks have good years and bad years and 2017 was proving to be a good one for them in England and elsewhere. Mild winters make life easier for ticks. We had the misfortune of being in one of about a half dozen tick hot spots in England on a good year for them and didn’t know it. One's tick avoidance policy could fluctuate with the annual hazard level.

One of the issues with ticks is that they don’t have a natural predator, unlike many species. Ants, spiders, and birds will eat them, but ticks aren’t #1 on their shopping lists. All 3 critters are generalists and eat what is at hand instead of seek out rascals like ticks. We presume that this lack of natural predators combined with global warming will make tick encounters increasingly frequent for us.

A Caution to Squatters!
Think twice about exposing your bare bottom to the ground when relieving yourself outdoors. I was horrified on a rainy, windy day to squat for a pee and when I arose, there was a tick on Bill’s jacket at the level of his collar bone. If they were being seen that high, they surely were lower too. What we didn’t know is how long that tick had been on him. All I could do was hope I hadn’t picked up one and have Bill check my bottom for ticks that night.

I pondered long and hard what the physics of tick transport might be. Would the movement of a urine stream on low grass be enough to set a tick in motion? If the grass was short, would I be safe? And what about leaf litter areas where they presumably crawl on board instead of being flicked? 

I finally decided that that was the last time I’d pee on grass while in England. Hence forth, I waited and waited until there was a bit of bare dirt on our path with no walker traffic at the moment or until I found a rocky area or a gravel patch. I was about ready to hang my hinnie off the end of the wooden step of a cow stile in dense scrub out in the middle of nowhere on a rainy day when 3 young men appeared to repair it. Like, we hadn’t seen anyone else for hours!

I was shocked that none of the women with whom I chatted about the tick issue on the trail had even considered their tick risk when peeing. I kept bringing the subject up for discussion after I realized that they were all unwittingly putting themselves at risk. One woman visibly blanched when I declined to use her grassy pee spot. I was about to pee in a partially shielded bit of high-traffic dirt path near their bench and had asked them to stay put until I was done when she recommended her place.

Tucking long pants into socks in the absence of a chemical tick repellent,

Ignorance Is Bliss??
Like with poison oak and rattlesnakes, I quickly decided to divert my outrage about our tick event into making the little guys a field research project while we walked. I’d learned with the other 2 topics that obtaining local knowledge can be very helpful and I talked ticks to anyone I could: locals out walking their dogs, fellow hikers, hospitality hosts, and pharmacist’s assistants. It immediately became clear: of all of these resources, dog owners were the best barometer of local risk.

Amazingly, fellow hikers on England’s SW Coast Path were a clueless bunch when it came to ticks. "If you don’t inspect your body for them, you usually don’t see them, and if you don’t see them, you don’t have any ticks" was my take-away about the mentality of our trail mates. 

Ticks are highly effective at literally digging into your skin without being perceived and then  dropping-off after they have satiated themselves with your blood. Rarely, the bites become infected like mine did but at that point, you have no way of knowing what the source of the infection was unless you’d looked for ticks like we had done.

The first hikers we spoke with lived in the area near the warning sign and considered tick bites a normal part of hiking. She expected to get multiple bites a year and had had so many that she’d developed an allergic reaction to them. She now knew in hindsight when she’d been bitten because she’d have an itchy red blotch for weeks after each bite. She cheerfully continued wearing shorts in high infestation areas and showed us her current raging skin reactions. 

A pair of highly athletic, 30-something British hikers who wore shorts and T-shirts on the track (even in a blustery storm) were totally oblivious to ticks. They knew nothing about them, absolutely nothing. They didn’t know that there was a high tick infestation on the route. 

They fell into the camp that thought they were safe from ticks even after they knew they'd traversed the same route as us for days on the same days and we’d picked up a dozen or so ticks on our skin and clothes. For them, ignorance was truly bliss and they didn’t seem to be concerned about disrupting their world with information. Adrain, a German woman we walked with several times had the same altitude: she confidently chose to believe that ticks and Lyme disease would not be a problem for her but with no explanation.

Two of our 5 embedded ticks. Yes, they were tiny.
Of the couple of dozen Brits we spoke with about ticks, only one woman, a local dog-walker, was on par with our level of knowledge. She knew the tick MO, was on top of the risks, and deeply appreciated what a life-ruining condition chronic Lyme disease could be.

