For all of us who love the outdoors, a familiar annoyance is quickly transforming into a real health threat to humans. The blood-thirsty tick waits for us on the shrubby vegetation and leaf-litter of our backyards and favorite parks, and along the trails, streams, and lakes where we play.
Most of us are familiar with ticks and have been dealing with them since childhood; however, during the past twenty-five years the variety of ticks, the diseases they carry, and the geographic range of people contracting tick-borne diseases (TBD) have increased significantly. It is critical that we increase our efforts to protect ourselves from TBDs. As hikers and paddlers, or simply users of our backyards, we can perform some simple preparations before heading outside, and follow some practical steps upon return from our adventures to protect ourselves from ticks. As outdoors advocates there are also actions we can all take to ensure that needed funding is available for public awareness, treatment, and prevention of Lyme disease and other TBDs.
Cases of Tick-Borne Disease Have Increased Steadily and Significantly
According to the U.S. Centers for Disease Control and Prevention (CDC), tick-borne diseases hit a new record high of almost 60,000 reported cases to the CDC in 2017. This number includes Lyme disease (42,743), anaplasmosis/ehrlichiosis (7,718), spotted fever rickettsiosis (6,248), babesiosis (2,368), tularemia (239), and Powassan virus (33). However, the CDC estimates that Lyme disease is under-reported by a factor of 10, so the likely nationwide number of Lyme cases in 2017 is 427,430. In New York, which reported 5,155 cases to the CDC in 2017, there are likely almost 52,000 cases of Lyme disease. The CDC discovered the under-reporting based on studies of insurance databases and clinical diagnostic lab data.
Although cases of these TBDs are occurring across the United States, most individuals who contract illnesses such as Lyme are in New England and the Middle Atlantic states (New York, New Jersey, Pennsylvania). The Middle Atlantic states represent over half of the total cases of Lyme disease nationwide. Massachusetts, New York, and Connecticut have the highest incidences of babesiosis, which is caused by tick-transmitted microscopic parasites that infect red blood cells.
Most of the TBDs cause flu-like symptoms in early stages and most can be treated if caught early. However, serious illness or death can occur if the diseases are not discovered before they cause extensive damage to the body. Complicating matters is the fact that not everyone develops, or is aware of, symptoms at an early stage.
More and more people are finding themselves stricken by one or more of the tick-borne illnesses, which are the most commonly occurring vector-borne diseases in the nation. At a recent panel discussion at the New York State Capitol, organized by Senator Sue Serino, speakers described a Lyme disease crisis: Existing measures of prevention are failing, diagnostic testing is inaccurate, there is no effective treatment for 60-90 percent of the Lyme cases, and at least 40 percent of those affected by what is known as chronic Lyme disease are leaving the workforce due to medical complications. The purpose of the panel discussion “Let’s Talk Ticks” was to urge legislators to support funding for TBDs in the New York State budget.
Budget Funding and Legislation Are Needed
Legislators in New York, including Assemblywoman Didi Barrett and Senator Serino, among others, have been raising awareness about TBD issues and are working to ensure there is sufficient funding in the New York State budget to fund public awareness, treatment, and prevention projects. However, at this time (March 13, 2019) $1 million in funding has been dropped from the previous year’s appropriation, leaving no money in the proposed budget for TBD issues. This funding is critical for programs like the Tick Project at Cary Institute of Ecosystems Studies, a five-year study developing and testing safe and effective means of reducing disease by controlling ticks. The project is being conducted in Dutchess County in some of the hardest-hit residential areas in the state. The bio-control for ticks, Met52 (a fungus Metarhizium brunneum (=M. anisopliae), is used as a spray for backyards. The Tick Project also uses baited boxes to kill ticks on rodents such as mice and chipmunks. As the animals move through the box they receive a tiny but effective dose of an insecticide that kills ticks without harming the mammals.
Other projects which were funded last year and need to be refunded in the current budget include laboratory insectaries to study TBDs, surveillance projects, education programs, medical collaborations, disease research, and effective treatment studies.
Assembly woman Barrett has also proposed several pieces of legislation which would help the TBD situation in New York, including studies of insurance coverage of Lyme disease, requiring the screening of blood donations for tick-borne illnesses, and including a new tick variety, the Asian longhorned tick, on the invasive species list. Other legislators have their own proposals to tackle different aspects of the TBD issue.
The best way to guard yourself from tick-borne diseases is to ensure that ticks do not have the opportunity to bite you. For those of us heading down the trail, or out for an afternoon in our favorite park with the family, wearing clothing (including shoes and socks) impregnated with the insecticide permethrin is a good strategy. (Cats are sensitive to permethrin, so make sure to keep it and any treated clothing away from your feline friends.) Clothing can be bought pre-treated, or you can treat your own clothing with products containing 0.5% permethrin (see also tickencounter.org). For bottled insect repellents, the CDC recommends using insect repellents registered with the Environmental Protection Agency (EPA), including products containing DEET, picaridin, IR3535 (e.g., Avon Skin-So-Soft Bug Guard Plus), oil of lemon eucalyptus (OLE), para-menthane-diol (PMD) (e.g, OFF! Botanicals).
