Entomologist Scott Campbell, Suffolk's chief of its Arthropod-Borne Disease Laboratory, with ticks recovered from a...

Entomologist Scott Campbell, Suffolk's chief of its Arthropod-Borne Disease Laboratory, with ticks recovered from a wooded area off River Road in Calverton. Credit: James Carbone

Summer on Long Island means sun, surf, sand — and ticks.

The increasingly warm winters have made the voracious, tiny critters — which can carry a number of diseases — a year-round problem. But they become even more frisky in the warm months. Experts are warning people, especially those visiting Long Island’s parks and beaches in the coming weeks, to take precautions.

Every year yields more information about ticks and the illnesses they cause. Clinicians said treatment should be based on symptoms and that a new surveillance criteria for Lyme disease may create a more accurate baseline for cases. And testing for Lyme disease isn’t always needed.

Researchers are also learning that Black people may be diagnosed with Lyme disease at a much later stage because their symptoms, including the rash, are not always immediately recognized. 

“Ticks are very adaptive arthropods,” said Anna-Marie Wellins, a doctor of nursing practice who works at Stony Brook Southampton Hospital’s Regional Tick-Borne Disease Resource Center in Hampton Bays, which opened last summer. “But we can outsmart them through education and prevention.”

Long Island is one of the epicenters for Lyme disease and a hotbed for ticks. But instead of trying to determine the tick population in Nassau and Suffolk counties, scientists focus on testing for pathogens the ticks carry that can cause diseases such as babesiosis, anaplasmosis, powassan virus disease and a version of Rocky Mountain spotted fever — as well as Lyme disease.

Wellins said, in general, about 20% of nymph (young) ticks carry some kind of virus, and 50% of adult ticks do.

The Suffolk County Health Department collects ticks at 10 different locations, one in each township, and tests them. In 2023, the majority of ticks tested positive for the bacteria that causes Lyme disease. The results ranged from 26% of adult ticks tested from Riverhead to 44% in Babylon, 50% in Smithtown and 70% on Shelter Island.

Nassau County does not conduct tick surveillance. But results from the 2023 Tick Blitz, a citizen science project operated by the Northeast Regional Center for Excellence in Vector-Borne Diseases, led by Cornell University’s Department of Entomology, showed most of the ticks collected were blacklegged ticks from the central and northern parts of Nassau.

“I have only been out once in Suffolk County to look for ticks, and I found a variety of species and life stages,” said Jody Gangloff-Kaufmann, senior extension associate and entomologist for New York’s Integrated Pest Management program at Cornell University. “Ticks are very active right now … Nassau County is no exception, although ticks tend to be in the greener spaces in the middle of the Island and north into the preserves and parks.”

Some experts believed for years that cases of Lyme disease were underreported because people didn’t have symptoms, didn’t seek treatment or there was not enough medical evidence to support a diagnosis.

In 2022, the Centers for Disease Control and Prevention changed the way cases of Lyme disease are reported, leading to a shocking rise in statistics. In 2022, 62,551 cases were reported to the CDC compared with an average 37,118 cases annually between 2017 and 2019.

A CDC study concluded the rise was from the reporting change, not from an increase in the risk of disease.

“In our areas and others where there’s a higher incidence of Lyme disease, they will now base their estimates on the number of positive lab results,” said Dr. Andrew Handel, a pediatric infectious diseases expert at Stony Brook Children’s Hospital who treats patients with tick-borne diseases. “But once you are positive for Lyme disease, you can have a positive test for years, so doing it just based on lab tests doesn’t always tell you if someone really has Lyme disease.”

Handel said if someone is bitten by a tick but doesn’t have symptoms such as the bull's-eye rash, fever, joint aches, fatigue and brain fog, they don't necessarily need to be tested.

“A lot of parents come in and they really want to have Lyme disease testing done after every tick bite their kids had,” he said. “It’s a tough situation because I understand wanting to make sure they don’t have Lyme disease, but it can open the door to a lot of confusion. It’s common to have these antibodies, but you may not be sick or have an infection.”

Tests also cannot be performed until about two or three weeks after a bite because it searches for antibodies, not the bacteria that causes Lyme.

Instead, Handel said people need to focus on the rash that accompanies a bite and immediate or developing symptoms. In some cases, people who have been bitten will receive a dose of an antibiotic for prevention as they continue to monitor for symptoms.

