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Lyme-carrying ticks have arrived in the Adirondacks

August 24, 2018
By AARON CERBONE - For the News (acerbone@adirondackdailyenterprise.com) , Lake Placid News

Ticks are spreading into the High Peaks, reaching elevations they never have before and carrying Lyme disease to communities in Wilmington, Malone and Tupper Lake, according to research from Paul Smith's College and the state Department of Health.

Lee Ann Sporn, a professor at Paul Smith's College, has researched the parasitic creatures for the past five years, collaborating with the state Department of Health and a capstone class of 12 senior students to monitor the Lyme-carrying arachnids' rapidly increasing populations in the North Country.

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Deer ticks

Sporn and her crew have found that the blacklegged tick - also known as the deer tick, which used to stay in southern New York and could not survive in higher elevations - is being discovered in higher densities around populated areas.

Sporn said it is not clear exactly what the reason for this spread is, but like many other strange environmental events these days, it may be related to climate change.

Ticks and Lyme disease exist in what is called an enzootic cycle, meaning it is a mystery how their association started. Ticks are born without Lyme disease but get it from the animals they bite. Animals are also born without Lyme disease but get it from tick bites.

"It's a chicken and the egg thing ... it just keeps it going," Sporn said. "Sometimes it will crash and it won't be there anymore, and then it will come back."

Sporn said this cycle always exists at low levels, spiking and falling due to numerous environmental factors. When environmental change, such as warmer temperatures, allows animals and ticks to wander and survive in areas and elevations they were not previously able to, it introduces new species of hosts and ticks to those locations, causing Lyme disease to spike.

Ticks are small and difficult to monitor, so Sporn collected a list of nearly 40 sites to survey, in six counties where people have reported encountering ticks. She knows mid-day, when foliage is dry, ticks are most likely to be out, hanging off weeds and grass, ready to latch on to passing mammals and birds.

The researching students drag a white cloth through the brush and pick up ticks, which may think they have found a tasty host. Usually, these passes come up with very few or even no ticks, but persistence is key to good canvassing.

The research has identified eight sites labeled as "high density," eight labeled as "medium density" and 19 as "low density." These terms do not designate a specific numerical value. Sporn said the data can be misleading, but designates a yearly rise in the number of ticks found.

The increased numbers of ticks in Sporn's research is paralleled by an increased number of reported cases of Lyme disease in the same areas.

"It says to me that field-collected tick data is a good measure of this disease," Sporn said. "It seems to follow pretty closely."

According to the Adirondack Watershed Institute at Paul Smith's College, half of the adult ticks tested from the North Country sites were infected with Lyme disease, as well as one-fourth of the immature ones.

North Country counties have lower populations than southern New York's, so the absolute number of reported cases is lower, but Sporn said they have some of the highest rates in the state if converted to number of cases per 100,000.

Dogs are also good indicators of Lyme disease exposure as they are frequently tested, unlike humans.

"Oddly, people test their dogs annually for Lyme, but we don't test our kids," Sporn said. "There's a vaccine for dogs, but there's not a vaccine for people."

According to Reuters, "A human Lyme vaccine was approved by the FDA in 1998 but was controversially withdrawn from the market in 2002 after claims were made by vaccine recipients that the compound caused arthritis."

Data from the Companion Animal Parasite Council in March 2018 shows that of the six counties Sporn canvasses - Clinton, Essex, Franklin, St. Lawrence, Herkimer and Hamilton - Franklin shows the highest rate for dog Lyme disease diagnosis: 30 percent. The state average at the same time was 11 percent.

Sporn said that in 2016, 250 cases of Lyme disease were reported in Franklin, Clinton, Essex and St. Lawrence counties, and added that the 2017 data is higher.

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A ticking clock

Lyme is a spiral-shaped bacteria related to syphilis that causes a range of symptoms found in other illnesses, making it hard to diagnose. It is often, but not always, characterized by a bull's-eye-shaped rash and can cause fatigue and joint pain that can be mistaken for the flu.

Sporn said these nondescript symptoms, coupled with the fact that everyone reacts to Lyme disease differently and at different speeds, means it is important to quickly determine if one has been bitten and how long the tick was attached.

"The Lyme bacteria live in the gut of the tick," Sporn said. "When it attaches to you, the Lyme bacteria start to move up to the mouth, but it takes at least a whole day, like 24 hours, for that to happen."

She suggested looking at the tick and even bringing it in to a health care professional to see if it is engorged. Ticks are usually flat, nearly two-dimensional, so when the abdomen is swollen, that means it is full of your blood.

Ticks hang out in short grass as nymphs in the spring and taller grass as adults later in the summer. They can grab onto ankles, pants or arms and climb around, searching for dark, moist places. In the springtime they can be as small as poppy seeds.

When a tick is found on one's body, Sporn said not to put anything on it, like Vaseline or alcohol. That irritates the tick and causes it to regurgitate the contents of its stomach into the bite wound, which is likely to spread Lyme disease to the host faster.

Instead, she said to remove the tick with tweezers as close to the skin as possible; if some of its mouth parts are left behind, that is OK, as long as the body of the tick is gone.

Sporn recommends tucking clothes in to cover vulnerable skin areas, using repellents and checking for ticks often when in tall grasses, the wilderness or marshy areas.

If it is caught early, doctors usually prescribe a single dose of an antibiotic, which reduces the chances of Lyme disease 20-fold. If someone is already suffering from the disease, doctors put them on a 30-day schedule of antibiotics.

Sporn said some people tend to over-treat tick bites; there is no need to get antibiotics every time you get a tick bite.