The EPA has a search tool that can help you find products that best suit your needs. In the epa.org site search box type “find the repellent that is right for you” to search for a repellent product. Consumer Reports recommends products that contain one of these three active ingredients: DEET (15-30%), oil of lemon eucalyptus (30%), or picaridin (20%). The CDC reminds us to always follow product instructions, not to use insect repellent on babies younger than two months old, and not to use products containing OLE or PMD on children under three years old. If using insect repellent in the backcountry, cleanse your body of the repellent before going for a swim to protect backcountry waters from contaminants. Always store your repellent along with food and toiletries (and anything else with a scent) in bear cans or bear hangs away from sleeping areas. Make sure you also consult with your veterinarian for a tick and flea prevention method for your pets and large animals.
When hiking, wear light-colored clothing to be able to more easily spot ticks; tuck your shirt into your pants and your pant legs into your socks; and wear gaiters. Walk in the center of trails and avoid wooded or brushy areas with higher grass and leaf-litter.
Once you return from your adventures, be sure to check your clothing, gear, pets, and yourself thoroughly. Showering within two hours of being outdoors has shown to reduce the risk of getting Lyme disease. Check your body for ticks including
- Under the arms
- In and around the ears
- Inside the navel
- Backs of the knees
- In and around the hair
- Between the legs
- Around the waist
Use a handheld and/or full-length mirror to be able to view all parts of your body. Hot water is recommended for washing clothing because cold and medium temperatures will not kill ticks. You can also put dry clothing in the clothes dryer on a high heat setting for ten minutes to kill ticks.
CDC Instructions for Removing an Attached Tick
- Use fine-tipped tweezers to grasp the tick as close to the skin’s surface as possible.
- Pull upward with steady, even pressure. Don’t twist or jerk the tick; this can cause the mouth parts to break off and remain in the skin. If this happens, remove the mouth parts with tweezers. If you are unable to remove the mouth easily with clean tweezers, leave it alone and let the skin heal.
- After removing the tick, thoroughly clean the bite area and your hands with rubbing alcohol or soap and water. Never crush a tick with your fingers. Dispose of a live tick by putting it in alcohol, placing it in a sealed bag/container, wrapping it tightly in tape, or flushing it down the toilet.
Learn More and Take Action
Governor Cuomo announced the formation of the New York State Lyme and Tick-Borne Disease Working Group in May of 2018. The group is drafting a comprehensive plan that, in collaboration with the Department of Health, Department of Environmental Conservation, and Office of Parks, Recreation and Historic Preservation (OPRHP) will: (1) target public lands in the counties with the highest risk of tick exposure and Lyme disease; (2) expand upon existing education and outreach efforts; and (3) make data available to the public.
On the federal level, the Tick-Borne Disease Working Group was established in 2016 as part of the 21st Century Cures Act. The TBD Working Group provides subject matter expertise, reviews federal efforts on TBDs, and produces a bi-annual report.
The #GetTickedOff social media campaign by Assemblywoman Barrett acts as an online point of connection to share information about tick-borne diseases and provide updates on relevant legislation, education opportunities, new research, and reporting from the field.
The “Don’t Get Ticked NY” website by Cornell University is a great resource with news, links, information, research, and FAQs.
The University of Rhode Island Tick Encounter Resource Center is a comprehensive resource for tick information.
Carey Institute of Ecosystem Studies has great resources and is engaged in the Tick Project, which is testing neighborhood interventions to prevent tick-borne diseases in communities.
TickReport provides tick testing services to the public and agencies.
Visit ADK.org/protect to review calls to action on this issue and policy positions on relevant legislation.
|Tick-Borne Disease*||Spread or Transmitted||Symptoms||Treatment|
(bacterium Borrelia burgdorferi)
|Blacklegged Tick (aka deer tick) (Ixodes scapularis). Western Blacklegged Tick (Ixodes pacificus)||Wide range of symptoms including fever, rash, facial paralysis, and arthritis. Erythema migrans (EM) “bullseye” rash.||Early stage: Antibiotics.
(bacteria Ehrlichia chaffeensis, E. ewingii, or E. muris eauclairensis)
|Lone Star Tick (Amblyomma americanum) and the Blacklegged Tick (Ixodes scapularis).||Fever, chills, headache, muscle aches, confusion, rash, nausea, and diarrhea. If untreated severe illness and death can occur.||Antibiotic doxycycline|
(bacterium Anaplasma phagocytophilum )
|Blacklegged Tick (aka deer tick) (Ixodes scapularis). Western Blacklegged Tick (Ixodes pacificus).||Fever, chills, headache, muscle aches, nausea, and diarrhea. If untreated severe illness and death can occur.||Antibiotic doxycycline|
|Rocky Mountain Spotted Fever||American dog tick (Dermacentor variabilis). Rocky Mountain wood tick (Dermacentor andersoni). Brown dog tick (Rhipicephalus sanguineus)||Fever, headache, rash, nausea, muscle aches.||Antibiotic doxycycline|
(Babesia microti, microscopic parasites that infect red blood cells)
|Blacklegged Tick (aka deer tick) (Ixodes scapularis)||Asymptomatic or Flu-like symptoms||Effective treatments are available|
*For a complete listing of TBDs see cdc.gov
This article will appear in the May-June edition of the Adirondac available May 1. Members will be able to view the magazine in their Members Area on the website. Non-members can purchase the magazine in our online shop.