Why are the ticks winning, and what can we do about it?

Human illness associated with tick bites is on the rise in the United States. One root cause is that several human-biting tick species serving as pathogen vectors, including the blacklegged tick and the lone star tick, have expanded their geographic ranges in recent decades, with many areas in the U.S. now harboring multiple species of vector ticks. As currently used, personal tick bite prevention and environmental tick control have not succeeded in stemming the rising tide of humans being bitten by ticks. A national strategy to prevent and control vector-borne diseases provides a blueprint to solve the problem, but this will require sustained investments in tick bite prevention and tick control. Efforts are needed to: (i) stimulate industry engagement in development of novel technologies and products; (ii) intensify research to clarify the benefit of using different tick bite prevention and tick control methods, and clarify barriers to their adoption and use; (iii) establish publicly-funded local organizational structures to support individuals and communities in their efforts to prevent tick bites; and (iv) strengthen the workforce in public health, academia, and industry with expertise in ticks and tick-borne diseases. Solving the problem with ticks in the U.S. will be challenging but is worth pursuing because the alternative is for the public to accept that illness associated with tick bites now is simply a fact of life and that the problem is likely to get worse over time. This perspective paper includes "take home messages" and a conclusions section for an abbreviated read.