
Tiny bugs can spread Lyme disease and other illnesses
How big of a problem will ticks be this year, and what diseases can they spread? Tick expert Saravanan Thangamani, PhD, provides an outlook and tips for avoiding ticks. Thangamani is a professor of microbiology and immunology and the director of Upstate’s Tick Testing Laboratory, which has begun charging a nominal fee for tick analysis.
Transcript
Host Amber Smith: Upstate Medical University in Syracuse, New York, invites you to be The Informed Patient, with the podcast that features experts from Central New York's only academic medical center. I'm your host, Amber Smith.
As tick season gets underway in Upstate and Central New York, I'm turning to professor of microbiology and Immunology Dr. Saravanan Thangamani. He's also the director of Upstate's Tick Testing Laboratory.
Welcome back to "The Informed Patient," Dr. Thangamani.
Saravanan Thangamani, PhD: Thanks for inviting me. I'm happy to share some of the information about our tick testing program and to give an outlook about what kind of ticks we are going to see and how much we are going to see.
Host Amber Smith: That tick testing program has been very popular, and at one point the lab was receiving 120 ticks a day.
Now there's a processing fee, but let's walk through how this works. If someone finds a tick on themselves or their dog in Onondaga County, they can have it tested to see if it carries any pathogens. Where and how do they send it to your lab?
Saravanan Thangamani, PhD: So briefly, when someone encounters a tick, either on themselves or on their pet, or livestock or companion animals, they can pull the tick, as prescribed by the CDC (Centers for Disease Control and Prevention).
There are a lot of videos out there where they actually tell clearly how to pull the tick carefully and then put the tick in a Ziploc bag with a moist tissue paper in it so that it doesn't get dry. And then what they can do is that they can go to our tick testing webpage, www.nyticks.org.
They can go there, they can click "tick submission form," and then it'll take them to a set of questions. Once they complete the questions, the most important information that we are asking them is the date when they encountered the tick and the ZIP code where they encountered the tick -- not where they live, where they encountered the check.
And then once they complete the form, we give them a unique tick ID. And using that ID, they continue to go to the payment portal, and once they pay the fee, they can actually ship the tick to the lab. And in our website we have multiple tabs that clearly tells how to do the tick submission, how to send the ticks, and also tick testing FAQs (frequently asked questions) there.
So for anyone interested in knowing more information about any question about the tick testing program, we have clearly articulated in our website.
Host Amber Smith: At nyticks.org.
Saravanan Thangamani, PhD: Yes, exactly.
Host Amber Smith: Do you treat ticks found in Onondaga County differently than ticks found elsewhere?
Saravanan Thangamani, PhD: Yes, absolutely. We have a collaborative agreement with the Onondaga (County) Department of Health. Through that collaborative agreement, we are providing tick testing at a 50% subsidized fee. So for Onondaga County residents, it doesn't matter where they encounter the tick as long as they're a resident of Onondaga County. We charge them a $37 tick testing fee. For the rest, we are charging them a $75 fee for each tick.
Host Amber Smith: And what pathogens (disease-causing microorganisms) are the ticks tested for?
Saravanan Thangamani, PhD: So we test for 16 different tick-borne pathogens that are most commonly present in the Northeastern United States. That includes Lyme disease agent; Babesia, agent of babesiosis; agent of anaplasma and Powassan virus. We test for bacteria, we test for protozoa, we test for virus as well. So we try to test a broader variety of pathogens that are most commonly present in the Northeastern United States.
Host Amber Smith: And how soon do people get results?
Saravanan Thangamani, PhD: On our website, we say three to five business days upon the receipt of the tick. However, we are trying to return the results within about 48 hours upon the tick receipt.
But most often, sometimes we even send the results on the same day that we receive the tick. It depends on how many ticks are being processed and what time the tick is being delivered to the lab.
Host Amber Smith: So this information could be useful clinically if the person is feeling sick or becomes sick after having found a tick on them. Their health care provider might want this information, right?
Saravanan Thangamani, PhD: Absolutely. So that's what I'm trying to advocate, that tick testing should be considered in conjunction to the human clinical testing or human diagnostic assay.
So when someone encounters a tick, if the tick has any pathogen, it delivers the pathogen to the human, right? And it takes a few days for the pathogen to replicate in it, in the human body, and result in a clinical disease.