Researchers are finding it takes longer for people with darker skin to be diagnosed with Lyme disease. A recent study from the Johns Hopkins Medicine Lyme Disease Research Center shows Black patients were more likely to have advanced stages of Lyme disease and experience delays in getting antibiotic treatment.

Researchers said there was a lack of community and physician awareness. Also, the way rashes appear on darker skin is less likely to be seen in textbooks.

Later diagnoses could mean people developing more serious symptoms, including severe fatigue and irregular heartbeat. “They are underdiagnosed and the early cases are missed,” Handel said. “It’s a real problem.”

He said he is working with staff at the hospital to conduct a survey to focus on the issue.

Gangloff-Kaufmann said the spread of invasive Asian long-horned ticks, which have been found on pets, livestock, wildlife and people, continues across Long Island since they were first discovered in the United States in 2017.

The CDC said one study found this tick is not likely to spread Lyme disease, but research is ongoing. Another study found it can spread the bacteria that causes Rocky Mountain spotted fever.

The female ticks can lay eggs and produce more female ticks without mating.

“This allows these ticks to quickly develop large populations where they find hosts,” including deer, opossum and raccoons, Gangloff-Kaufmann said. “They are not fond of people, but we should keep in mind our pets and make sure they are protected.”

The Gulf Coast tick also has made its way to Long Island from the southeastern United States. It can transmit a form of spotted fever to humans, according to the CDC.

“We don’t fully know what their consequence will be,” Gangloff-Kaufmann said.

Summer on Long Island means sun, surf, sand — and ticks.

The increasingly warm winters have made the voracious, tiny critters — which can carry a number of diseases — a year-round problem. But they become even more frisky in the warm months. Experts are warning people, especially those visiting Long Island’s parks and beaches in the coming weeks, to take precautions.

Every year yields more information about ticks and the illnesses they cause. Clinicians said treatment should be based on symptoms and that a new surveillance criteria for Lyme disease may create a more accurate baseline for cases. And testing for Lyme disease isn’t always needed.

Researchers are also learning that Black people may be diagnosed with Lyme disease at a much later stage because their symptoms, including the rash, are not always immediately recognized. 

Anna-Marie Wellins, a doctor of nursing practice at Stony Brook...

Anna-Marie Wellins, a doctor of nursing practice at Stony Brook Medicine, says education and prevention is the key to outsmarting ticks. Credit: Stony Brook Southampton Hospital

“Ticks are very adaptive arthropods,” said Anna-Marie Wellins, a doctor of nursing practice who works at Stony Brook Southampton Hospital’s Regional Tick-Borne Disease Resource Center in Hampton Bays, which opened last summer. “But we can outsmart them through education and prevention.”

Tracking ticks

Long Island is one of the epicenters for Lyme disease and a hotbed for ticks. But instead of trying to determine the tick population in Nassau and Suffolk counties, scientists focus on testing for pathogens the ticks carry that can cause diseases such as babesiosis, anaplasmosis, powassan virus disease and a version of Rocky Mountain spotted fever — as well as Lyme disease.

Wellins said, in general, about 20% of nymph (young) ticks carry some kind of virus, and 50% of adult ticks do.

The Suffolk County Health Department collects ticks at 10 different locations, one in each township, and tests them. In 2023, the majority of ticks tested positive for the bacteria that causes Lyme disease. The results ranged from 26% of adult ticks tested from Riverhead to 44% in Babylon, 50% in Smithtown and 70% on Shelter Island.

Nassau County does not conduct tick surveillance. But results from the 2023 Tick Blitz, a citizen science project operated by the Northeast Regional Center for Excellence in Vector-Borne Diseases, led by Cornell University’s Department of Entomology, showed most of the ticks collected were blacklegged ticks from the central and northern parts of Nassau.

“I have only been out once in Suffolk County to look for ticks, and I found a variety of species and life stages,” said Jody Gangloff-Kaufmann, senior extension associate and entomologist for New York’s Integrated Pest Management program at Cornell University. “Ticks are very active right now … Nassau County is no exception, although ticks tend to be in the greener spaces in the middle of the Island and north into the preserves and parks.”

