They
can wait for months, clinging to the edge of a blade of grass or a bush, for the
whiff of an animal's breath or vibration telling them a host approaches.
They
are ticks—and when they attach to your skin and feed on your blood over many
days, they can transmit diseases. Often hard to diagnose and tricky to treat,
tick-borne illnesses—led by Lyme disease—can cause symptoms ranging from
headache and muscle aches, to serious and long-term complications that affect
the brain, joints, heart, nerves and muscles. Preventing bites to head off
illness is particularly important, experts say, because the complex interaction
between ticks, their hosts, bacteria and habitats isn't completely
understood.
Warmer
temperatures are leading some experts to warn that tick activity is starting
earlier than usual this year, putting more people at risk.
"This
is going to be a horrific season, especially for Lyme," says Leo J. Shea III, a
clinical assistant professor at the Rusk Institute of Rehabilitation Medicine,
part of New York University Langone Medical Center. He is also president of the
International Lyme and Associated Diseases Society.
Lyme
may be identified after a tick bite, for example, by an expanding rash that
looks like a bull's-eye. But that doesn't always happen, and even after a tick
bite, antibodies against Lyme may not show up for weeks, so early blood tests
can turn up false negatives. Symptoms such as fatigue, chills, fever, headache
and swollen lymph nodes may be misdiagnosed. Some infections can go undetected
for months or even years. When caught early, tick-borne diseases can be treated
successfully with two weeks of antibiotics, but doctors and researchers still
argue about whether a chronic form of Lyme exists, and whether it should be
treated with longer courses of the drugs.
To Fight Ticks
Between
1992 and 2010, reported cases of Lyme doubled, to nearly 23,000, and there were
another 7,600 probable cases in 2010, according to the Centers for Disease
Control and Prevention. But CDC officials say the true incidence of Lyme may be
three times higher. Other infections, including babesiosis, Rocky Mountain
spotted fever, and anaplasmosis are steadily increasing, too. While not all
ticks carry disease, some may spread two or three types of infections in a
single bite.
Researchers
say the primary reasons for the global rise of tick-borne illness include the
movement of people into areas where animal hosts and tick populations are
abundant, and growth in the population of animals that carry ticks, including
deer, squirrels and mice.
"We
haven't even begun to scratch the surface of the type of pathogens ticks can be
harboring and transmitting," says Kristy K. Bradley, state epidemiologist and
public health veterinarian for the Oklahoma State Department of Health.
Animals
"are a traveling tick parade," Dr. Bradley adds, with pet dogs "bringing them
into the home and onto furniture and carpets."
Regularly
checking the body for ticks can reduce exposure, because removing them quickly
can prevent transmission of disease, says Kirby C. Stafford III, chief
entomologist at the Connecticut Agricultural Experiment Station, or CAES, in New
Haven.
Showering
or bathing quickly after being outdoors can also help wash off crawling ticks or
make it easier to find them. What won't work: simply jumping in the pool or
lake, because ticks can hide in bathing suits and don't quickly drown in water.
There are tick-repellent sprays for clothes, but it is wise to immediately
launder and dry garments at high temperatures after hiking or golfing in areas
where ticks are present.
The
CDC is conducting the first study of its kind to determine whether spraying the
yard for ticks can not only kill pests, but also reduce human disease.
Participating households agreed to be randomly assigned a single spray with a
common pesticide, bifenthrin, or one that contained water, without knowing which
they would receive.
Paul
Mead, chief of epidemiology and surveillance activity at CDC's bacterial-illness
branch, says preliminary results from about 1,500 households indicate that a
spray reduced the tick population by 60%.
"But
there was far less of a reduction in tick encounters and illness," indicating
that even a sharp drop in tick populations leaves infected ones behind. "We may
have to completely wipe out ticks to get an effect on human illness," he
says. The CDC is enrolling
households for a second arm of the
study and expects final results late in the fall. Organic repellents such as
Alaska cedar are also being tested in other studies.
Sometimes
fire is the only solution: Wildlife biologist Scott C. Williams roams
Connecticut's woods armed with a propane torch to incinerate clumps of Japanese
barberry, an invasive plant species that chokes off native vegetation and
provides a favorite habitat for ticks.
The
CAES program to control the red-berried shrub—once cultivated as decorative—is
part of the growing, multifaceted effort around the country to prevent the
spread of infections like Lyme, which Dr. Williams has been treated for twice
since beginning the project in 2007.
Dr.
Bradley's home state of Oklahoma is one of several working with the One Health
Initiative, a global program to improve communication between physicians and
veterinarians to prevent the spread of infectious disease from animals to
people, such as recommending tick collars, sprays or topical treatments with
pesticides for dogs.
One
problem, says Laura Kahn, a founder of One Health, is that "vets don't like to
advise people on human health and physicians don't typically think about these
things, so it falls through the cracks." About 75% of new diseases that have
emerged globally in the last 30 years are spread from animals to people, many of
them through ticks, says Dr. Kahn, who is also a science-and-global-security
researcher at Princeton University.
Jason
Lipsett, 21 years old, was diagnosed with Lyme in November, after suffering for
three years with symptoms including problems with his jaw, recurring sinus
infections, migraines and trouble sleeping. He had to give up playing tennis and
take a medical leave from Bentley University in Waltham Mass., where he was a
senior. He doesn't remember being bitten by a tick but had been camping in the
woods in New Hampshire and often spent time outdoors during the summers at a
family home in Cape Cod.
Doctors
told him he might have chronic fatigue syndrome or fibromyalgia. Depressed about
his health, he began seeing a therapist who knew about the symptoms of Lyme and
referred him to another physician. That doctor determined he had Lyme—and
babesiosis, caused by a parasite that destroys red blood cells.
Mr.
Lipsett has been on an antibiotic regimen for four months. He says he has felt
better each month and that he is prepared to stay on the drugs until he and his
doctor are confident the disease is under control. He is making up courses and
hopes to graduate next year. He plans to participate in a 5K run on April 29 to
raise money for Time for Lyme, a Stamford, Conn. nonprofit that supports
research into Lyme and other tick-borne illnesses.
"I
may not be able to run, but I'm going to try to walk it," he says.
Write to Laura Landro at laura.landro@wsj.com
A version of this article appeared Mar. 27, 2012, on page
D1 in some U.S. editions of The Wall Street Journal, with the headline: This
Season's Ticking Bomb.
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