It might take a few days for the symptoms to appear, so only then, if you don't have symptoms, you don't visit the doctor.
But what we do in the lab is that as soon as ticks are sent to the lab, we test it, we return the results back to them, so in most cases, before they even actually exhibit symptoms, they have the result in their hand. So if they have an acute febrile illness after a tick bite, and if the tick bite comes with the positive data, that is a valuable information for the clinician now to consider the patient at high risk for the particular agent, and then either diagnose them appropriately or prescribe medications appropriately.
But I must tell a disclaimer here, we are not an FDA (Food and Drug Administration) approved testing program. So that is the thing that is up to the discretion of the clinician to decide: Are they going to take our results seriously or not?
Host Amber Smith: So it at least puts it on their radar of things to consider if the patient is sick, and they know that they were exposed.
Saravanan Thangamani, PhD: You're right. It actually puts them in the radar, and it actually tells the clinician that the person who encountered the tick is now at a higher risk of acquiring a disease caused by that agent.
So we are giving that one additional (piece of) information for the clinician to diagnose the patient.
Host Amber Smith: This is Upstate's "The Informed Patient" podcast. I'm your host, Amber Smith.
I'm talking with professor of microbiology and immunology Dr. Saravanan Thangamani, who is also the director of Upstate's Tick Testing Laboratory.
After you came to Upstate Medical University in 2019, what have you found out about the ticks in this region?
Saravanan Thangamani, PhD: So we started this tick testing program in 2019, and then we paused the program, beginning March 2023. So during that time, we continuously monitored the emergence of ticks and also tick-borne pathogens in New York state.
So our data indicates that one in three ticks encountered by a human carry at least one tick-borne agent, and a good majority of the ticks are co-infected with more than one tick-borne agent. And the Lyme disease agent, Borrelia burgdorferi, is the agent that is most prevalent in the ticks that are collected from or encountered by humans in the state of New York.
A majority of the ticks that we receive are actually deer ticks, followed by dog ticks and lone star ticks. These three are the primary ticks of human health importance in New York state. In addition to that, our lab has received 13 different tick species from New York state that are encountered by humans.
I would say there are two more ticks that are on the horizon that we are continuously monitoring: the Gulf Coast ticks and the Asian longhorned ticks. They are already making their way in the New York City or Tri-State area. And we are actually seeing a pattern in such a way that we might be seeing these ticks here in Central New York very soon.
So by us continuing to monitor, by us continuing to do this tick testing program, I think in the next few years we will actually try to monitor the emergence of tick-borne pathogens in Central New York.
Host Amber Smith: But right now the most common one is the one that carries Lyme disease, right?
Saravanan Thangamani, PhD: Yes. Yes. So depending on the county -- some counties, we see about 50% to 60% of ticks that carry the Lyme disease agent, in some counties only 20%, so depending on the county, we can tell that there is a range of differences. However, I think the kind of program we do, we can actually tell exactly to the neighborhood which neighborhood has the highest risk for ticks that carry the Lyme disease agent. So that information we share with the county health departments. So that's the kind of collaborative partnership we have with Onondaga County, where we share the neighborhood-level data for them to make informed policy decisions for tick control, tick education and other policies that influence human health.
Host Amber Smith: When we spoke with you last year, you predicted a big tick season for 2023. Did that come to pass?
Saravanan Thangamani, PhD: I think based on the anecdotal information that I'm hearing from some of my collaborators in other places, I think they tend to agree what they tended to observe: an increase in the number of ticks in 2023, compared to the prior seasons.
And the trend is going to continue, like an upward trajectory. And in addition to the increase in the number of ticks, ticks are appearing in new geographic areas that never had ticks before. That's another important point I want to drive home, is that it's not just the total number of ticks that are increasing, it's about the ticks appearing in areas that never had ticks before.
Host Amber Smith: I thought that ticks stayed in grassy, brushy, wooded areas, but as their numbers are increasing, are you saying that they're spreading into different territories?
Saravanan Thangamani, PhD: Yes, exactly. So they hitchhike on small mammals, they hitchhike on deer, so wherever the deer migrate, they can actually expand their geographical niche.
And human behavior is also a major driving force. So, for example, if I take my pet to the Adirondacks and then get a tick bite there, and then bring it to Cental New York or bring it to the Syracuse area, I'm actually, somehow, explanting (transferring) a tick from the Adirondacks to Syracuse, right?
