Ticks, carriers of Lyme disease and other pathogens, are a growing problem on Long Island. Take a look at what researchers are doing to raise awareness. NewsdayTV's Steve Langford reports.  Credit: Newsday/James Carbone; John Paraskevas; Alejandra Villa Loarca

On Long Island, every season has become tick season.

Scientists and medical experts say the warm winters have helped keep ticks unusually active year-round. That means more bites and more chances to be infected with diseases the tiny creatures carry.

Doctors also are still trying to unravel the impact of lone star ticks, which appear to be gaining ground across the region. Even though they don’t carry the bacteria that cause Lyme disease, they carry other pathogens that cause health problems.

Dr. Luis Marcos, an infectious disease expert with Stony Brook Medicine, said he and his colleagues have seen patients in March and early April with “tons of tick bites.”

While most of them were identified as bites from lone star ticks, they also have had cases of Lyme disease, as well as anaplasmosis, another tick-borne disease with symptoms that include fever, headache, chills and muscle aches.

Both Lyme disease and anaplasmosis are carried by deer ticks, also known as blacklegged ticks.

“All these things we are used to seeing in late May, June, July,” Marcos said. “Now for about the last two years we are seeing more tick cases in April. This is not what we are used to seeing.”

Entomologist Scott Campbell said Long Islanders should be taking precautions against tick bites all year long.

“In the spring, we have different species active, and that’s when people are more active outdoors,” said Campbell, chief of the Arthropod-Borne Disease Laboratory at the Suffolk County Department of Health Services. “The lone star ticks are more active in the spring … They are aggressive biters, and a lot of the residents of Long Island will come into contact with them.”

For years, Long Islanders have focused on avoiding deer ticks, which can spread Lyme disease. These ticks primarily use deer and mice both as a source of food and a method of transportation.

Tick surveillance is conducted in 10 sites across Suffolk County and is focused on testing for pathogens rather than trying to estimate the population of ticks. Since 2014, between 42% and 70% of deer ticks tested in Suffolk tested positive for the bacteria that causes Lyme disease.

Nassau County does not conduct tick surveillance. But many ticks, mostly the blacklegged species, were detected in Nassau during the 2021 and 2022 "Tick Blitz," a citizen-science project run by the Northeast Regional Center for Excellence in Vector-Borne Diseases, led by Cornell University’s Department of Entomology.

Campbell said the deer tick population appears to be a little lower than in previous years, but lone star ticks are “plentiful” and could be taking over as the predominant species in Suffolk.

Adult female ticks have a white dot on their backs, which give them their name. Both adults and nymphs, or the young ticks, will bite humans often. This may cause an itchy rash and skin irritation due to an allergic reaction to the tick's saliva. 

Others bitten by lone star ticks have developed a syndrome known as alpha-gal, where they become allergic to red meat, said Dr. Andrew Handel, a pediatric infectious diseases expert at Stony Brook Children's Hospital who treats patients with tick-borne diseases. Those with alpha-gal can develop severe stomach pain, hives or an itchy rash, swelling of the lips, throat, tongue or eyelids — among other symptoms — two to six hours after eating meat or dairy products, as well as gelatin-coated medications.

“There’s a component in their saliva similar to a chemical found in red meat,” he said. “This is becoming more common.”

There's another worry: Handel said the lab is also studying another lone star tick-carried pathogen, Rickettsia amblyommatis, which he describes as a first cousin to the bacteria that causes Rocky Mountain spotted fever.

“We know about 60% of our lone star ticks are infected with it, but there is close to no literature on what it actually does in humans that get infected, though we expect it briefly causes mild symptoms,” Handel said.

Researchers at Stony Brook Medicine will study blood samples from young children in an effort to track the disease. 

"We know that Rickettsia amblyommatis is found in a majority of our local lone star ticks, but we don’t know much about its impact on people," Handel said. "A few cases have been documented of people with mild symptoms — fever, rash, and headache — which typically improve without antibiotics. We suspect other people have similar symptoms from infection, but we are studying it at Stony Brook to get a better understanding."

