The Heat Is Online

Milder Winters Spur More Lyme Disease

Dangerous Pest of Suburbs Is More and More at Home

By Andy Newman, The New York Times, July 12, 1999

In Fire Island, where the hot look for summer gardeners now includes masking tape, long sleeves and multiple pairs of socks, ticks drift down from the trees onto plates of pasta, horrifying the guests. In Putnam County, N.Y., about an hour north of New York City, a surveyor who makes his living traipsing through high grass ends every workday hunched over a pair of tweezers, hoping to yank the critters out of his skin before it is too late.

From Cape May, N.J., to Kinderhook, N.Y., to Cos Cob, Conn., and beyond, children, dogs and lawns are liberally doused with bug repellent and pesticide, long-cherished gardens lie fallow, even down payments on houses have been walked away from. In Ocean County, N.J., at least one backyard has been pre-emptively covered with asphalt.

The problem is Ixodes scapularis, better known as the deer tick, the scourge of suburbia that transmits the unpleasant and occasionally irreversible neurological illness known as Lyme disease.

While tick populations are notoriously spotty and difficult to generalize about, it has been a particularly heavy season in some parts of the region, worse than ever, residents say, thanks in part to two mild winters and a damp early spring.

But for two decades or so in the Northeast, every year has been a heavy one for deer ticks, their numbers and access to human hosts continuing to increase as development creeps ever farther into the woods. Notwithstanding the introduction of a new vaccine this year, the experts say that Lyme disease, which sickens a total of 7,000 to 10,000 people each year in New York, New Jersey and Connecticut and a few thousand more in the rest of the country, is here to stay. So are the ticks.

And as they have made themselves at home, the ticks have crawled into the public consciousness and lodged there, subtly transforming the fabric of life in leafy places (the Northeast in particular, though deer ticks also abound in the upper Midwest and parts of northern California and the Pacific Northwest). For anyone in tick zones who spends any appreciable time outdoors, deer ticks have brought new sensations and rituals: the daily once-over of self and children, the frequent phantom feelings of tiny legs picking their way across the landscape of one's body, the routine hassle of deer-proof fences in places where people go to get away from barriers.

Ticks in general are not a recent problem. Dog ticks, which occasionally carry Rocky Mountain spotted fever, were common in the Northeast when the first settlers arrived and are still around.

But deer ticks, which feed on white-footed mice and deer as well as birds, people and pets, are much more likely to be infected -- about 25 percent carry Lyme disease, and they can spread rarer disorders like ehrlichiosis, which can be fatal, and babesiosis. And their pinhead-sized nymphs, which are miniature versions of the orange-brown adults, are more likely to escape detection, giving them time to feed long enough to transmit disease. That makes them more dangerous -- nearly all cases of Lyme are caused by nymph bites -- and scarier.

"Mankind is an intensely visual species," said Dr. Leonard H. Sigal, the director of the Lyme Disease Center at the Robert Wood Johnson Medical School in New Brunswick, N.J. "We avoid risks by seeing things. So when out of the wilderness comes an invisible risk factor, it plays to all our environmental and development anxieties. I think it plays to really primal concerns for Homo sapiens."

Sometimes, Dr. Sigal said, precautions can be excessive.

"I know of parents who spray their children with tick repellent every time they go outside," he said. "There are other people who basically don't let their children go outside. Such is the concern about the disease that there are people who have totally modified their life styles to avoid a disease that you can largely avoid with basic measures, and I find that really sad."

The basic measures he recommended include keeping lawns short, using repellent on skin and clothes in tall grass and in the woods, and checking oneself and one's children thoroughly to remove ticks before they have time -- usually at least 24 hours is required -- to infect their host.

But people who live and work in tick-infested areas have learned the hard way that even diligence in preventive measures can have limited success. Mark Husik, the executive director of the New Jersey Society of Professional Land Surveyors, said that the disease is practically epidemic in his profession, and that most people on his block in tick-conscious Princeton Township had at least one family member who had had it.

Some people would rather not talk about ticks, for business reasons. An hour and a half north of New York City in Dutchess County, which has overtaken Suffolk in recent years as the county with the most Lyme cases in the state, a summer camp operator refused to discuss how he dealt with ticks.

But tick culture has perhaps reached its fullest flower on Fire Island, the thin strip off Long Island's South Shore where the deer and mice are innumerable and infested, and the summer season now usually ends with a Lyme test.

