Using Education And Prevention to Stop Tick-Borne Diseases

Media coverage and conversations surrounding the Zika mosquito virus have diverted attention away from the ever-present reality of Lyme and associated tick-borne diseases (TBDs). While it is prudent to prepare for the inevitable spread of the Zika virus in select geographic areas of our country (being ever mindful of already established eastern equine encephalitis and West Nile virus), we must acknowledge that TBDs are not only present and endemic in many parts of the United States, but are increasing at an alarming rate.

While the fall months are not peak for the actual transmission of Lyme disease, fall is the peak season for the adult deer tick in many areas of the country. As busy families settle in with back-to-school activities and enjoy the upcoming holiday season, it is easy to see how communities can overlook what many believe to be a summer phenomenon.

In November 2015, Dr. Tom Mather, director of the University of Rhode Island TickEncounter Resource Center, and I spent about an hour walking the perimeter of a typical lawn-woods interface here in Southern Maine. It was a beautiful fall day, temperatures in the mid 50s. Most of the beautiful fall foliage that had dressed our landscape only a month earlier was now scattered on the ground. Mather and I covered a distance of about 300 yards, sampling 10-15 feet into the wooded edge. After 68 minutes, our tally was 125 adult deer ticks — 68 female and 57 male.

Following our session, I asked Mather whether or not we would collect additional ticks if we re-visited the same area a day or two later. He replied that the ticks we gathered that day represented only 20% of the actual number of ticks present in that immediate area and that questing ticks usually vary their activity dependent on the micro-climate conditions at any given time. Prolonged dry conditions yield fewer questing ticks, as deer ticks require high humidity and often retreat to moist areas in order to survive.

An interesting note on our collection method. While many people who sample for ticks employ the flagging and/or dragging method with a cloth, our collection method consisted simply of “eyeballing” the ticks in their questing position. Within minutes of reaching the wooded edge, Mather said, “See those three ticks?” I strained to see what he was looking at, but saw nothing. Bending down and using a pair of fine-pointed tweezers, Mather carefully collected each specimen and placed it in a plastic vial. The man possesses amazing eyesight! He was responsible for collecting 120 of the 125 ticks that we gathered that afternoon. Mather and his team typically gather 13,000-15,000 ticks per year for research purposes using this method.

MORE TICKS IN MORE PLACES. There are more ticks in more places yielding more tick encounters. Among tick-borne diseases, Lyme disease is the most frequently reported vector-borne illness in the United States and it is on the rise. In some areas of the United States, as many as 40-70% of blacklegged ticks are infected with the Borrelia burgdorferi bacteria. While Lyme disease is endemic in the Northeast and Upper Midwest states, other tick-borne diseases, including Babesiosis, Ehrlichiosis, Rocky Mountain Spotted Fever and Anaplasmosis are also prevalent in these and other parts of the United States.

The vectors of B. burgdorferi and other disease agents now have been identified in a total of 1,531 (49.2%) counties spread across 43 states. This marks a 44.7% increase in the number of counties that have recorded the presence of these ticks since the previous map was presented in 1998, when 1,058 counties in 41 states reported the ticks to be present. Notably, the number of counties in which I. scapularis is considered established (six or more individuals or one or more life stages identified in a single year) has more than doubled since the previous national distribution map was published nearly two decades ago.¹

THE PROBLEM. Reported cases of Lyme disease usually average around 30,000 each year. In 2013, the CDC confirmed that figure is likely only 10% of the actual number of people infected each year. Those 300,000+ cases impose an ever increasing personal and financial burden on our friends and neighbors. Direct medical costs for Lyme disease alone are estimated at $0.7 to $1.3 billion annually ($3,000 per patient average), and along with associated overall indirect costs, the public health burden just for Lyme disease may be three times higher.2 As the number of cases increases, the future personal and economic impact of Lyme disease is likely to increase. At a recent Tick IPM symposium in Washington, D.C., the CDC predicted the estimated 2026 costs to be $8.3 billion.

WHO’S AT RISK? Anyone spending time outdoors in proximity to tick habitat is at risk, including children playing in the yard, homeowners gardening or raking leaves, hunters, fishermen and your furry companion animals.

According to the CDC, 75% of Lyme disease cases are contracted within 100 feet of the home. So you need not be hiking the Appalachian Trail to pick up a tick.

The highest incidence of Lyme disease is among children ages 5-14 (see related chart). As parents, there is nothing we wouldn’t do to protect the health and well-being of our children. Imagine a child dealing with debilitating health issues for their entire lifetime, all the result of an encounter with one tiny tick. Of the total cases of Lyme disease each year, approximately 37 percent are children, according to the Lyme Disease Association.

In the Northeast and Upper Midwest, children, often barefoot and dressed in shorts, are especially vulnerable to Lyme and other tick-borne diseases during the months of May, June and July (peak for nymphal deer tick activity). They roll in the leaves, build forts, chase balls into the woods, run through tall grass, with many interacting with companion animals on a daily basis which increase their exposure to ticks.

