How to avoid dog ticks, lone star ticks -- and their diseases

[00:00:00] 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. New types of ticks have migrated to parts of Central New York, according to research from the lab of Upstate molecular biologist and tick expert, professor Saravanan Thangamani. He's here to tell us about these ticks and explain how they transmit viruses. Welcome back to "The Informed Patient," Dr. Thangamani.

[00:00:31] Saravanan Thangamani, PhD: I'm happy to return back and talk about the ticks that we are finding in our program.

[00:00:37] Host Amber Smith: Well, you've told us so much about deer ticks, in the past, and Lyme disease, but now there are a couple other tick varieties to be concerned about. Which ones are you going to tell us about today?

[00:00:48] Saravanan Thangamani, PhD: In addition to the deer ticks, there are four other takes that are emerging in the New York state. With specific reference to Central New York, I would like to focus on the dog tick, dermacentor variabilis, and the lone star tick, or amblyomma americanum. So the dog ticks, originally in the past few years, we were receiving the docs from I would say counties like Westchester and Albany, anywhere in the lower Hudson Valley. That's where the majority of the ticks were submitted to us. However, now this year we are actually seeing a lot of these dog ticks being encountered by humans in Central New York as well, in addition to the Western New York. So that is a change in pattern we were observing in the ticks that are submitted to us.

So dog ticks, unlike the deer ticks, they look different. Morphologically, they are a little bigger than the deer ticks. Dog ticks are bigger, and they're, I would say morphologically, the cuticle that we call the surface of the tick is a little bit more ornate and patterned than the deer tick. And also the dog ticks, they do have shorter mouthparts. So what I always tell that in the lab when we get the ticks, dog ticks are morphologically easy to differentiate from the deer ticks. There are key features that we look in the lab when we receive a tick. The first thing is the the cuticle of the tick. Cuticle is what the outer surface of the tick, they look different. And also the mouthpart of the tick. That is what that is inserted into this human skin. There are key anatomy that we look in the lab. I don't want to get into scientific terms in that, but dog tick mouthparts are smaller, and deer tick mouthparts are very long.

So what it means is that when a dog ticks attach on a human, they literally stay attached to the, barely attached to the top of the skin. However, the deer ticks, they actually pierce deeper, and then they stay inside the human skin a little stronger than the dog tick. So these dog ticks, or why we should be worried about these dog ticks? The dog tick actually carries an agent called Rickettsia rickettsii, a causative agent of Rocky Mountain Spotted Fever. It is a type of bacteria that can cause acute febrile illness. It can be treated with antibiotics, however, if it's not diagnosed early in humans, it actually can cause severe health consequences.

The second tick of human health importance that we are seeing more in the Central New York is the lone star tick....

[00:03:23] Host Amber Smith: Excuse me. Can I ask you about the dog ticks before we get into lone star?

They're called dog ticks. Is that because they, do you find them on dogs as well, or where do they get their name?

[00:03:33] Saravanan Thangamani, PhD: I think in the older literature and it is believed that the adult stage of the ticks prefer to feed on dogs and larger mammals like dogs. Unlike the deer ticks, the adult stage of the ticks like to feed on the deer. That's why it's called deer ticks, right? Dog ticks preferentially feeds on dogs. However, humans are accidental host. What I mean, "accidental host," is that the humans are not natural host for the these ticks. We happen to be next to the pet. We happen to be next to the dog. We happen to sleep next to the dog ticks in our bed; the dogs sleep in the bed with us, right? So basically accidentally these sticks are actually are attached to humans. So we are not a natural host for these ticks.

[00:04:16] Host Amber Smith: When you were describing how they attach, and it sounds like the dog tick doesn't go as deep in, does that mean that it can jostle loose easier, or not?

[00:04:27] Saravanan Thangamani, PhD: No. So they're very clever. So what they do is, in any tick, before they actually start feeding, the first thing they do is secrete glue-like proteins, what we call cement proteins. That allows the tick to stay anchored nicely on the human skin so that it doesn't drop off by itself. Since dog ticks don't have deeper mouthparts or longer mouth parts, what they do is actually they secrete huge amounts of these glue proteins first. So although they don't go deeper, they secrete more glue proteins in such a way that they actually stay attached to it. So equally, they are strongly attached to the skin, but it's about how deep they go into the skin makes a difference.

[00:05:08] Host Amber Smith: Now, do these dog ticks get along with and coexist with the deer ticks and the lone star ticks? Or are they competing for food sources?

[00:05:17] Saravanan Thangamani, PhD: They're competing for the resources. They're competing for the resources. So it's very rarely you would find dog ticks together with deer ticks. However, I know that we will be talking about the lone star tick later. Lone star tick adult stages, they like to feed on deer. So there, that is a direct competition between the deer tick and the lone star tick for this larger mammal, that's the deer.

