Wilderness Medical Society Clinical Practice Guidelines for the Prevention and Management of Tick-Borne Illness in the United States

Published:October 09, 2021DOI:
The Wilderness Medical Society convened an expert panel to develop evidence-based guidelines for the prevention and management of tick-borne illness (TBI). Recommendations are graded based on quality of supporting evidence according to criteria put forth by the American College of Chest Physicians. The guidelines include a brief review of the clinical presentation, epidemiology, prevention, and management of TBI in the United States, with a primary focus on interventions that are appropriate for resource-limited settings.
Strong recommendations are provided for the use of DEET, picaridin, and permethrin; tick checks; washing and drying clothing at high temperatures; mechanical tick removal within 36 h of attachment; single-dose doxycycline for high-risk Lyme disease exposures versus “watchful waiting;” evacuation from backcountry settings for symptomatic tick exposures; and TBI education programs. Weak recommendations are provided for the use of light-colored clothing; insect repellents other than DEET, picaridin, and permethrin; and showering after exposure to tick habitat. Weak recommendations are also provided against passive methods of tick removal, including the use of systemic and local treatments. There was insufficient evidence to support the use of long-sleeved clothing and the avoidance of tick habitat such as long grasses and leaf litter. Although there was sound evidence supporting Lyme disease vaccination, a grade was not offered as the vaccine is not currently available for use in the United States.  (See Link for article)
Any document that refuses to include ILADS material is rigged.  In the conclusion the authors admit:
The recommendations presented in this CPG are largely consistent with those presented by the CDC (
In essence they are telling us they’ve used tax-payer dollars to tell us nothing new.
  • These guidelines are a regurgitation of the accepted narrative by a supposed “expert panel” whom were chosen based on interest or research experience.
  • They essentially sifted through The Cabal’s research with keywords, and then looked at existing guidelines and CDC references – all of which are stacked against patients, but of course were peer-reviewed.
  • They didn’t even address the polarity which exists in both Lyme/MSIDS research and clinical practice.
  • The first glaring misnomer & simplification is that they state the black-legged tick is only in the Eastern US, despite independent research showing migrating birds are spreading ticks globally and that patients are infected globally.
  • While there is a greater risk of being bitten at certain times of the year, you can be bitten 24/7/365Never forget that and never let your guard down.
  • They continue to downplay transmission if you remove the tick before 72 hours.  Don’t buy it.  I know too many who have defied this 4-cornered box, including myself.  Remove all ticks ASAP.
  • They continue to push the one-dose doxy prophylactic treatment which doesn’t work. Neither does two pills. Unfortunately, researchers still believe the EM rash is some magical symbol.  The EM rash comes and goes at will and should never be a marker for effectiveness of treatment.
  • The EM rash is a poor indicator of Lyme, and highly variable, although if you have it, you ARE INFECTED WITH LYME, no testing needed – start treatment ASAP.
  • Ironically, if the doctor can’t identify the tick, or if attachment time is unknown, they still recommend the “wait and see” approach, even though that particular refrain has caused untold damage.
  • The “experts” then give a complicated diagram showing a triage of events (many of which are faulty) leading to either remaining in the field or evacuating.  In other words, they are asking you to again trust the “experts” and their four-cornered box which has been defied again and again.
  • And lastly, and certainly expected is their belief in a Lyme vaccine as an “attractive option,” despite the fact patients have literally been maimed by it.
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