HHA, seeing no sign of virus, calls for plan

By Deborah E. Lans

For Capital Region Independent Media

There aren’t many reasons to dislike spring and summer, but ticks are one. The blacklegged tick, aka deer tick, becomes active once the temperature hits about 40° F.

It is a highly unusual organism, a spirochete (spiral-shaped) that can spread six different diseases through multiple means — a bacteria, a virus and a parasite — in the second year of its two-year life cycle. Lyme disease, anaplasmosis, ehrlichiosis and babesiosis are the most prevalent illnesses in our area.

This year, the ticks are expected to be especially active and numerous, the product of a warmer climate and the increase in animal host populations (deer and white-footed mice).

According to Dr. Ronald Pope, vice president of Medical Services at Columbia Memorial Health, in the 12 months from March 2022 through February 2023, the CMH lab diagnosed 343 cases of Lyme, 157 of anaplasmosis, 118 of ehrlichiosis and 109 of babesiosis. Although there are Lyme diagnoses throughout the year, diagnoses rise in April and peak in August. The other three diseases spike beginning in May, peaking in June and again in October.

Experts agree the best approach to ticks is to avoid a bite altogether. The Cornell Cooperative Extension, Environmental Protection Agency (EPA) and Centers for Disease Control (CDC) websites, among many others, all offer advice.

Simplified, this includes:

• GO LONG: Wear long pants, a long-sleeved shirt and high socks. Also, wearing light colors makes tick-spotting easier.
• TUCK: Tuck your shirt into your pants and your pant bottoms into your socks, to close off entry points.
• DETER: To ward off ticks, you can treat clothing with Permethrin or spray on Picaridin or, to go natural, Lemon Eucalyptus oil. (A full list of effective products can be found on the EPA website.)
• AVOID: Ticks are most prevalent in brushy, wooded and high-grass areas. Avoid these or, when hiking, stick to the middle of the trail.
• CHECK: Frequently, check your clothes, yourself and your pet for ticks, hoping to remove them before they embed.
• REMOVE: The longer a tick is attached, the greater the chance of disease transmission. You can simply pick off a tick that is not embedded, without risk. But, tempting as it is to remove an embedded tick by hand the moment you spot it, don’t, as you’ll increase the risk of disease transmission. Use a sterilized fine-tipped tweezer, pull upwards, don’t twist or jerk.
• DOSE: It takes up to 36 hours for a tick to transmit Lyme. So, the CDC recommends that in areas like ours, within 72 hours of removing an embedded tick, you take a single, high dose of doxycycline. The symptoms of tick-borne diseases make diagnosis “tricky,” according to CMH infectious disease specialist Manuel Revuelta. Symptoms overlap with many other conditions, including vitamin D deficiency, gout, celiac and other autoimmune conditions, and the available tests are notoriously inadequate.

Nevertheless, Dr. Revuelta says patients should seek medical advice if they have symptoms, as tick-borne illnesses can have serious consequences if left untreated. Symptoms of Lyme, anaplasmosis, ehrlichiosis and babesiosis all include a feeling of general malaise or flu-like symptoms, headaches, fatigue, fever, rash, chills, sweats, nausea or loss of appetite, and, occasionally, confusion.

The dramatic increase in tick-borne disease diagnoses in the past 20 years has spurred greatly needed research into better diagnostic tools and vaccines, although experts lament the inadequacy of funding in New York state for education and research. The efforts are primarily directed at Lyme disease.

A partnership of the U.S. Department of Health and Human Services (HSS) and the Steven & Alexandra Cohen Foundation recently launched the LymeX Diagnostics Prize to accelerate the search for better tests, and in 2023 it funded 10 groups with promising approaches to Lyme diagnosis.

At the Cary Institute of Ecosystems Studies in Millbrook, Dr. Richard Ostfeld, a disease ecologist, and others are exploring the biological control of ticks with an environmentally safe and effective means of controlling ticks using a native fungus. Metarhizium anisopliae, a fungus widespread in local soil and leaf litter, is known to attack and kill or weaken ticks.

Under consideration is spraying forest understory vegetation with a fungus solution in the fall and delivering the fungus to the nesting area of the host white-footed mouse.

A number of vaccines are also under development. At MassBiologics of UMass Chan Medical School, researchers have developed a human vaccine that delivers a monoclonal antibody into ticks when they bite that neutralizes the bacterium that causes Lyme. The vaccine conveys immunity almost immediately.

A vaccine invented by a partnership of Pfizer and Valneva will require three doses, induces the development of antibodies, and is entering Phase 3 human trials, with a goal of coming to market in 2025.

At the Yale School of Medicine, researchers have developed a vaccine that, using mRNA technology, recognizes a tick’s saliva, weakens the tick’s ability to stay attached for the 36-plus hours needed to transmit the disease, and makes it easier to pull a tick off.

Moderna recently announced it is exploring two Lyme vaccines, using the mRNA technology employed in Moderna’s COVID-19 vaccine.

There are also developments underway for treating Lyme disease. Currently, broad spectrum antibiotics are used, which have drawbacks including that the drugs kill not only the Lyme-causing bacterium B. burgdorferi but also damage organisms (gut microbes) important to a patient’s health.

Recently, a team at Northeastern University discovered that an antibiotic, hygromycin A, developed in 1953 but abandoned because it was effective only against a few bacteria, was very effective against B. burgdorferi; Now what was perceived as a weakness of the drug is seen as a benefit. The drug does not affect gut microbes or other healthy bacteria. The drug is being studied as a targeted therapeutic for Lyme disease.

Research is also underway into the use of stem cell therapy to reduce the severity of Lyme disease symptoms and promote the repair of tissues damaged by the bacterium, particularly for patients who have not responded well to other treatments.

Finally, a few words in favor of ticks and to remind us of the interconnectedness of all life.

Ticks are an important food source for some reptiles, amphibians, birds (including wild turkeys) and opossums. (Some people raise guinea fowl because they eat ticks and thereby reduce the population.)

Accordingly, scientists study tick populations for indications of ecosystem health. To take two examples: a low tick population can indicate that predators of the small animals that host ticks may be out of control; and, since healthy snakes eliminate thousands of ticks by eating the small mammals on which ticks feed, an increase in ticks may suggest a problem within the snake population.

And ticks serve the evolutionary purpose of controlling the population of certain animals. By transmitting their illnesses to their hosts, ticks cause weaker and older animals to die, promoting the natural selection process.

A one-hour program recently hosted by state Sen. Michelle Hinchey, D-41, and available on her Facebook page covers the areas of prevention, diagnosis and treatment through four brief presentations by ecological and medical experts.