So the human behavior also plays a role. And we don't do the tick check on our pet if it is a day trip. We don't check it. We check only after we come home, right? So there is that human behavior component. And also the wildlife migration also impacts the geographic spread of the ticks in any area.
Host Amber Smith: Well, this year we've had a relatively mild winter again and a rainy early spring. Are these conditions that ticks like?
Saravanan Thangamani, PhD: Yes. Absolutely. The conditions are conducive for the ticks to kind of come up earlier in the season to get attracted to humans and other mammals to get blood feeding. I think rain is not a good thing for the ticks because it creates a high humidity, so they don't normally come out. Also, humans don't go out when it rains as well, so humans don't encounter ticks during rainy times. So I can tell from our own program that if it was a rainy weekend, the next week, we may not get a lot of ticks in the lab, but if it's a warm, sunny weekend, we'll get a lot of ticks.
So there is a pattern because the ticks try to shield themselves from overpouring water, and also humans don't go out when it is heavy rain, so it's a combination of factors. But definitely I think it's a very warm season. And I anticipate more ticks coming to our lab for testing, irrespective of the fact that we are now charging. And also I must tell that, we are now receiving ticks from throughout the United States. So we are not restricting ourselves to the state of New York because we are charging. We decided that we can actually expand our program to the entire United States' public.
Host Amber Smith: So you could get ticks from California or anywhere?
Saravanan Thangamani, PhD: Yes. We have already received ticks from Arkansas, and also Connecticut, Massachusetts.
Host Amber Smith: Well, talking to you, it sounds like if I want to protect myself from ticks, I should just stay indoors and not go anywhere or do anything. But you don't want to tell people that they can't be active and get outside.
What is your best advice? Where are the best places to go to be active outdoors, but not be vulnerable to ticks?
Saravanan Thangamani, PhD: Well, there are a few precautions we can take and still enjoy outdoor activities without worry of getting a tick bite or any disease after that.
First, prepare your outdoor clothing in such a way that it can be treated with permethrin or any acaricidal (tick-killing) product that repels ticks or kills ticks.
You can treat your socks, you can treat your outdoor clothing material, with commercially available permethrin. That is before you go out.
While you're going outdoors, like on the day, just before you leave the home, you can actually spray with the bug spray that protects from mosquito bites and fleas and other blood-sucking insects, in addition to ticks.
And then when you are in the park, when you are in the walking trail, try to be in the middle, as middle as possible. Don't go to the edges of the trails. That's where the grasses are tall. Ticks actually wait, at least deer ticks, actually, quest there. And if a human passes by, close by, they just latch on.
And also, we normally walk with our pets. We try to give the pets a long leash. They kind of wander into the bushes so that when they come, they come with the ticks. So we've got to be more careful, watchful, for pets that wander off the trail and come back. They might be having ticks on them.
And that goes with the kids, as well. When kids are young, they like to kind of swat the bushes and this and that; that also puts them at a higher risk of getting a tick bite. So stay in the middle of the trail and don't go closer to the bushes. I think that should be fine.
And then after you finish your outdoor activity, either gardening or walking in the trails or hunting, do a tick check right away. Within 10 minutes of coming home, do your tick check and take off the clothes, put them in the dryer, go take a shower, do a tick check, and that essentially eliminates the risk of getting a tick-borne disease because we are removing the tick very quickly.
So the tick-borne agents, particularly the Lyme disease agents, require at least 24 to 48 hours of attachment on a human body for a successful transmission of the infectious agent. So if we are able to locate the tick on the human body and remove it as soon as possible, I think we actually reduce our risk of getting Lyme disease.
Host Amber Smith: That's good advice. Thank you. I appreciate you making time for this interview, Dr. Thangamani.
Saravanan Thangamani, PhD: Well, I'm glad to kind of spread the word. Unfortunately, we have to charge a nominal fee for the public, but that is the only way we can sustain this program for the longer period and also provide a quality tick testing service at a very affordable price.
Host Amber Smith: That's really good to know.
My guest has been Dr. Saravanan Thangamani. He's a professor of microbiology and immunology at Upstate and the director of the Tick Testing Laboratory.
"The Informed Patient" is a podcast covering health, science and medicine, brought to you by Upstate Medical University in Syracuse, New York, and produced by Jim Howe.
Find our archive of previous episodes at upstate.edu/informed.
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