Talking Ticks: An Interview with Dr. Casey Kelley

Dr. Kelley, a member of the Institute of Functional Medicine (IFM), a Director on the board of The International Lyme and Associated Disease Society (ILADS), Founding Member of the Academy of Integrative Health and Medicine (AIHM), faculty at the Feinberg School of Medicine at Northwestern University, talked ticks with Alex Moresco, Lyme warrior and owner of A Moresco PR.

Each year, the Centers for Disease Control and Prevention (CDC) estimates that over 300,000 people will contract Lyme disease, although many of those cases won’t be reported because of misdiagnosis or lack of reporting by state health officials. 

Often, symptoms are treated by doxycycline, but a 2019 study by BMC Public Health estimated that the number of people suffering from post-treatment Lyme disease (PTLD), the lingering side effects of Lyme disease that cause cognitive disfunction, joint pain, and extreme exhaustion, could spike to almost 2 million in 2020.

If you are newly diagnosed, it can be difficult to separate the true facts about tick-borne illness versus the outdated guidelines that are often referenced in the media.  

In May, during Lyme Disease Awareness Month, I had the pleasure of sitting down to pick the brain of Casey Kelley, PhD, to find out what information we should be paying close attention to as tick season hits a record high. 

Dr. Kelley graduated from The Ohio State University College of Medicine and completed her residency in Family Medicine at St. Joseph Hospital in Chicago.  She is a 10-year member of the Institute of Functional Medicine (IFM), a Director on the board of The International Lyme and Associated Disease Society (ILADS), and is a Founding Member of the Academy of Integrative Health and Medicine (AIHM).  Dr. Kelley is also on the faculty at the Feinberg School of Medicine at Northwestern University.

Alex Moresco: Thank you so much for myth busting for us! I saw a statistic recently that a tick has to be attached to the body for 48 hours to transmit Lyme to a human host. In your professional opinion, is this true?

Dr. Casey Kelley: The longer a tick is attached the higher the likelihood of transmitting infection(s) with the highest likelihood if the tick is completely fed (engorged). Some studies show the infections like the Powassan virus can be transmitted in 15 minutes! Most studies show that the ticks need to be attached for 12-24 hours to spread the Borrelia burgdorferi bacterium. 

AM: If they are aware at all, people tend to think that DEET is the only spray that will keep you safe from ticks, which is untrue. For example- Ranger Ready uses a DEET alternative, Picaridin, in their repellent. What it is about Picaridin that keeps ticks at bay? 

Dr. CK: Picaridin is a synthetic compound made to look like natural piperine which comes from the plants that are used to produce table pepper. Picaridin has been available since 1998 in Europe and Australia and since 2005 in the United States. It is considered safe and non-toxic. Picaridin is a great alternative to DEET for keeping yourself, children and pets safe while outside.

AM: You and I have chatted about the amount of tick bites you have seen since the warmer weather started in Chicago, all from patients who live in the city. I think there is a big misconception that you cannot get Lyme disease in the city. How do ticks make it to the city?

Dr. CK: Ticks can get transported to cities not only by deer, but also by mice and birds and we have plenty of those in the city! Ticks also love the city because it’s warm. But, as long as it’s not below freezing outside, ticks can thrive. We had a patient get a tick bite in December of 2019!  

AM: If you take preventative measures but somehow still get bit by a tick, what is the proper way to pull it out?  

Dr. CK: Use tweezers and grab the tick as close to the skin as possible and pull straight out until it pops off. Do not burn it or use Vaseline to get it off. There are also small plastic tick twisting devices you can get to twist the ticks off as well.  

AM: If you think you may have been bitten by a tick, what are the first symptoms of tick-borne illness that could be a sign that you are infected?

Dr. CK: Less than half of people bitten by a tick infected with Lyme will have the tell-tale bullseye rash, but if you do have the bullseye please seek medical attention as soon as possible to get started on antibiotics. Other rashes can occur, too, and often get mistaken as cellulitis. The most common initial symptoms are flu-like: fevers, chills, body aches, fatigue, and migratory joint pain. This can progress to swollen joints, nerve pain, numbness, headaches, and palpitations. These symptoms can start days or weeks after a tick bite. 

AM: What other preventative measures can people take to lower their risk of getting bit by a tick and contracting Lyme disease? 

Dr. CK: Wear non-toxic tick repellent when you are outdoors, like Ranger Ready, even if you are “just weeding.”  If you camp or hike you can spray your clothes with permethrin and let it dry before wearing to help reduce transmission. Wear long pants and long sleeves and be fashion forward by tucking your pants into your socks. If you have long hair, pull it back and/or wear a hat. Do a tick check when you get home - make sure to look in your hair, armpits and groin. Also, protect your yard - you can make tick tubes and use non-toxic sprays to help keep the tick levels low. Don’t forget to talk to your vet about protecting your pets too!