We were also shocked that next to no one knew that tick repellents were an option, even the the savvy dog walker.  We knew the answer and asked repeatedly if repellents were an option and were almost always told “No.” One B&B host knew about using DEET. No one ever responded with a  confident “Yes!”, however. That was a stunning bit of ignorance. Unfortunately, the best tick repellent ingredient, Picaridin, is no longer available in retail stores in the UK but it was and is still available online. One British website on the subject even specifically recommended the product.

Inspecting Your Body for Ticks

It’s hard to completely check your body yourself for ticks but start by viewing yourself in a mirror if you are on your own. They can be as small as a flattened poppy seed, so check your entire body carefully. It can be quite a challenge at the end of a long hiking day to take the time needed to do a thorough inspection, especially if the needed bright light is not available. And good luck checking your own scalp and ears. The most effective way to complete a proper tick check is to suspend your modesty and have a patient partner do the job. 

And what in the world are tent campers to do? They are the ones at highest risk because they could be pitching their tents in tick habitat and can easily bring ticks into their tent on their clothes or skin. In addition, the likely don’t have bright ambient light to make tick inspection easier.

Treating a Bite
While in England, we were repeatedly told to get a grip on the embedded tick with tweezers and give it a sharp twist while pulling it out. The explanation always came with a dramatic, twisting, hand gesture. The Center for Disease Control (CDC) in the US disagrees: they recommend a slow, steady pull straight out from the skin with tweezers. The CDC also advises against other conventional wisdom interventions like holding a lit match to the rear end of a burrowed tick or using noxious gels or solvents on them. 

Since being shown a Tick Key removal tool by a friend back home, we favor using tick tools to avoid squishing the tick. Simply slide the tool under the exposed part of the tick to extract it. It’s quick and simple. Our tool however was too thick for one tiny tick on my leg and Bill dug it out with a pocket knife. Another tick appeared to have been decapitated when I scrubbed my leg in the shower and presumably the mouth parts remained in my skin. Bill wasn’t able to get the last bits out until a couple of days later when it was obviously infected. 

After our struggles with our tick tool, we went on a search for others that were thinner. Now, we have 4 differently shaped tools with which to tackle the troublemakers.

After removing the tick or ticks, scrub your skin with soap and water and we also applied topical antibiotics. Even so, both of my bites became infected and I eventually sought medical care to obtain oral antibiotics. It took more than a month for my skin to return to normal after that infection.

Make a note as to the date of the bite just in case you develop flu-like symptoms weeks or months later that may warrant ruling out Lyme disease.

Before abandoning our futile search for Autan, I noticed an ‘anti-itch’ product next to the DEET in a grocery store. I was dumbstruck: 3 of the first 4 ingredients were butane, isobutane, and propane, with alcohol being the fourth item. My instant mental image was “Kaboom! It sounded like a highly flammable mix to me and I wondered what else it would do to skin besides stop the itch.

Lyme Disease
Some of the Brits we spoke with thought that Lyme disease was only an issue in US, which is where it was identified in 1975, and only a few others understood the potential seriousness of the disease.  Current estimates are that there are 2,000-3,000 cases of Lyme disease per year in the UK.

Consensus is that if you remove a tick within 24 hours of attachment, that you have next to no risk of Lyme disease infection. We keep hoping that is always true. Elsewhere, I’ve read that removal within 48 hours is sufficient to prevent disease transmission but the English nurse from whom I obtained the antibiotics wasn’t convinced that I had no risk of contracting the disease.

Should you choose to learn more about Lyme disease, this electronic copy of a paper leaflet I received in England is a tidy summary. It’s a good overview and I was also intrigued to learn about the differences between the disease in the US and in England.

A hot tip from a webpage reader: wear support weight pantyhose to keep the ticks and leeches off your skin in high-risk areas. Some in the US military do so with impressive results. I’ll be buying a pair to have on hand and perhaps wear on our second trek on England’s SW Coast Path. Undoubtedly hot, but a good option in cooler weather and when repellant isn’t available. The military guys apparently buy women’s pantyhose but one company in Poland makes an inexpensive line for sportsmen http://www.glieberman.com (some of amazon’s selection is slanted towards sex play).