Lone star ticks also are behaving in ways that are unlike deer ticks, said Brian Kelly, of East End Mosquito and Tick Control.

“They don’t seem to be as temperature sensitive,” Kelly said. “We are finding them in the middle of the lawn or crawling on a hot driveway or on pool furniture. Deer ticks stay on the edge of the woods. You aren’t going to find them in the middle of the lawn.”

Asian longhorned ticks were first found in the U.S. in 2017 and have been found on pets, livestock, wildlife and people, according to the Centers for Disease Control and Prevention.

They have made their way to Long Island.

“The newcomer to the block is the Asian longhorned tick,” Campbell said. “They appear to be expanding in range throughout [Suffolk] County, as well as in number.”

Campbell said their impact on public health is still unknown.

In other countries, the Asian longhorned tick has been known to carry diseases that can sicken or kill animals and livestock. And the CDC said one laboratory study showed it can spread the bacteria that causes Rocky Mountain spotted fever, but those germs have not been found in ticks in nature.

“They do have some pathogens, but don’t appear to be aggressive biters of humans and have the ability to transmit those pathogens,” he said. “Right now, we’re just watching those.”

Lone star ticks may be gaining ground, but doctors and scientists agree that Lyme disease carried by deer ticks is still very much a concern on Long Island.

Handel said he believes incidences of tick-borne diseases and Lyme disease in particular have been rising over the years. The CDC has said tracking cases is difficult because of underreporting, and there is no way to know exactly how many people get infected.

About 30,000 cases of Lyme are reported to the agency by state health departments each year, but some estimates show more than 450,000 people could be contracting Lyme disease annually.

The majority of cases are found among children between the ages of 5 and 10, followed by adults around 50 to 60, Handel said. Symptoms of Lyme disease include fever, chills, headaches, fatigue, muscle and joint aches. Some people infected with Lyme disease may develop the distinctive bull's-eye rash at the area of the bite.

“Patients with these flu-like symptoms in the spring or summer have to be assessed for a tick-borne disease,” Marcos said. “Sometimes I see patients who have gone to three doctors with fever and night sweats, and nobody runs the test for Lyme.”

Handel said they are seeing cases of arthritis, which is a manifestation of Lyme disease contracted during the fall, noting it takes about six months for the joint swelling to develop.

Stony Brook is looking for volunteers between the age of 5 and 17 to participate in a clinical trial for a new Lyme disease vaccine.

“Children are at greater risk of being exposed to ticks and contracting Lyme disease,” he said. “Having a vaccine to prevent that would be phenomenal.”

About 10% to 30% of people who get Lyme disease have recurring, long-term symptoms, sometimes for years after the original infection. Marcos said more studies are needed to learn more about this syndrome and how to treat it. Current research into long COVID may help.

“There is most likely a change in the immune system that is causing these symptoms,” he said. “I believe long COVID may give us some insights about chronic Lyme.”

On Long Island, every season has become tick season.

Scientists and medical experts say the warm winters have helped keep ticks unusually active year-round. That means more bites and more chances to be infected with diseases the tiny creatures carry.

Doctors also are still trying to unravel the impact of lone star ticks, which appear to be gaining ground across the region. Even though they don’t carry the bacteria that cause Lyme disease, they carry other pathogens that cause health problems.

Dr. Luis Marcos, an infectious disease expert with Stony Brook Medicine, said he and his colleagues have seen patients in March and early April with “tons of tick bites.”

WHAT TO KNOW

  • Experts say the threat of being bitten by a tick and possibly contracting a tick-borne disease can happen all year long due to warmer weather and other factors.

  • The lone star tick appears to be more plentiful in Suffolk County, edging out deer ticks.

  • While lone star ticks don’t carry the bacteria that cause Lyme disease, being bitten by one can cause an itchy rash and other, more serious health issues.

While most of them were identified as bites from lone star ticks, they also have had cases of Lyme disease, as well as anaplasmosis, another tick-borne disease with symptoms that include fever, headache, chills and muscle aches.

Both Lyme disease and anaplasmosis are carried by deer ticks, also known as blacklegged ticks.

