Tiny, Ubiquitous, Thirsty for Blood

The most dangerous things in the woods are the villains you can barely see
Ticks that harbor a handful of illnesses may barely be noticed due to their small size. The most prevalent this year so far has been the lone star type, which can bring on an allergy to red meat. Christina Perez/East End Tick Control

    Eastern Long Island is one of the most hospitable habitats in the country for ticks, according to the Centers for Disease Control, and these tiny eight-legged creatures wreak havoc on the lives of hundreds of residents and visitors each year.
    Suffolk County’s reported cases of tick-related diseases in 2011, the most recent available, according to Lauren Barlow, a public health nurse epidemiologist for the county, included 656 probable cases of Lyme disease, 206 of babesiosis, 29 of anaplasmosis, 20 of ehrlichiosis, and 2 of Rocky Mountain spotted fever, all of which can be life altering or even fatal.
    In recent years, people have begun to report a new complication caused by the bite of infected lone star ticks — a severe allergy to red meat, causing difficulty breathing, severe abdominal and chest paint, or loss of consciousness, symptoms that appear three to six hours after eating.
    The allergy, first identified in 2009 by researchers at the University of Virginia, may have been affecting people on the East End for years, but those who developed it often had no clue as to its cause. Patrick Milazzo, a Sag Harbor police officer, is one of them. He had his first allergic reaction in August of 2009 not long after being bitten by tiny nymph ticks in Northwest Woods and a few hours after finishing dinner.
    His second attack six months later, after having a gyro, sent him to the hospital. He felt an intense pressure on his chest and his throat began to close, making it difficult to breath. The hospital had no idea what it was, he said, and it was only much later after seeing Dr. Erin McGintee, an allergist with ENT and Allergy Associates in East Hampton, that he learned that the fatty content in the lamb had triggered the reaction.
    People who develop the allergy do not experience symptoms each time they eat red meat, Dr. McGintee explained in an article for her practice’s quarterly magazine last spring. The more red meat they eat and the higher its fat content, the more likely it is to trigger a reaction. Some patients lose the allergy over time, she said, but if they are bitten again by an infected lone star tick, it can be reactivated.
    Dr. McGintee now has 69 patients with the allergy and diagnoses a few new cases every month, she said in an e-mail on Monday. Nationwide, the majority of cases are in the Southeast, but as the lone star tick becomes more prevalent on the East End, so do the number of tick-related meat allergies, Dr. McGintee wrote in her article.
    Along with a doctor from the University of Virginia, she is collecting data from three different “patient populations” with the allergy — here, in Virginia, and in North Carolina.
    Locally, the lone star tick is now more common than all other ticks, according to Dan Gilrein, an entomologist with the Cornell Cooperative Extension. It can also carry ehrlichia, a bacterial pathogen that causes fevers, aches, and kidney and lung damage, according to New York State Department of Health. As with deer ticks, lone star ticks range from poppy seed to sesame seed size during their life cycle. The adult female has a white dot on her back.
    Lyme disease, a bacterial infection transmitted by the deer tick, is more familiar to New Yorkers, with 95,000 cases diagnosed in New York State since the illness became reportable in 1986, according to the State Department of Health. It affects the skin and nervous system and can spread to the joints, heart, and the brain if not caught and treated early. Deer ticks also transmit babesiosis and anaplasmosis, also known as human granulocytic ehrlichiosis.
    According to the Health Department, 4,000 Americans will be infected with the babesie parasite this year. Babesiosis can cause fever, fatigue, and anemia for days to months, according to the department, and can have severe results for the elderly or immuno-compromised.
    On the East Coast, children exposed to pets or tick habitats are the ones most often infected with Rocky Mountain spotted fever. Carried mostly by the dog tick, it can be identified by a rapidly spreading rash as well as other symptoms common to tick-borne diseases. Most of the country’s cases of Rocky Mountain spotted fever occur on Long Island.
    It’s enough to make you want to stay inside all summer, but there are ways to minimize the risk of being bitten and not everyone bitten by a tick becomes infected with the many illnesses they carry.
    In a release sent earlier this month, State Assemblyman Fred W. Thiele Jr. encouraged his constituents to learn the facts and take precautions: Wear long-sleeve shirts and long pants tucked into socks when in wooded or grassy areas. Wear light-colored clothing so ticks will stand out.
    In most cases, according to the State Health Department, the tick must be attached for 36 hours or more before the bacteria can be transmitted, so regular checks of people and pets are essential, with particular attention to the backs of knees, behind the ears, the scalp, and backside. Proper removal is also essential to reduce chance of infection. Tweezers are recommended to “pull the tick in a steady, upward motion away from the skin, without jerking or twisting the body,” which can increase chance for infection. The bite area and hands should then be disinfected and the tick placed in a small container of rubbing alcohol.
