Tick and Powassan Virus Update From Dr. Richard Cooper

Last year everyone was talking about Mosquitos and Zika virus, this year it is Ticks and Powassan virus. Chances are over the past week or two you have seen, heard, or read at least one major news story about the prevalence of ticks and the concern over Powassan virus. As with any high-profile story, misinformation and widespread speculation can muddy the facts, create confusion, and lead to unnecessary panic. We want to take the opportunity to provide you some basic information regarding ticks and tick-transmitted diseases, including Powassan virus.

Are ticks really occurring in greater numbers than normal in New Jersey and Pennsylvania?

The answer is yes, tick populations are truly soaring and are more active than we have seen in at least several decades. The increase in tick activity is likely the result of unusually high rodent populations and the mild winter experienced in 2016/17. Rodents which serve as an important host for ticks have been climbing at a very rapid rate the past two years, and the abundance of rodents is contributing to the increase in tick activity this year. While rodents set the plate for a boom in tick activity, it was the unseasonably warm winter that allowed the perfect storm to occur. With larger than normal populations of ticks in the fall, the mild winter enabled a higher than normal survival rate as we entered the spring months. The result is that ticks are more abundant than usual.

How big of an issue is disease transmission by ticks where we live?

Ticks are a very serious public health pest. Most people are familiar with Lyme disease but there are at least 15 other diseases that ticks are known to transmit to humans in the U.S., and at least 9 of these are transmitted by ticks that occur in New Jersey and Pennsylvania. Based upon the most recent records from The Centers for Disease Control and Prevention (CDC) the following tick-transmitted diseases occur in our area.

Diseases transmitted by ticks in the Northeastern US (modified from CDC Website)

• Anaplasmosis is transmitted to humans by tick bites primarily from the blacklegged tick (Ixodes scapularis) in the northeastern and upper midwestern U.S. and the western blacklegged tick (Ixodes pacificus) along the Pacific coast.
• Babesiosis is caused by microscopic parasites that infect red blood cells. Most human cases of babesiosis in the U.S. are caused by Babesia microti. Babesia microti is transmitted by the blacklegged tick (Ixodes scapularis) found primarily in the northeast and upper midwest.
• Borrelia miyamotoi infection is transmitted by the blacklegged tick (Ixodes scapularis) and has a range similar to that of Lyme disease.
• Ehrlichiosis is transmitted to humans by the lone star tick (Ambylomma americanum), found primarily in the southcentral and eastern U.S.
• Lyme disease is transmitted by the blacklegged tick (Ixodes scapularis) in the northeastern U.S. and upper midwestern U.S. and the western blacklegged tick (Ixodes pacificus) along the Pacific coast.
• Powassan disease is transmitted by the blacklegged tick (Ixodes scapularis) and groundhog tick (Ixodes cookei). Cases have been reported primarily from northeastern states and Great Lakes region.
• Rocky Mountain spotted fever (RMSF) is transmitted by the American dog tick (Dermacentor variabilis), Rocky Mountain wood tick (Dermacentor andersoni), and the brown dog tick (Rhipicephalus sangunineus) in the U.S.
• STARI (Southern tick-associated rash illness) is transmitted via bites from the lone star tick (Ambylomma americanum), found in the southeastern and eastern U.S.
• Tularemia is transmitted to humans by the dog tick (Dermacentor variabilis), the wood tick (Dermacentor andersoni), and the lone star tick (Amblyomma americanum). Tularemia occurs throughout the U.S.

Visit https://www.cdc.gov/ticks/diseases for a complete list of tick-borne diseases in the United States.

What is Powassan virus and how concerned should I be?

Powassan virus is a very serious disease that is transmitted by ticks. It has recently made news headlines due to the potentially fatal nature of the disease and the fact that there is no known vaccinations or medications to treat the infected individuals. Fatalities from the disease occur in approximately 10% of the time, however among survivors nearly 50% suffer some type of permanent neurological effects, ranging from headaches, muscle deterioration, and memory loss.

It was first discovered in Powassan Ontario (hence the name) in 1958 but has been reported in the United States since 2005. The disease is transmitted by two ticks that are common in our area, the blacklegged tick (Ixodes scapularis) also known as the deer tick, and the groundhog tick (Ixodes cookei). Fortunately, at present tick-transmitted cases of Powassan virus are very rare in the US. The Centers for Disease Control and Prevention (CDC), report no more than 12 cases of Powassan virus per year since 2006. While most cases have occurred in the Northeastern and Great Lakes regions in the US, there have only been 4 cases in NJ and Pennsylvania, but experts are concerned that the number of cases could rise given the explosion of ticks this year.