“All these things we are used to seeing in late May, June, July,” Marcos said. “Now for about the last two years we are seeing more tick cases in April. This is not what we are used to seeing.”

A deer tick makes its way around a petri dish...

A deer tick makes its way around a petri dish at a Stony Brook University lab this month. Credit: Newsday/John Paraskevas

Entomologist Scott Campbell said Long Islanders should be taking precautions against tick bites all year long.

“In the spring, we have different species active, and that’s when people are more active outdoors,” said Campbell, chief of the Arthropod-Borne Disease Laboratory at the Suffolk County Department of Health Services. “The lone star ticks are more active in the spring … They are aggressive biters, and a lot of the residents of Long Island will come into contact with them.”

Lone star makes its mark

For years, Long Islanders have focused on avoiding deer ticks, which can spread Lyme disease. These ticks primarily use deer and mice both as a source of food and a method of transportation.

Tick surveillance is conducted in 10 sites across Suffolk County and is focused on testing for pathogens rather than trying to estimate the population of ticks. Since 2014, between 42% and 70% of deer ticks tested in Suffolk tested positive for the bacteria that causes Lyme disease.

Nassau County does not conduct tick surveillance. But many ticks, mostly the blacklegged species, were detected in Nassau during the 2021 and 2022 "Tick Blitz," a citizen-science project run by the Northeast Regional Center for Excellence in Vector-Borne Diseases, led by Cornell University’s Department of Entomology.

Campbell said the deer tick population appears to be a little lower than in previous years, but lone star ticks are “plentiful” and could be taking over as the predominant species in Suffolk.

A lone star tick at Suffolk County's Arthropod-Borne Disease Laboratoy...

A lone star tick at Suffolk County's Arthropod-Borne Disease Laboratoy in Yaphank. Credit: John Roca

Adult female ticks have a white dot on their backs, which give them their name. Both adults and nymphs, or the young ticks, will bite humans often. This may cause an itchy rash and skin irritation due to an allergic reaction to the tick's saliva. 

Others bitten by lone star ticks have developed a syndrome known as alpha-gal, where they become allergic to red meat, said Dr. Andrew Handel, a pediatric infectious diseases expert at Stony Brook Children's Hospital who treats patients with tick-borne diseases. Those with alpha-gal can develop severe stomach pain, hives or an itchy rash, swelling of the lips, throat, tongue or eyelids — among other symptoms — two to six hours after eating meat or dairy products, as well as gelatin-coated medications.

“There’s a component in their saliva similar to a chemical found in red meat,” he said. “This is becoming more common.”

Dr. Andrew Handel, left, and Dr. Luis Marcos inspect deer tick...

Dr. Andrew Handel, left, and Dr. Luis Marcos inspect deer tick specimens at the infectious disease lab at Stony Brook University earlier this month. Credit: Newsday/John Paraskevas

There's another worry: Handel said the lab is also studying another lone star tick-carried pathogen, Rickettsia amblyommatis, which he describes as a first cousin to the bacteria that causes Rocky Mountain spotted fever.

“We know about 60% of our lone star ticks are infected with it, but there is close to no literature on what it actually does in humans that get infected, though we expect it briefly causes mild symptoms,” Handel said.

Researchers at Stony Brook Medicine will study blood samples from young children in an effort to track the disease. 

"We know that Rickettsia amblyommatis is found in a majority of our local lone star ticks, but we don’t know much about its impact on people," Handel said. "A few cases have been documented of people with mild symptoms — fever, rash, and headache — which typically improve without antibiotics. We suspect other people have similar symptoms from infection, but we are studying it at Stony Brook to get a better understanding."

Lone star ticks also are behaving in ways that are unlike deer ticks, said Brian Kelly, of East End Mosquito and Tick Control.

“They don’t seem to be as temperature sensitive,” Kelly said. “We are finding them in the middle of the lawn or crawling on a hot driveway or on pool furniture. Deer ticks stay on the edge of the woods. You aren’t going to find them in the middle of the lawn.”

