PROVIDENCE, R.I. (AP) — Rhode Island health and environmental officials are urging residents to take precautions this summer to prevent contact with the ticks that cause Lyme disease.

A relatively mild winter during which many more ticks than usual have likely survived until spring means that 2021 may be a bad year for ticks and the transmission of tick-borne diseases, the state’s departments of Health and Environmental Management said in a statement Friday.

Rhode Island continues to be a high incidence state for Lyme disease. According to health department data, Rhode Island had 971 cases of Lyme disease in 2019, the latest year for which the information is available. That’s 91.8 cases per 100,000 people.

Residents are urged to avoid wooded and brushy areas when possible, spray clothes with permethrin to keep ticks away, wear long pants and long-sleeve shirts when outside, check for ticks after being in a grassy or wooded areas, and remove them when found.

Lyme disease can cause a rash that looks like a target, headaches, fever, body aches, and fatigue. It can lead to swelling and pain in the joints and neck, and even forgetfulness or trouble paying attention. In rare cases it may even cause heart problems.