[00:05:38] Host Amber Smith: This is Upstate's "The Informed Patient" podcast. I'm your host, Amber Smith. I'm talking with professor Saravanan Thangamani. He's a microbiologist and immunologist, and his laboratory focuses on the biology and ecology of virus transmission.

So, tell us about the lone star ticks. Are they from Texas?

[00:05:59] Saravanan Thangamani, PhD: Not really, but they are from the southern United States. They're from the southern United States. Primarily, however, due to human behavior and climate change and the deer migration, we are seeing lone star ticks up all the way to the Canadian border, and we have traditionally seen this tick in the Suffolk County or Long Island in the state of New York. However, we are starting to see more of these ticks submitted to us from Central New York, and we are starting to see an increase in numbers as well from the Central New York region.

And morphologically, these are much bigger ticks. This is one of the largest tick I can tell. And also, the larger the tick means that it stays attached to the humans for a longer period of the time. Deer ticks on an average, they can stay attached to humans for five days, but lone star ticks because of its size, it needs to take more blood, so it has to stay attached to the human for seven to nine days, or even 10 days. To get that full complete blood feeding, however, humans will be able to find a big bump on our body, and we will try to remove it before the tick actually completes its feeding. However, in animals and deer, you can actually see these ticks, I would say, almost like a kidney bean size in a fully fed tick, you can imagine that.

And these ticks have larger, longer mouthparts than the deer ticks, which means that they can penetrate deep into the subcutaneous space of the skin. And also it can cause rashes. And this is the tick that also causes the meat allergy, or otherwise called as Alpha-gal allergy, to these bites of this tick as well.

In addition to the Alpha-gal allergy, this particular tick is of human health importance for the following reasons: it transmits agent that cause human ehrlichiosis. It transmits heartland virus, bourbon virus, and also it has the potential to transmit Powassan virus. So this tick is, in my opinion, the biggest, public health concern tick, that we have to be look out for in the, I would say, in the next couple of years.

[00:08:00] Host Amber Smith: And when you mention that Alpha-gal, that's the one that causes the meat allergy?

[00:08:05] Saravanan Thangamani, PhD: Exactly. It is an allergic reaction to a carbohydrate called galactose-alpha-1,3-galactose, otherwise known as alpha-gal. Humans don't have this particular protein. So when a tick is feeding on a human, it actually injects this particular carbohydrate into our body. Our body, in response to any other foreign substances, it actually generates immune antibodies. In this case, it's IgE antibodies or immunoglobulin E antibodies.

So when we are already sensitized to this particular alpha-gal carbohydrate, when we take a meat or red meat that actually has this carbohydrate, our body responds to it. Some people respond much robust than the others. So in those cases where someone's body responds to it, they get an allergic reaction, typically between two to four hours after consuming a red meat.

[00:08:57] Host Amber Smith: Well, I'm still surprised about the size difference, because didn't you tell us the deer ticks are about the size of a poppy seed?

[00:09:05] Saravanan Thangamani, PhD: I must clarify here that there are three lifecycle stages of the tick, larvae, nymph and adult, right? Each stage has different lifecycle stages. The poppy seed-sized ones are the nymphal stage ticks, I would say. And even within in the nymphal stage ticks, the size difference is vastly different between these different ticks that we encountered in New York State. Of that, lone star ticks are the largest one. Even in a nymphal stage, you can clearly see the morphological differences of the tick in comparison to the deer ticks.

[00:09:38] Host Amber Smith: So people, it sounds like, might have a little more luck at seeing or finding on their skin a lone star tick, just because it's going to be a little bit bigger. Is that right?

[00:09:49] Saravanan Thangamani, PhD: You are absolutely right. You are absolutely right. So people can actually identify the tick on the human body much more easier than a deer tick.

[00:09:57] Host Amber Smith: Now, does it have a star on it?

[00:09:59] Saravanan Thangamani, PhD: OK, it does not have a star on it, but it has a small white, pale colordot that you have to assume that as a star. And that's why the tick is commonly referred as a lone star because it resembles the star in the Texas flag.

[00:10:14] Host Amber Smith: Now you mentioned a bunch of the different diseases that these ticks can transmit. Are those also threats to dogs or other mammals that are out and about?

[00:10:24] Saravanan Thangamani, PhD: Yes, of course. I think they do transmit ehrlichia that can cause disease in dogs and other specific, like tularemia that can actually cause disease in pets and veterinary animals and also humans as well.

But again, we are focusing primarily on the human, so that's why I kind of focused on this, but they do transmit agents that cause disease in dogs, pets, and wildlife as well.

[00:10:48] Host Amber Smith: So all of these ticks that we've discussed, do you remove them the same way? Can you walk us through how best to remove them? Let's say you find one on your body after you've been in the woods.

