Dr. Jean Tsao: Ticks, the diseases they cause, and how to avoid them

[0:00:21]

JEAN TSAO: I am Jean Tsao. I am an associate professor in the departments of fisheries and wildlife and large animal clinical sciences at Michigan State University. And I’m a disease ecologist specializing on tick-borne diseases and primarily Lyme disease.

[0:00:44]

JEAN TSAO: We’ve been seeing a very, you know, steep increase in tick-borne diseases over the past couple of decades in part because the ticks have been spreading. And most of this rise in tick-borne disease is due to Lyme disease. And most of that rise is due to then the spread of the blacklegged tick in the Eastern U.S.

[0:01:15]

JEAN TSAO: Tick ranges are growing in part because we, as humans, have been creating lots of great habitat for the ticks, lots of great habitats that support the wildlife hosts that feed the ticks. And, in fact, the habitats that we’re creating—mainly our suburban habitats where we live—they are bringing us, then, much closer in contact with all these wildlife and the ticks that transmit these pathogens.

[0:01:53]

JEAN TSAO: Certainly, there are some areas of the country that seem to have a higher risk of tick-borne diseases. And, in part, that’s because there are ticks in these areas that are expanding in ranges and coming into contact more with where much of the U.S. population lives. And this is really a lot in the Eastern U.S. The diseases that are really causing the most problem for people are Lyme disease, human anaplasmosis—and then, to a lesser extent, babesiosis, ehrlichiosis and Powassan virus. And those diseases actually are all caused by pathogens transmitted by the blacklegged tick.

The second tick that actually is expanding in range and increasing the amount of disease that it’s causing people is the lone star tick. And that’s also in the Eastern U.S., and that actually is spreading northward from its traditional center of the home range of its own ranges in the Southeast and South Central U.S. And it also transmits several pathogens. Ehrlichiosis is probably the disease that it’s most associated with. But now in recent years, it’s also associated with another—with a syndrome that actually—it’s not caused by an infectious agent, but it’s actually considered an allergy. And so, this is the red meat allergy, or alpha-gal syndrome, that’s associated with the lone star tick.

[0:03:36]

JEAN TSAO: There are some other diseases. I mean, one of the most famous tick-borne diseases, the first one really studied in the U.S., is Rocky Mountain spotted fever, and that is transmitted by a few different tick species—the American dog tick, also known as the wood tick, and then there’s a Rocky Mountain wood tick, and then also in Southeast—I’m sorry—Southwest U.S., there’s the brown dog tick. This disease is not as prevalent as some of the other diseases, but it can be—it has a higher fatality rate. And so that’s why it has—it is often a disease that really catches a lot of people’s attention that we should be aware of.

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JEAN TSAO: If you know you’re going to be outside, which is where ticks are in general (laughter), then you want to think about what kind of habitats best support ticks. And so, in general, for the ticks that seem to contact people the most, they’re in tall, grassy areas, and they’re also in the woods. And so, when you’re in these areas, the first thing to do is to just stay on the path. You know, don’t be wandering off into the woods. But if you do, because many of us do like to explore nature, then hopefully, you remembered to bring along your EPA-registered repellent, all right? And so you can find out what those are on the EPA’s website, CDC’s website. Make sure you use one of those EPA-registered repellents so you make sure that you know you’re using repellent that people—that researchers, scientists have tested and made sure that they actually are effective against ticks. But you use that. And then also, when you’re out there in the habitats, you want to make sure that—once in a while, check yourself for ticks because the sooner you stop a tick from feeding on you, the sooner—the less likely it’s going to be transmitting any infectious agent if it were infected.

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JEAN TSAO: The CDC recommends that you should actually shower or bathe within 2 hours of coming home. That’s because you’ve taken off your clothes. You’re then able to better inspect your body. Also, what you can do is to take your clothes and put them in the dryer and dry your clothes at high heat for 10 minutes. This is so that any ticks that are just traveling along on your clothes—any hitchhikers—they can be exposed to this high heat and die. All right? Ticks are very prone to drying out, and so the high heat is what’s important. Don’t wash the clothes and then dry them. Directly dry them.

[0:06:31]

JEAN TSAO: What you’ll want to do is you want to grab the tick with the pointy tweezers at the closest point of contact to your skin. Pull straight out, put that tick in a vial or in a Ziploc bag, and then clean the area where the tick just bit you. So, if you can, soap and water—if not, some antiseptic—all right?—because you don’t want a secondary bacterial infection.

But then what you’ll want to do once you’ve done that is turn back towards the tick in your container. And what you want to do is obviously seal it and then label it. And label it with the date, label it with the location where you think you picked the tick up, and you can just freeze that tick away, and then you’ll have that tick in case you start feeling sick. You can bring it to see—when you go to the—your health care provider because what species that is, what life stage that is has so much information in there that can be helpful to your health care provider for thinking about what kind of disease you may have and so what kind of diagnostic tests they can order and what kind of drugs and regimen then to apply to help you get better.

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JEAN TSAO: Yes, it is. And so, you can use pesticides that you can purchase from a garden—home and garden type stores. You can also contract with pest control operators, licensed pest control operators. But certainly, you can use pesticides that can be applied at the right time of year for just a short amount of time of year to be able to then kill the ticks that might be on your property.

Otherwise, what you can do is manage the landscaping—all right?—and how you have certain—where you have placed certain objects in your yard so that you can reduce the available habitat for the ticks, as well as reduce the habitat for the small mammals, birds and large mammals that would potentially be bringing ticks into your yard. So, brush piles—instead of having them right near the house and where mice will then come to, push them to the edge. Also, your leaves that you’re composting—push them to the edge. And bird feeders, you know, attract birds but also small mammals. Again, put them a little bit further out such that you can enjoy watching all these critters but that they’re not necessarily bringing ticks closer to your house where you may be spending more time.

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JEAN TSAO: I don’t want people to be scared of nature. There are so many studies that have shown that being outside, whether it’s just outside, you know, in your backyard, sitting there watching the birds, the trees, or actively taking a hike or going kayaking, etc.—you know, it’s so important to be outside. But what I do want to say is that—just be prepared. Take some preventive measures. They take a little planning in the beginning when you’re not used to thinking about ticks. But as one can see, it’s really not that much extra work.

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JEAN TSAO: It serves two functions. The first function, for us—it’s a research app. We’re interested in finding out from the community what kind of tick risk they are subjected to, but also importantly, what kind of tick prevention measures people do or they don’t do because we know what some of the measures should be. But we’d like to know what people are willing to do or not so willing to do so that we can try to come up in the future with other methods that will hopefully nudge people into using some of these adoption measures or perhaps finding new ways to make it more easy for people to prevent ticks from contacting them. That’s No. 1—so: research app.

The second part is it’s a great outreach tool. And we hope people will use it because there’s so much information online about ticks, and we just think that there is—we can collate all that information into—reliable information—to one place such that if you want to know what kind of species of ticks you may be encountering, how to prevent ticks, what to do if you contact a tick, all that information is on the app.

And then very, I think, importantly and useful for the person who’s using the app is that if you do contact a tick, when you remove it, after you’ve cleaned yourself up from the tick, what you can do is take a picture of that tick and upload it to the website, and then an expert will be able to identify that tick, the life stage, probably a little—how long it’s been feeding on you and then return all that information to you such that you can use that information to help decide whether you think you should see a health care provider, or if you don’t feel sick that later on if you do feel sick, actually, then if you see a health care provider, then you’ll have this information to help inform what the diagnosis and treatment might be, since every tick carries a different pathogen.