"I liken it to, 'Well, maybe we should all just be on chemotherapy in case we have cancer,'" Sporn said. "That's extreme, but if you live in an area where you are going to get tick bites occasionally, if you remove them quickly there is probably no reason for treatment.

"If you go on a 30-day doxycycline regimen every time you get a tick bite, that's going to introduce other health problems."

Still, she said with half of adult ticks carrying the disease, it is good to assume that one is infected when bitten. The tick should be removed and the spot monitored as soon as possible.

She said if someone is confused about what to do, refer to the directions set out by the U.S. Centers for Disease Control and Prevention.

"You can't get better than the CDC guidelines," Sporn said. "There's a lot of misinformation out there, and there's a lot of sensationalism and a lot of arguing."

Sporn also mentioned that doctors in the North Country have for years ignored the rise of Lyme disease, believing it is not common in the area and have not treated it properly. She said many are starting to adjust their practices based on the new research, but according to a Tupper Laker who spent last summer in extreme pain, they still have a long way to go.

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Citizen's diagnosis

Tupper Lake Chief of Police Eric Proulx first noticed the symptoms of Lyme disease in early April 2017, a week after a bite on the back of his head swelled to the size of a golf ball. The swelling had subsided and he never saw a bull's-eye-shaped rash, so he did not suspect the neck and head pain to be Lyme disease.

However, he did suspect that the bite and the pain radiating through his head were related, and he told that to his family doctor at Adirondack Health in Saranac Lake, doctors at Champlain Valley Physicians Hospital in Plattsburgh and neurologists.

"Every time I saw a doctor or spoke to somebody, my conversation always started, 'Well, back in spring I got bit by a bug in the back of my head that swelled up to the size of a golf ball,'" Proulx said. "Not once ... had any of them mentioned anything about Lyme disease."

During the next four months of head-splitting pain, Proulx was put on a regimen of steroids and muscle relaxers to no relief. He made over a dozen visits to doctors and couldn't get sleep for days and weeks on end.

In mid-August 2017, Proulx was put on a new medication and started to believe he was having an allergic reaction to it. He went to CVPH and learned it was actually Bell's palsy, a symptom of Lyme disease. Bell's palsy is similar to a stroke; Proulx lost sensation and control of half of his face, could not taste or chew, had one droopy eye and his jaw hung open.

A neurologist diagnosed him in the hospital via video conference call, and he was again sent home without relief.

Even with Proulx and his wife Brittany, who is the Enterprise's news editor, demanding some sort of pain medication or sleep aid, doctors refused to prescribe him anything.

Proulx said he understands they may have believed he was trying to get his hands on addictive pain pills, but he was confused why they were so wary in his case when he sees them given away every day through his job.

"Being the chief of police, I see people that get countless supplies of pain medication that I know abuse them and ... turn around and sell them," Proulx said.

He was prescribed some non-narcotic medications that he said didn't work and found that Tylenol was the only thing that helped. After talking with his doctor, he found out he was taking a toxic dose of it to get any alleviation.

Proulx was finally diagnosed toward the end of August, but not by a doctor.

"From my wife sitting in the ER for two nights going through her phone and reading my symptoms, she's actually the one that asked the doctor in the ER, 'Hey, could this be Lyme disease?'" Proulx said. "And he said, 'Well, he has the symptoms. I guess we could test for it.'"

Proulx's blood was taken that evening. By the next day he was diagnosed with Lyme disease and within two days of taking antibiotics finally found the relief he had been asking for all summer.

Proulx had been to dozens of doctor visits, had his insurance cover tens of thousands of dollars worth of CAT scans and MRIs, and even had several blood tests done, but the medical professionals never tested for Lyme.

"You would think that Lyme disease would be a standard blood test," Proulx said, adding that he believes Lyme should become one of the core diseases tested for, especially when someone exhibits the telling symptoms as he did.

"The [Lyme disease] education level in our area isn't where it should be," Proulx said. "I was a clear case study. I was the poster child for Lyme disease."

He now tells anyone who has similar symptoms to advocate for themselves and tell their doctors to test them for Lyme disease. He doesn't want others to experience the "unbelievable pain" he felt for an entire summer.

Proulx said he had not left the Tupper Lake area when he got his initial bite and believes he picked up the tick in either his backyard or hunting camp.

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Closing Lyme

The animals that carry Lyme disease do not suffer from it. They are merely reservoirs for the affliction. While the disease brings intense suffering to humans and domestic animals, the tiny wild mouse that spreads the disease is unaffected.

"We have bacteria associated with us in our gut, and we have a symbiosis with that," Sporn said, drawing comparisons with human resilience to certain afflictions. "If you have a long history with a parasite, often you kind of come to an agreement and there's no harm either way, but early on when it's new to a species, it often causes disease."

She said this means that, hypothetically, in the future humans and Lyme disease could coexist.

"It sounds a little far fetched, and we don't know the answer to that for sure," Sporn said. "For some reason the small mammals have been able able to harbor it without any ill effects. So it's not science fiction."

Mice, she pointed out, are often used as substitutes for humans in laboratory tests.

Until humans and bacteria reach this great symbiosis, though, people are still searching for a solution as ticks and Lyme disease spread into northern and western New York.

Sporn said in 2014 a company named US Biologic placed bait vaccines in areas around New York for a trial study. Infected mammals would eat the vaccine and hopefully be cleaned of the disease, breaking the enzootic cycle.

According to the study, after two years of feeding mice the vaccine-laced oatmeal, 23 percent fewer tick nymphs were infected with Lyme disease, and after five years, 76 percent fewer tick nymphs were infected.

Sporn said she has not heard of any more studies like this one since, so results are not yet proven. She said a statewide solution would be costly.

 
 
 

 

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