By Bara Vaida
Ticks are emerging earlier from winter hibernation and staying active longer because of climate and deforestation, according to public health experts. Now Americans’ risk of infection from pathogens carried by the outdoor pests is rising.
“There are more tick-borne disease cases every year,” said John Aucott, M.D., director of the Johns Hopkins Lyme Disease Clinical Research Center during a June 8 AHCJ webcast “This is an insidious epidemic. It hasn’t been as dramatic as COVID-19, so it has crept up on us.”
Ticks are parasites belonging to the arthropod family that carry bacteria and viruses. The black-legged tick (the most prevalent tick) carries pathogens that cause Lyme disease (the most common tick-borne illness) anaplasmosis, ehrlichiosis, Rocky Mountain spotted fever, babesiosis, tularemia and powassan virus.
For background in understanding more about why climate change impacts ticks and how they reproduce and spread, read this story, this blog post and check out my 2019 AHCJ tip sheet.
Here are some new resources and story ideas for covering ticks in your community.
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Sources for tick data. The CDC gets its tick data from the states and at least one state – Massachusetts — doesn’t report its tick data to the CDC. The CDC only reports its data once a year, and the last report was 2019 data, which said there were 50,865 tick-borne disease cases. The CDC says this is a huge underestimate of tick-related cases and that cases are likely 10 times higher. Pennsylvania, for example, estimates that there will be 100,000 cases of Lyme disease in its state in 2022.
So, if you are reporting on ticks in your community, check your state health department. Massachusetts, for example, provides its tick data on a state website. Check out a new Lyme disease tracking dashboard, by the Johns Hopkins Spatial Science for Public Health, the Bloomberg School of Public Health and Johns Hopkins School of Medicine. Right now, the dashboard’s data is limited by what has been provided by the CDC, but Johns Hopkins researchers are in the process of gathering data from states, health insurance records and social media to provide a broader picture of the prevalence of Lyme and other tick-borne diseases.
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New tick threats. The Asian longhorned tick was found in the U.S. in 2017 and had spread to 17 states by September 2021. Though it hasn’t been found to carry a pathogen dangerous to humans, it has been shown to carry Lyme disease in other countries. The tick also can reproduce without a mate and is so prolific that it can make livestock bleed to death. The lone star tick has spread aggressively over the past decade from the south, where it was endemic, to the north and west of the country. The tick bites aggressively and can cause the alpha-gal syndrome, which is an allergy to red meat. Check out my Q&A with journalist Bianca Nogrady, who has been covering the expansion of alpha-gal syndrome.
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Diagnosis confusion. Symptoms of Lyme disease and other tick-borne diseases — like headache, fatigue, fever and rashes can mimic COVID-19, so physicians might not be looking for tick-borne diseases this year. See this study. Find out whether health care providers in areas where there are a lot of ticks are investigating whether ticks are a cause of illness instead of just COVID-19. The lone star tick bite can cause a rash that can look like Lyme disease but isn’t. The CDC calls this southern tick-associated rash illness (STARI). Further, a race may affect the appearance of rashes caused by ticks making it harder to diagnose. For example, Aucott says more reporters should write about how Lyme disease rashes on Black skin may be harder to diagnose because it is more challenging to see the telltale Bull’s eye on darker skin. See this study that Aucott co-authored.
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Post-infection syndromes. Like COVID-19, bites from ticks can cause lingering disease symptoms that last from months to years. Among the more controversial diseases is chronic Lyme disease, or post-treatment Lyme disease, where someone has long-term symptoms from Lyme disease like fatigue, body aches, headaches and shortness of breath. Around 14% of people diagnosed with Lyme disease have long-term symptoms, but physicians can’t pinpoint why it is occurring. Now that there is a lot of research on long-COVID, researchers may find an answer to what causes chronic Lyme disease.
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Vaccines and prevention. Progress is being made on the development of a Lyme disease vaccine. Pfizer and its partner Valneva announced in April 2022 that they had completed Phase 2 of a clinical trial of a Lyme disease vaccine, setting on the path for a larger Phase 3 trial. Two Yale researchers have developed a vaccine based on mRNA technology (the platform used to create the COVID-19 vaccine) to reduce the risk of developing Lyme disease. CRISPR technology has been used to edit the gene of black-legged ticks, which may help scientists with developing vaccines and treatments. Researchers are investigating vaccinating mice that carry ticks, and genetically engineering mice to prevent them from becoming reservoirs of diseases that ticks ingest when they feed on mice.