    Not all ticks are infected with disease-causing bacteria. Those that are contract the disease from creatures they feed on, such as mice, chipmunks, deer, and birds.
    Although spray repellants can keep ticks from biting you, there are health risks associated with exposure to some of these repellants or improper application, the State Health Department warns.
    Products containing permethrin, for example, will kill ticks and insects that come in contact with it, but are for use on clothing only, not on skin, the state  says. Some people used geranium, cedar, lemongrass, soy, or citronella oil to repel ticks, “but there is limited information on their effectiveness and toxicity,” according to the department’s Web site.
    Brian Kelly of East End Tick Control has made a business out of dealing with ticks, and has plenty of tips to share. “In order to decrease the risk of tick-related illness, maintain a clean trimmed lawn, cut back branches to let in more sunlight, and consider sprays, natural or conventional, and collars to prevent ticks being carried into the home by animals,” he said. The Health Department Web site also suggests clearing brush, leaf litter, and tall grass from around the house, stacking woodpiles away from the house and off the ground, and keeping the ground under bird feeders clean to avoid attracting small animals that can carry ticks.
    For those with children, the state suggests putting swing sets and other play equipment in sunny, dry areas of the yard, away from the woods.
    And it recommends that people in especially tick-prone areas consider “an approved insecticide once a year, in June.”
    When Mr. Kelly is called to analyze and treat a property he first uses a procedure called “flagging” — dragging a white sheet along the bushes and tall grass to learn the density and types of ticks he is dealing with. His recommendations usually include monthly ground spraying of a synthetic chemical related to the chrysanthemum called Astro permethrin. Although sprayed areas are said to be safe for human activity within 15 minutes, he warned that permethrin will also kill good insects, such as bees and butterflies. And, according to the Environmental Protection Agency’s permethrin fact sheet, the chemical is also “highly toxic to freshwater and estuarine aquatic organisms.”
    Mr. Kelly tries to confine spraying to areas underneath decks and near woodpiles and stone walls, where mice and chipmunks congregate. There is no need to spray higher than 18 inches above ground, he said, and “spraying in the middle of the lawn would not be good for anyone.”
    He also uses Damminix in areas where mice and chipmunks hang out. The cardboard tubes are stuffed with the chemical-soaked cotton. The animals use it to make nests and it kills ticks in the process. Another nonchemical method that can help, he said, is to put up backyard boxes to attract screech owls, which feed on mice, or keep guinea hens, which eat ticks.
    Barbara Ferichs, the owner of All Natural Tick Solutions in Sag Harbor, said that a garlic-based spray certified for use on organic farms is just as effective as permethrin, but a little more expensive because it requires bi-monthly applications. 
    On Shelter Island, permethrin is applied topically to deer in 14 locations by a town-funded program involving units called four-posters, baited with corn. The chemical is applied to their necks via rollers as the deer eat.
    “Our work showed the four-poster does dramatically bring down tick populations over time in areas where it is used,” Dan Gilrein said in a recent e-mail, a conclusion that he said is based on data from sheet drags in their proximity. But there are questions about the impacts to groundwater and to the meat of deer that have come in contact with permethrin.
    Richard Kelly, a Shelter Island resident who has spent a great deal of his own time and money investigating the program, helped pay for a soil test of an area surrounding a unit. The results, he said, showed an “off the charts” concentration of the chemical in the soil beneath the unit, and significant concentrations 100 yards from it, both of them higher than the EPA safety levels for permethrin in soil. “It washed off with the rain,” he said, “and rolled downhill.”
    A hunter himself, Mr. Kelly said he took several deer organ and tissue samples to the Long Island Analytical Laboratories, where tests, he said, revealed permethrin in the deer’s tissue at a concentration “way over the threshold” used by the United States Department of Agriculture for cattle and pigs.
    “The four-poster thing is a joke,” Jack Reiser, a former North Haven Village mayor and member of the village’s deer management committee said earlier this month. The possibility of four-posters in the village, known for one of the highest incidences of ticks on the South Fork, was presented to its trustees a few weeks ago. Out of 11 members of the deer management committee, he said, “there wasn’t one of us that wanted it.” The cost of the four-poster program, Mr. Reiser said, with the physical structure, maintenance, corn, and technicians, “would easily be a half million dollars every year.”
    “We have a huge problem with Lyme disease,” Mr. Reiser said, but a combination approach is necessary, including deer birth control and reduction of the herd, which would also help reduce the number of car-deer collisions, he said.