NCDHHS: Fight The Bite: Warmer weather leads to greater risk for tick- and mosquito-borne illnesses

RALEIGH — Governor Roy Cooper proclaimed April as Tick and Mosquito Awareness Month in North Carolina. According to preliminary data, in 2021 there were more than 1,000 cases of tick- and mosquito-borne diseases.

Tick and mosquito-diseases are all preventable using pest management strategies and personal protective measures during the seasons where the insects are most active, typically the spring, summer and early fall in North Carolina.

"Ticks and mosquitoes cause a high level of disease in North Carolina; they carry bacteria, viruses, and protozoans that can cause serious infections," said Alexis M. Barbarin, Ph.D., State Public Health Entomologist. "The best way to prevent illnesses associated with ticks and mosquitoes is to take protective measures, like using DEET and other EPA approved repellants and avoiding wooded, grassy or brushy areas."

Rocky Mountain spotted fever, Lyme disease and ehrlichiosis — all bacterial infections that can cause fever, headache, rashes, flu-like illness and other symptoms — are commonly acquired from tick bites. Most diagnoses are reported in June through September. Confirmed, probable and suspected cases of Lyme disease accounted for more than half of tick-borne diseases reported last year. 

To reduce exposure to ticks: 

• Avoid tick habitats, such as wooded, grassy or brushy areas.
• Use tick repellent that contains DEET (or equivalent) on exposed skin and wear permethrin-treated clothing. Use caution when applying to children.
• Reduce tick habitats with selective landscaping techniques.
• If there is a tick attached to your body, carefully remove the tick by grasping it with fine-tipped tweezers as close as possible to your skin, then apply a steady, gentle pull until it releases.

The most common mosquito-borne illnesses in North Carolina are West Nile virus infection, eastern equine encephalitis and La Crosse encephalitis. North Carolina reported the second-highest number of LAC cases in the United States between 2011–2020. 

Nearly 70% of mosquito-borne infections reported in the state in 2021 were acquired during travel outside the continental United States, including 32 cases of malaria and three cases of dengue. There were no cases of Zika virus infection reported in North Carolina in 2021; to date, all cases of Zika reported in North Carolina have been associated with travel outside of the continental United States. 

To reduce exposure to mosquitoes: 

• Use mosquito repellent that contains DEET (or equivalent) when outside. Use caution when applying to children.
• Consider treating clothing and gear (such as tents) with 0.5% permethrin.
• Install or repair screens on windows and doors and use air conditioning if possible.
• Talk with your primary care provider or local health department if you plan to travel to an area where exotic mosquito-borne diseases occur. 
• Always check your destination to identify appropriate prevention methods.
• Reduce mosquito breeding by using the "Tip and Toss" method of emptying standing water from flowerpots, gutters, buckets, pool covers, pet water dishes, discarded tires and birdbaths at least once a week.

To increase awareness of these prevention strategies the North Carolina Department of Health and Human Services Division of Public Health collaborates with health agency partners and schools on the Fight the Bite campaign and poster contest. Fight the Bite aims to elevate awareness about the dangers of tick- and mosquito-borne diseases and to educate about protective measures. Winners the K-12 poster contest will be announced at the end of April.