Dr. Maria Diuk-Wasser: Ticks and tick-borne diseases

[0:00:19]

MARIA DIUK-WASSER: Hi, my name is Maria Diuk-Wasser. I’m a professor in the Department of Ecology, Evolution and Environmental Biology at Columbia University, and I study the epidemiology of ticks and the diseases they transmit. So I try to understand which ticks transmit diseases and how people can get infected and how we can prevent it as well.

[0:00:47]

MARIA DIUK-WASSER: So, there’s actually a total of 15 different tick-borne diseases, but of course, not all of them are very common or present in all areas in the U.S. So, the most important one most people heard about is Lyme disease. So that’s transmitted by the deer tick, and there’s also two other diseases transmitted by this tick, which are babesiosis and anaplasmosis, that are also on the rise. They’re not as common as Lyme disease, but they’re also present in the same areas. So, the areas this deer tick exists in are mostly the Northeast quarter of the country, so the North, especially the New England and New York and the Upper Midwest area, but they’ve been also expanding like into Ohio, so basically filling up like that upper northeast corner. So, those are the areas of more risk for this disease. And there’s other diseases transmitted by a tick called the lone star tick, which is called like that because has a star as a circle in the back. And this tick transmits several diseases. One is called ehrlichiosis, and it’s quite known now because it transmits a red meat allergy, or the Alpha-gal. So that has been increasing significantly. It is now estimated that there’s like 100,000 cases or so. So now it’s being reported, and we’re finding out it’s more common than we thought. So those are the main two. And the lone star tick actually is more of a southern tick. So, most of the southern areas are where the lone star tick is present, up to Long Island, parts of New York, and New Jersey; it’s kind of a northern limit.

[0:02:29]

MARIA DIUK-WASSER: Yeah, so I would say most ticks are expanding. So the Lyme disease tick, the deer tick, is expanding by now more into Canada because it’s just reached most of that area in the U.S., and it’s also expanding south into Virginia, West Virginia, as well. So we in—and then the lone star tick has been expanding north. We think originally it was actually present in many areas, but you don’t find it in the north as much, but we’re finding it more and more further north as well.

[0:03:07]

MARIA DIUK-WASSER: So, there’s a number of reasons we definitely think climate change is playing a role, although sometimes it’s hard to know exactly what the role is. But for deer ticks, we know that Canada is kind of the limit of the distribution. It can get too cold in Canada for the ticks to complete their life cycle. So, we know that that there’s definitely an expansion north into Canada for sure. Then if there’s other reasons so climate also would, would increase this expansion into Canada and also increase the timeline, so the ticks can be active year-round now, instead of just during the summer months that it used to be more common. So, you can get a tick in the middle of the winter, so expanding the space and also the time where the ticks are active and biting. Same with a lone star tick. We think it’s definitely the climate change that might be facilitating its spread north.

[0:04:05]

MARIA DIUK-WASSER: So basically, if you are in this—what we call endemic area, where the deer tick is present—any place that has forested deciduous forest, like oaks, and you know, other trees like that, is suitable for ticks. And most likely, there will be ticks there. In most of this region, the ticks need a lot of humidity, especially the deer tick. So, it needs this leaf litter to exist, to survive, and so those are areas where people doing outdoor activities might get exposed. So that could be in your own backyard, so if you live next to a forested area, or it could be when you travel, hiking, you know, anywhere in the Northeast, basically, and the upper Midwest. It’s a little bit different for the lone star tick, for example, because it does live more in, like, grassy areas or not, not necessarily forest. So, the habitats are a little more general. And also, of course, it’s more common as well in the South. So, but kind of same thing. If you go to an area where there’s tall grasses and you become in contact with that, there’s ticks kind of everywhere in the South.

[0:05:10]

MARIA DIUK-WASSER: Your risk of getting a tick bite, basically, will depend on those through three things, right? And so if you live in a very urban area, let’s say in Manhattan, right? There’s no black-legged ticks or deer ticks in Manhattan, at least, we haven’t found any or extremely rare. So all of your risk there is because you travel, right? You travel to some coastal area or New England area, and that’s all your risk. Now, as you move into more and more vegetated areas, for example, in Long Island, in some areas of Long Island, there’s going to be parks that are very connected, you know, so there’s wildlife there, and deer, and so you can get infected by visiting those parks, or the deer can come to your backyard and drop ticks there. So falls in your backyard there. And as you move to areas that are like Connecticut, New York, or even eastern Long Island, people will have a lot of ticks in their own backyard. So your risk will depend, really, on the type of area you live in and what your activities are.