[00:10:59] Saravanan Thangamani, PhD: Absolutely. The mechanistic approach of removing a tick is the same. It doesn't matter what tick species. You just use a fine tip tweezer. Just go right underneath the mouth part, and pull it perpendicular to your body, in such a way that you don't try to angle it. Because sometimes when you're angling it -- as I said earlier, the ticks secrete large amount of glue proteins -- so you want to make sure that you are pulling the tick in such a way that you don't pull your skin as well. So that's why going perpendicular to your skin or perpendicular to the angle of the tick that is attached to it, it's always an easy way, with less damage to your skin. In the case of a lone star tick, as I said, the mouthparts are even longer than a deer tick. The chance of pulling a bit of your skin is there, so you have to be a little bit more careful when pulling. You know, don't yank it, don't swirl it. Just gently pull, with gentle pressure. It might take 10, 15 seconds to pull gently, so that you have the least injury to your skin, but you have to be patient, particularly with the lone star tick.

[00:12:05] Host Amber Smith: Is this something where a person needs to let their primary care provider know that they've removed a tick? I mean, is there anything that can be done if the disease has already been transmitted? Is there anything you can do at this stage?

[00:12:18] Saravanan Thangamani, PhD: Absolutely. It's very important for the healthcare provider to know that you are a bitten by a tick. That's one thing that our program is helping the public is that when they send the tick to us, within a couple of days, we send the results back to them to let the public know, the tick submitter know what agent that it carries. So by the time they go to the primary care provider, they have the tick results with them. So if they tell that information to the public healthcare provider, they will make informed decision because a lot of these agents, a lot of these diseases can be treated with antibiotics if diagnosed early. So that's the key point. If it's diagnosed early.

Like rickettsiosis. Like Lyme disease. If it is diagnosed early, you know the healthcare provider will prescribe the appropriate antibiotics to treat it. Even ehrlichiosis, you can actually get treated with the antibiotics if diagnosed early. So that's why it's very important to tell the healthcare provider that you got bitten by a tick.

And then if you, in some cases, people don't send the tick for tick testing. In those cases, the healthcare provider will have an epidemiological knowledge about this tick and also where they are coming from. For example, if it comes from Central New York, they can go to our tick dashboard and then find out what are the current agents that are transmitted by this tick, and then the healthcare provider can prescribe or even do a diagnosis on the human accordingly.

[00:13:44] Host Amber Smith: Let's remind people of the website they can go to to learn more about tick submission or for the tick dashboard. What is your website?

[00:13:53] Saravanan Thangamani, PhD: It's www.NYticks -- T I C K S -- .org So that is, again, www.nyticks.org.

[00:14:05] Host Amber Smith: Very good. And before we wrap up, I want to ask you if you'll go over the steps people can take to minimize the chance of tick bites. What do they need to know before they head out?

[00:14:16] Saravanan Thangamani, PhD: It is important to know the basic information about where ticks are living. Often they are living by the under brushes or, depending on the tick, there can be under brushes or on the top of the grass blades. But the most important thing is to actually know how to walk in the woods, know where to walk in the woods. I always tell people don't walk on the almost at the corner of the trekking tracks, because that's where the ticks are waiting because it's where the grasses are un-mowed, and if you go closer to that will actually hop on. Basically, when you brush against the grass, ticks will actually easily move from the blade of the grass to your socks, and then they will crawl onto your body. And also you can do preventive measures like treat your clothes with permethrin, or have the insect repellent sprays that are good in protecting ticks and fleas, and also mosquitoes, because the current insect repellents that are being marketed, they can actually prevent people from getting mosquito bites, tick bites, flea bites, and also tick bites. And they can prevent it.

And once they come (in) from doing an outdoor activity, it's important to the tick check. And it's important to make sure that they put their outdoor clothing into in the dryer for 10 minutes at high temperature, because high temperature removes the humidity, and that essentially kills the ticks because ticks need high humidity for its survival. The moment you remove the humidity from the environment, they will die.

[00:15:42] Host Amber Smith: Now they can't bite you through your jeans, but they could stay on your jeans and come home with you and then crawl onto your skin?

[00:15:51] Saravanan Thangamani, PhD: Exactly. So they can come, they are good hitchhikers, though. They will try to find spaces that we normally wouldn't notice or normally would ignore. And, so we can bring them home. It's like the pets. Sometimes these ticks don't actually feed on the pets, but they are actually crawling on the pets. And then if we don't do the tick check on the pets, and they actually will crawl on the surface and they will find a perfect human to feed on.

[00:16:16] Host Amber Smith: Well, Dr. Thangamani, I appreciate you making time for this interview.

[00:16:20] Saravanan Thangamani, PhD: Thank you. It's always nice to share some information about the ticks and tick-borne diseases in Central New York.

[00:16:25] Host Amber Smith: My guest has been Dr. Saravanan Thangamani. He's a professor of microbiology and immunology at Upstate, and the Thangamani Lab focuses on biology and ecology of virus transmission. "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. If you enjoyed this episode, please tell a friend to listen too. And you can rate and review "The Informed Patient" Podcast on Spotify, Apple podcasts, YouTube, or wherever you tune in. This is your host, Amber Smith, thanking you for listening.