‘Newcomer to the block’

Asian longhorned ticks were first found in the U.S. in 2017 and have been found on pets, livestock, wildlife and people, according to the Centers for Disease Control and Prevention.

They have made their way to Long Island.

“The newcomer to the block is the Asian longhorned tick,” Campbell said. “They appear to be expanding in range throughout [Suffolk] County, as well as in number.”

Campbell said their impact on public health is still unknown.

In other countries, the Asian longhorned tick has been known to carry diseases that can sicken or kill animals and livestock. And the CDC said one laboratory study showed it can spread the bacteria that causes Rocky Mountain spotted fever, but those germs have not been found in ticks in nature.

“They do have some pathogens, but don’t appear to be aggressive biters of humans and have the ability to transmit those pathogens,” he said. “Right now, we’re just watching those.”

Lyme threat continues

Lone star ticks may be gaining ground, but doctors and scientists agree that Lyme disease carried by deer ticks is still very much a concern on Long Island.

Handel said he believes incidences of tick-borne diseases and Lyme disease in particular have been rising over the years. The CDC has said tracking cases is difficult because of underreporting, and there is no way to know exactly how many people get infected.

About 30,000 cases of Lyme are reported to the agency by state health departments each year, but some estimates show more than 450,000 people could be contracting Lyme disease annually.

The majority of cases are found among children between the ages of 5 and 10, followed by adults around 50 to 60, Handel said. Symptoms of Lyme disease include fever, chills, headaches, fatigue, muscle and joint aches. Some people infected with Lyme disease may develop the distinctive bull's-eye rash at the area of the bite.

Entomologist Scott Campbell searches for ticks in the woods in Calverton.

Entomologist Scott Campbell searches for ticks in the woods in Calverton. Credit: James Carbone

“Patients with these flu-like symptoms in the spring or summer have to be assessed for a tick-borne disease,” Marcos said. “Sometimes I see patients who have gone to three doctors with fever and night sweats, and nobody runs the test for Lyme.”

Handel said they are seeing cases of arthritis, which is a manifestation of Lyme disease contracted during the fall, noting it takes about six months for the joint swelling to develop.

Stony Brook is looking for volunteers between the age of 5 and 17 to participate in a clinical trial for a new Lyme disease vaccine.

“Children are at greater risk of being exposed to ticks and contracting Lyme disease,” he said. “Having a vaccine to prevent that would be phenomenal.”

About 10% to 30% of people who get Lyme disease have recurring, long-term symptoms, sometimes for years after the original infection. Marcos said more studies are needed to learn more about this syndrome and how to treat it. Current research into long COVID may help.

“There is most likely a change in the immune system that is causing these symptoms,” he said. “I believe long COVID may give us some insights about chronic Lyme.”

PROTECTION FROM TICKS

  • Wear long sleeves and long pants when venturing into wooded areas. Make sure shirts are tucked in and pants are tucked into socks.
  • Consider using insect repellent with permethrin on clothing and repellent with DEET on skin. Read all directions before using repellent.
  • Shower and inspect yourself for ticks when you return from outdoors. Important areas include around the hairline, ears, behind the knees, belly button and any skin folds. Young children may need help doing this.
  • Place all clothing in a dryer on high heat. Do not place clothing in a washing machine first. Ticks will survive the washing machine but not the dry heat.

WHAT IF I'M BITTEN?

  • Take a clear, focused photo of the tick with your phone to help identify it later.
  • Remove as soon as possible by using tweezers close to the skin and trying to grab the tick’s neck.
  • Disinfect the bite area with rubbing alcohol, iodine or soap and water. Wash your hands.
  • You may want to save the tick in a baggie or pill bottle containing alcohol. Write the date the tick was removed and the location of the bite.
  • Monitor your health symptoms for a few weeks. See a doctor if you develop symptoms, including rash, a fever, fatigue, muscle aches and swollen joints.

For information about participating in the Lyme vaccine clinical trial at Stony Book, call (631) 638-2684 or email SBM_LymeVaccine_Study@stonybrookmedicine.edu

SOURCE: Regional Tick-Borne Disease Resource Center at Stony Brook Southampton Hospital

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