In Saltaire, near the western end of of the island, Sheryl London emerged from her rhubarb patch one recent Sunday and asked, "Would you like to see the museum?" Spread out on her kitchen table were several dozens of scraps of paper, each with 1, 2, 3 or 12 ticks Scotch-taped to them and a legend like, "Mel -- toe -- 8/ 30/96" (Mel is her husband) or "9/12/98 Sheryl -- groin."

But this year, Ms. London, a 73-year-old filmmaker and cookbook author, stopped adding to the museum because there have been too many ticks to keep track of. Like dozens of people on the island, Ms. London, who started saving ticks to track their life cycle and see when they were most numerous, said this year had been the worst ever.

Jane Ekstein, a real estate broker, tends the big garden surrounding her house in Saltaire clad from head to toe in unfashionable but tick-revealing white, except for the beige masking tape that seals the border between her pant legs and her outer layer of socks. Even so, the ticks get through, so Ms. Ekstein, 56, and her husband, Carl, spend a lot of time picking ticks off each other.

"We groom each other like baboons," she said. "It's a way to add a little spice to your marriage."

Elsewhere in the region, two mild winters in a row seem to have helped produce a bumper crop of ticks. (Scientists disagree on the extent that tick numbers are influenced by temperature, but they agree that it is one of many factors, which may also include rainfall, humidity, the host population and the production of acorns, a favorite food of white-footed mice.)

"We had ticks all through the winter," said Bruce Blair, a surveyor in central New Jersey who also hunts deer.

"I was dressing a couple of deer in Hunterdon County, and I had to just let them go because they were just loaded with ticks. I have to take all kinds of special precautions now."
John Van Nuys, Hunterdon County's chief sanitarian, said his office had been logging better than a dozen calls a day this year -- the most he could remember -- from residents who had found ticks that they were worried might be infected with Lyme.

In the southern part of the state, another surveyor, Frank Blum, said that when he and his crew came out of the woods in Atlantic County last month, "we were pulling off ticks eight or nine at a time with no problem. Then driving home I pulled another five or six off my arms. When I got home my wife pulled out another five or six that had already started biting. If it gets any worse, I don't even want to go in the woods anymore."

Lyme disease, named for the Connecticut shore town where it came to prominence in 1975, is usually but not always accompanied by a red bulls-eye rash around a tick bite, and starts with joint pain and flulike symptoms. If not treated with antibiotics, the disease can cause permanent damage to the heart and nervous system as well as mental problems ranging from memory loss to psychosis.

Just in time for the tick infestation, there is a new vaccine against Lyme disease this year, Lymerix, but it has met with a mixed reception. According to the manufacturer, SmithKline Beecham, 300,000 doses had been administered as of late June -- representing 150,000 to 300,000 patients, considering the vaccine needs to be given twice in the first year.
Potential customers have complained that the vaccine is expensive -- about $300 for the full course of three shots -- only 78 percent effective, and is good for an unknown period.

Husik, of the New Jersey surveyors group, said that many insurance plans refuse to cover the vaccine, discouraging more people.

Another drug maker, Pasteur Merieux Connaught, is developing a vaccine called ImuLyme that it claims has been 92 percent effective in trials, but it is still at least a year away from Federal approval.

There is also a new, faster blood test for Lyme disease available this year, giving a result in an hour. The traditional test can keep people waiting for up to two weeks. But like the old test, the new one cannot detect the disease until four to six weeks after a person is bitten, and even then it is often wrong.

At Fordham University's Louis Calder Center in Armonk, N.Y., in Westchester County, Thomas J. Daniels, a biologist on the tick study team, said that the deer-tick nymph population does appear to be up this year.

Since 1987, Dr. Daniels and his colleagues have run what they believe to be the world's only catch-tag-and-release study of ticks -- marking them with different color paint each time they are caught -- as part of their research into the natural factors that kill them.
The scientists found more ticks in their first few days of collection this season than they did in the same period last year.

Over the years, Dr. Daniels has developed a deep respect for ticks' ability to adapt easily to new hosts and invade new areas.

"They're really pretty remarkable animals," he said. "They're incredible, actually." But even a fan's affection has its limits.

"I like them," he said. "They keep me working; they keep me employed. But if we could get rid of them, that'd be great. I'd be more than happy to move on to something else."