Counting Lyme cases

Some experts believed for years that cases of Lyme disease were underreported because people didn’t have symptoms, didn’t seek treatment or there was not enough medical evidence to support a diagnosis.

In 2022, the Centers for Disease Control and Prevention changed the way cases of Lyme disease are reported, leading to a shocking rise in statistics. In 2022, 62,551 cases were reported to the CDC compared with an average 37,118 cases annually between 2017 and 2019.

A CDC study concluded the rise was from the reporting change, not from an increase in the risk of disease.

“In our areas and others where there’s a higher incidence of Lyme disease, they will now base their estimates on the number of positive lab results,” said Dr. Andrew Handel, a pediatric infectious diseases expert at Stony Brook Children’s Hospital who treats patients with tick-borne diseases. “But once you are positive for Lyme disease, you can have a positive test for years, so doing it just based on lab tests doesn’t always tell you if someone really has Lyme disease.”

Dr. Andrew Handel, a pediatric infectious diseases expert at Stony...

Dr. Andrew Handel, a pediatric infectious diseases expert at Stony Brook Children’s Hospital, treats patients with tick-borne diseases. Credit: Randee Daddona

Handel said if someone is bitten by a tick but doesn’t have symptoms such as the bull's-eye rash, fever, joint aches, fatigue and brain fog, they don't necessarily need to be tested.

“A lot of parents come in and they really want to have Lyme disease testing done after every tick bite their kids had,” he said. “It’s a tough situation because I understand wanting to make sure they don’t have Lyme disease, but it can open the door to a lot of confusion. It’s common to have these antibodies, but you may not be sick or have an infection.”

Tests also cannot be performed until about two or three weeks after a bite because it searches for antibodies, not the bacteria that causes Lyme.

Instead, Handel said people need to focus on the rash that accompanies a bite and immediate or developing symptoms. In some cases, people who have been bitten will receive a dose of an antibiotic for prevention as they continue to monitor for symptoms.

A late diagnosis

Researchers are finding it takes longer for people with darker skin to be diagnosed with Lyme disease. A recent study from the Johns Hopkins Medicine Lyme Disease Research Center shows Black patients were more likely to have advanced stages of Lyme disease and experience delays in getting antibiotic treatment.

Researchers said there was a lack of community and physician awareness. Also, the way rashes appear on darker skin is less likely to be seen in textbooks.

Later diagnoses could mean people developing more serious symptoms, including severe fatigue and irregular heartbeat. “They are underdiagnosed and the early cases are missed,” Handel said. “It’s a real problem.”

He said he is working with staff at the hospital to conduct a survey to focus on the issue.

Ticks to watch

Gangloff-Kaufmann said the spread of invasive Asian long-horned ticks, which have been found on pets, livestock, wildlife and people, continues across Long Island since they were first discovered in the United States in 2017.

The CDC said one study found this tick is not likely to spread Lyme disease, but research is ongoing. Another study found it can spread the bacteria that causes Rocky Mountain spotted fever.

The female ticks can lay eggs and produce more female ticks without mating.

“This allows these ticks to quickly develop large populations where they find hosts,” including deer, opossum and raccoons, Gangloff-Kaufmann said. “They are not fond of people, but we should keep in mind our pets and make sure they are protected.”

The Gulf Coast tick also has made its way to Long Island from the southeastern United States. It can transmit a form of spotted fever to humans, according to the CDC.

“We don’t fully know what their consequence will be,” Gangloff-Kaufmann said.

How to avoid ticks

  • Check yourself every day. Ticks like skin folds such as under the arms, behind the knees, inside the belly button and around the waist. Children should be checked thoroughly as well.
  • When going outdoors, pull socks up over pant legs and tuck in shirts. Wearing light-colored clothing can help spot ticks. Use insect repellent but make sure to follow product instructions.
  • Shower as soon as possible after being outdoors. Throw items of clothing in a hot dryer before washing them.
  • Talk to your veterinarian about protecting dogs and cats with treatments.

What to do if bitten by a tick

  • Use tweezers to remove the tick by grabbing its head. You may want to save the tick in a small container or bag for identification purposes.
  • Use rubbing alcohol or soap and water to disinfect the tick bite area.
  • Monitor your health and contact your doctor if you develop a rash, fever, aches, fatigue or swollen joints.

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

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