What makes this disease so scary is the speed of transmission by ticks. Diseases like Lyme disease can be prevented simply by removing ticks with the first 24-36 hours after their mouthparts have been embedded into their host’s skin. In contrast, Powassan can be transmitted by ticks in less than 3 hours, and it is believed to be as short as 15-30 minutes after the tick’s mouthparts have been embedded. This leaves virtually no time for prevention of disease transmission by detecting and properly removing ticks before they have had the opportunity to inject the virus into their host through their blood feeding activity

What can I do to protect myself when I am in a tick-prone environment?

You are very much at risk for picking up ticks anytime you are spending time in wooded areas, meadows, or un-manicured fields.  You are also at great risk for picking up ticks if you are spending time in areas that border tick environments in your yard, at athletic fields, in parks, on playgrounds, etc.

Some recommendations to help prevent or at least detect the presence of ticks quickly in tick-prone environments include:

• Consider applying an EPA registered tick repellent product containing DEET. There are also EPA registered products containing Permethrin for the treatment of clothing. Always follow label use directions when using EPA registered products.
• Wear light colored clothing (if really concerned wear white socks and pull them up over the legs of your pants)
• Try and stay on cleared paths and avoid brushing up against vegetation as much as possible.
• Check your clothing frequently for the presence of ticks.
• Perform a “tick check” when you get home. This is best done by having someone else check you from head to toe for the presence of ticks.

What can I do to reduce ticks on my property?

1. Make your property less attractive to ticks
   Proper lawn maintenance and planning of landscaping and lawn features can go a long way in reducing tick activity on your property. Here are some examples of what you can do. 

• Keep the lawn well-manicured by mowing grass frequently, at least once per week. Also remove brush, debris and leaf litter.
• Keep children’s play sets, sandboxes, at least 10’ away from property edges that border tick environments.
• If installing a fence, keep a manicured buffer zone between the fence and wooded areas or un-manicured fields.
• Keep piles of firewood away from the structure and store on the part of the property away from decks, patios, play areas. Firewood piles are a favorite nesting area for deer mice and will promote tick activity associated with rodents.
• Avoid dense landscaping and heavy ground cover such as ivy, pachysandra, crawling juniper, or thick shrubs. Densely landscaped areas are attractive to birds, rodents, and a variety of small animals that will introduce ticks to these areas.

2. Treat the property for tick activity
   Very effective treatments are available to drastically reduce the number of ticks that entering from tick habitat into manicured areas of properties. However, beware of companies offering organic or natural pesticide control solutions (i.e. garlic oil or other natural plant oils). None of the natural products tested have proven effective.

It is not necessary to treat the entire yard to control ticks. Instead, targeted/prescription treatments can be made to areas where tick environments and the manicured yard interface.

Cooper Pest Solutions does have a highly effective tick reduction program available if you have an interest in managing ticks on your property. Our treatment uses a minimal amount of low toxicity pesticide in a very targeted fashion while significantly reducing tick activity on your property.

What is the correct way to remove a tick that is embedded in your skin?

It is imperative that you use the correct method to remove any ticks that have embedded their mouthparts into your skin. There is only one correct method for removing ticks once their mouthparts have been inserted and many wrong ways.

Never:

• Never use Vaseline or petroleum jelly to try and smother a tick
• Never pour rubbing alcohol on a tick or wet it with an alcohol soaked cotton ball, etc.
• Never poke a tick with a hot needle
• Never try to remove a tick by grabbing it by its body and pulling it out

All of these are common recommendations and can cause a tick to regurgitate their gut contents into your bloodstream, possibly resulting in the delivery of a disease pathogen. Grabbing a tick by its body can also result in the mouthparts breaking off while still embedded in the skin and may cause an infection.

The Proper Way to Remove a Tick is to use a pair of fine tweezers to grab the tick by the mouthparts as close to the skin as possible (practically pinching the skin) and carefully pulling the tick out. Once the tick has been removed, the live tick can be killed by placing it in a jar with rubbing alcohol.  If for any reason you are concerned that you may have contracted a tick-borne disease you should consult with a medical professional.

Other resources for information on ticks, disease, control and prevention include:

The CDC is an authoritative source of information about ticks and the diseases they transmit. The information on the CDC website is regularly updated and is one of the best sources of information based upon the most recent research. Additionally, information regarding prevention and control is available at http://www.cdc.gov/zika/intheus/florida-update.html

The NJ State Department of Health has created an excellent brochure that is focused on ticks, disease and disease prevention. The information applies to ticks found in New Jersey as well as Pennsylvania and can be downloaded at http://nj.gov/health/cd/documents/topics/vectorborne/tbd_brochure.pdf

We hope that the information and websites provided will be a resource to help answer questions that you may have regarding the widespread tick activity that is occurring this year and the associated disease threats.

Sincerely,