[0:06:12]

MARIA DIUK-WASSER: So actually, there is one in the works. Good news. It’s scheduled to come up maybe in a couple of years. So, the reason, I mean, there used to be a vaccine, but it was taken off the market because of poor sales. So, there were just some side effects or where people perceived they had them, so they were the sales kind of dropped and it was taken off the market. That was about 20 years ago. So since then, we have been, you know, getting ready for a new vaccine, but it hasn’t happened yet. But hopefully there’s one coming, coming up soon.

[0:06:50]

MARIA DIUK-WASSER: So, there’s different levels of precaution. Basically, if this area is your own backyard, basically where a lot of people get their ticks while they’re doing gardening or, you know, activities in the yard. So, if that’s the case, you want to make sure that your yard, you know, if there’s forested area, you want to keep a barrier like it could be stones or wood chips. And you want to stay in the grass and away from the forest. So, most of the chicks will only survive next to the forested area, maybe a meter away, but if it’s in the middle of the grass and it’s really sunny, it’s pretty safe. So, you can also spray for ticks around your yard. And there’s also some methods that are targeted to the animals. So, you kind of treat the animals with the where the pesticide that killed ticks. So that’s in your own home. Now, if your risk comes more from your travel or your hiking, you want to make sure you protect yourself, individual protection that you can also use in your yard. So, you want to wear long pants and long socks. Ideally tuck your pant in your socks. And you want to spray these with a product that’s called permethrin, that you typically kind of have to order it, and that product, you spray it the day before, not on you, and so it dries in your clothes, and it stays in the fabric, so it protects you from tick bites. So, it’s really effective, because it takes on contact and then your exposed areas, you would spray with DEET, like the same you use for mosquitoes, basically. So that combination is really the best. And then when you come home, you want to shower in case they’re still crawling, and then check for ticks very carefully.

[0:08:33]

MARIA DIUK-WASSER: So, we want to check every night, because the ticks will be—so the deer tick for example—transmits the bacteria takes a couple of days. So, if you check every night, it’s best. You want to keep checking though the following night, sometimes you missed it, and you can see it as it becomes bigger, as it takes blood. And so you want to check all your body. We say, check your crevices. They like humid area, so make sure, like you have, you know, you check very carefully, and the whole body, basically. And then if you find it, you grab some tweezers and you know, you pull them from the mouth, part that touches your skin, and pull them right up. And you can, I mean, you can throw it away, if you are so inclined, you can keep it just in case you develop some symptoms. And there’s some places where you can send it to have it tested. But I would say, you know, at least maybe you want to keep it in an alcohol or some container like that, and then watch for symptoms, basically. Make sure you don’t get a rash. So, you can also go to the doctors, and doctors will give you doxycycline, the antibiotic, just preventative. Or you can just wait and see. So, if you get the rash, the bullseye rash, or you get fever or any symptoms, go to the doctor and get the treatment.

[0:09:45]

MARIA DIUK-WASSER: It’s a smartphone app that Columbia University and University of Wisconsin and other collaborators we created in 2018. And so it’s a free app, you can download it, and then it has a lot of information on ticks and prevention. It also if you find a tick, you can send a picture, and we can tell you what kind of tick is, what we think, how long it might be—might be on you. So, you can both inform yourself and also contribute to the research, because we are trying to understand where people are encountering the ticks more often. So, it’s basically a citizen science type of project, plus highly educational and a practical tool for people to protect themselves.

[0:10:41]

MARIA DIUK-WASSER: Basically, I always like to say, you know you want to—you don’t want this to keep you indoors. And the outdoors are known to have so many health benefits, green spaces for mood, for mental health, for physical health, so make sure you go outdoors. But knowledge is power. So, you want to be informed. You want to know how to protect yourself and be aware of tick bites. So that combination, I think it’s the safest to stay happy and also stay protected.