More Resources Are Needed To Mitigate East End’s Enduring Tick Problem

A special working group in the U.S. Department of Health and Human Services, which focuses on tick-borne diseases, submitted its first report to Congress in November, and it calls for more federal funding and resources to combat tick-borne diseases year-round.

Calling it a “serious public health problem,” the department’s Tick-Borne Disease Working Group recommends, among other things, additional outreach efforts and research for better diagnostic testing and treatment.

The department notes that Lyme disease is the most common tick-borne disease—the Centers for Disease Control and Prevention say there are more than 300,000 new cases diagnosed each year—but there are at least 20 different infections that are transmitted by ticks in the United States.

The Tick-Borne Disease Working Group was formed by the U.S. Department of Health and Human Services in 2016, and it will issue a report every two years after this initial report.

In Suffolk County, government officials and medical specialists agree with the Working Group report that more needs to be done. The county has one of the highest numbers of tick-borne disease cases in the state, Lyme disease being the most common, and there are presently no vaccines available and only inconclusive diagnostic testing.

To worsen the problem, the Asian longhorned tick was recently discovered for the first time in Suffolk County, according to Scott Campbell, the laboratory chief of the Arthropod-Borne Disease Laboratory at the Suffolk County Department of Health Services.

His lab found two specimens of the tick in central Suffolk County near the South Shore in August, but he and his team are unsure of its potential health risk and to what degree the tick is present in the region.

“It is unquestionable that additional support is needed for what is now an epidemic in Suffolk County and on Long Island,” said Suffolk County Legislator Bridget Fleming, who represents the South Fork. “There are very few people in my community who don’t know someone badly impacted by these terrible diseases.”

Suffolk County reported 523 cases of Lyme disease and 226 cases of other tick-borne diseases, including anaplasmosis, babesiosis and ehrlichiosis, in 2017, according to the State Department of Health. Those numbers were lower than the county’s previous three years, yet still were the third-highest in the state, according to the report.

In August, for the first time in five years, U.S. Senate Minority Leader Chuck Schumer secured an additional $1.3 million in federal funding for New York State, bringing the total to $12 million for fiscal year 2019. The money will be used for more research into vector-borne pathogens.

Ms. Fleming said that her office will follow up with Mr. Schumer regarding the funding boost. She sponsored legislation to reinstate the Suffolk County Tick Control Advisory Committee in 2016, which guides tick surveillance and control efforts with other departments within the county.

One of the biggest obstacles to treating tick-borne diseases, as the Working Group report points out, is the lack of adequate diagnostic testing.

People exposed to a tick bite must wait about four weeks to be able to test positive for Lyme disease though the two-tier blood test, the only diagnostic test currently available. But if they were already treated with antibiotics prior to that, test results will come back negative regardless of whether they still have it or not, according to Anna-Marie Wellins, a nurse practitioner in Sag Harbor and a Stony Brook University nursing professor.

And while most cases of Lyme disease can be treated early, some patients sustain lingering symptoms and get what is sometimes called “chronic Lyme disease,” but properly known as Post-Treatment Lyme Disease Syndrome, according to Ms. Wellins. She published a review article in 2017 titled “Tick-Borne Diseases: Identification, Management and Prevention.”

Ms. Wellins is currently helping with research for rapid testing, but she explained that it will take a few more years before being ready for FDA approval.

“There is still no early test, because the organism that causes Lyme disease is a spirochete. It doesn’t stay in blood very long and then goes into tissues,” Ms. Wellins said. “There is a type of culture that can be done, but it is not accurate.”

Diagnosing Lyme disease is further complicated because its symptoms are very similar to those of other illnesses. Symptoms differ among each person but can include flu-like symptoms like fever, headache, chills, visual changes, and muscle, joint and neck pains, as well as the bull’s-eye rash that sometimes appears around the tick bite.

“We can’t be 100 percent sure if patients have it or not. That’s where more direct testing comes in, to say conclusively if they have Lyme disease,” said Rebecca Young, the “Help Line” nurse for the Stony Brook Southampton Hospital’s Tick Resource Center.

Ms. Fleming said that she would support an effort to make testing better and more available for all tick-borne diseases.

In addition to diagnostic studies, Ms. Young said that Stony Brook University researchers are conducting tick-borne disease vaccine trials as well.

The recent arrival of the Asian longhorned tick has Mr. Campbell and his team now focusing on a fourth species of tick that poses a potential health risk in Suffolk County. The three other species are the blacklegged tick, also known as the deer tick, the American dog tick, and the Lone Star tick.

Mr. Campbell, whose lab conducts tick and pathogen surveillance throughout the county, said that they plan to look more in depth in the spring of next year for the presence of this new tick species.

“The good thing is, it appears to be a tick that won’t readily bite humans,” he said of the Asian longhorned tick. “It does, but not in large numbers. It prefers farm animals and wild mammals as opposed to humans.”

Since the Asian longhorned tick was discovered in the United States in 2017, there have been no reported cases of illness in humans or animals, according to Mr. Campbell. He added that the CDC and other groups are currently exploring if this tick is capable of transmitting pathogens.

In terms of public awareness and education efforts for tick-borne diseases, the hospital’s Tick Resource Center continues to host community programs and medical provider informational sessions throughout the year.

Ms. Wellins, a member of the center’s advisory board, said that they recently held an event at the Hampton Bays Public Library as well as a symposium for the medical community in September at the Stony Brook University Southampton campus, but more events are held during the summer when ticks are more active.