BEYOND PESTICIDE TREATMENTS. Education and awareness are essential elements in a sound Integrated Pest Management (IPM) strategy, particularly one that reduces future tick encounters for humans and companion animals. This effort must be collaborative in nature among the local pest management professional and the general public, veterinarians, health care professionals, youth groups and municipalities.

IPM strategies should include:

• A thorough understanding of tick biology, species distribution and associated pathogens.
• Acknowledging the impact of recent changes in tick populations that may be attributed to ecological changes and shifts in land use, a healthy deer herd and/or abundant rodent population.
• Improved identification and surveillance of ticks.
• Understanding the 2-year life cycle of deer ticks.

Create a partnership with customers, educating them to:

• Become proactive rather than reactive.
• Identify and avoid tick habitat.
• Properly identify and promptly remove attached ticks.

Provide timely outreach and valuable educational resources to current homeowners, new customers, Lyme support groups, businesses, community groups, youth groups (Boy Scouts, Girl Scouts, American Camping Association, local youth sports teams), healthcare professionals (doctors, school nurses, veterinarians, local hospitals, quick care clinics, sports clinics, etc.), community groups (libraries, adult education, Rotary, Kiwanis, additional fraternal organizations), municipalities and other government agencies.

EDUCATION AND SCIENCE. In late 2004, my brother Ed and I combined a talent for business with a passion for education which led to the formation of Mainely Ticks, with a focus on providing residential tick control while educating the public at large about ticks and tick-borne diseases in Southern Maine. Our mission is protecting people, pets and properties from ticks and tick-borne illnesses with a personal, professional and effective tick management program centered around education and awareness. Our slogan, “Tick Management Through Education and Science,” reflects our commitment to educate first.

Our IPM program began in 2005 with Ed taking on the role of lead customer relations officer and spray technician and me, the teacher, visiting individuals and neighborhoods, while developing and presenting educational workshops to raise the level of tick education and awareness. The first year allowed our team to test the marketing concept behind the education and awareness program along with the science behind our services. The results from that first year-end customer survey were overwhelmingly positive and our two-man company booked revenue of $29,369 for the year (six months). Ten years later, with four full time and four seasonal employees, revenues for the 6-month spray season of 2015 were $463,000, with a healthy 19% year-to-date increase for 2016.

Since inception, increasing the level of education and awareness of ticks and tick-borne diseases has been the highest priority of Mainely Ticks. My wife Barb (who also is an educator) and I have focused our energy and efforts on providing a variety of community-based educational seminars; disseminating information and educational materials to homeowners; building and maintaining our educational website, www.mainelyticks.com; providing content for various newspaper and online articles; and offering occasional commentary for local television and radio interviews.

THE ART OF LEARNING. As a professional educator, I recognized early on that children learn most effectively when they are actively engaged in a “hands-on, minds-on” learning environment that allows them to see relevancy in the materials that are being taught.

As an industrial arts instructor, I witnessed first-hand how important it was for children and young adults to be encouraged to solve problems with their hands as well as their minds. As I transitioned from my role as industrial technology instructor in the classroom to a “residential tick-nology” teacher in the field, I continued to see value in the real world, real-time kinesthetic approach to connecting with and educating my prospective customers.

Within minutes of meeting a new customer at their home, we hand them our educational brochure, tick identification guide and magnified fine-pointed tick removal tweezers. Many who call for our services report a recent tick encounter. Our conversation with the customer allows us the opportunity to review the tick ID guide to identify the species of the attached tick and demonstrate how to properly remove a tick using the tick removal tweezers. We ask that they review the contents of the educational brochure while the site survey is conducted, and once completed, specifics of the quote are reviewed and additional questions answered.

In our fast-paced instant messaging, Facebook society, many have forgotten the value of a face-to-face connection and the feel of quality educational materials and tools. Our hands-on awareness and education program along with the presentation folders and tick removal kits are truly unique.

Tis the season to protect and to prepare…as pest management professionals, our collective efforts to raise the level of awareness on all vector-borne diseases must be proportional to the ever increasing threat. The opportunities to increase both revenue and goodwill have never been better.

When it comes to vector-borne illnesses, prevention is the best prescription!

The author, a retired industrial arts educator of 31 years, is president of Mainely Ticks, and can be contacted at bmaurais@gie.net. For a list of educational resources and tools, many of which can be used in the field by pest management professionals, visit www.mainelyticks.com. Additional educational resources available at www.TickEncounter.org.

References

¹ County-Scale Distribution of Ixodes scapularis and Ixodes pacificus (Acari: Ixodidae) in the Continental United States. Rebecca J. Eisen, Lars Eisen, Charles B. Beard. DOI: http://dx.doi.org/10.1093/jme/tjv237 349-386 First published online: 18 January 2016

² Adrion ER, J Aucott, KW Lemke, JP Weiner. 2015. PloS One. 10:e0116767. Epub 2015/02/05. doi: 10.1371/journal.pone.0116767