Even though it was a gorgeous, late summer afternoon, ready made for recreating, a good number of up-Islanders were inside the Chilmark Community Center last Friday, attending a discussion on tick-borne illness, sponsored by the Martha’s Vineyard Boards of Health Tick Borne Disease Council (TBDC).
The TBDC is made up of Island board of health members, physicians, and health and environmental management professionals whose mission is to educate Islanders about prevention and early recognition of tick-borne diseases.
Given that four days earlier the Center for Disease Control made the stunning announcement that Lyme disease is ten times more prevalent than previously estimated, the timing of this TBDC talk at ground zero couldn’t have been better.
“There should be a thousand people here,” said Aquinnah resident Sondra Mekonian. “I know so many people with Lyme, even my dog had it. It’s scary.”
Prevention, prevention, prevention
Matt Poole, Edgartown health agent and co-chairman of the TBDC, opened the discussion emphasizing the message TBDC has been hammering for the past two years — while we do live at the epicenter of an insidious pox, individuals can drastically reduce their risk by taking simple steps: wearing protective clothing, using repellent, doing preventative landscaping, making daily tick checks and and knowing the early symptoms of tick-borne diseases.
“I cleared a ton of brush this year and I should have had a few tick bites” said Mr. Poole, “But the combination of protective clothing and Premethrin spray, I haven’t had a single bite. Anyone who knows they’re crossing paths with ticks, just wearing protective clothing and using Premethrin can greatly reduce your odds.”
Mr. Poole also urged the every Islander to make use of the Boards of Health Island-Wide Tick Borne Illness Prevention Program website for the most up-to-date information. He also suggested that they download the comprehensive Tick Management Handbook, produced by the Connecticut Agricultural Experiment Station.
Mr. Poole quickly turned the program to speakers Sam Telford, professor of infectious diseases at the Tufts University School of Veterinary Medicine and consultant to the TBDC; and Thomas Millette, professor of Geology and Geography and Director of the Geoprocessing Laboratory at Mount Holyoke College.
Both men had new reconnaissance to share in the battle against tick-borne diseases on the Island. Some of it sobering, some of it hopeful, all of it useful.
Telford talks ticks
If there is an upside to being a hot spot for an epidemic, it’s that you get the world’s foremost experts coming here to study it. Mr. Telford has been studying tick-borne illnesses since he was a Harvard post-graduate on Nantucket in 1984, and he has become a renowned authority on the subject. He began studying on the Island in 1994 and has been coming back regularly ever since.
“The first thing to understand is the life cycle of a tick,” said Mr. Telford. “Not every single day of the year is risky.”
Mr. Telford explained that the tick has a two-year life cycle. A female lays her 2,000 plus eggs in May and they hatch in July. In July through September, larvae (baby ticks) are looking for something to feed on so they can grow to the next stage. Larvae are born uninfected so they won’t cause disease. “That means you can enjoy the Vineyard now; it’s the perfect time to be here,” he said.
The mites of spring
Ticks become dangerous during the second year of their lives. “Ticks are in the nymphal, or teenager stage, from April through the end of June,” said Mr. Telford. “They’re the ones we’re concerned about. April through July is the riskiest time for Lyme disease. The bulk of the cases appear during the middle of the summer. Most cases are acquired in mid to late June.”
Mr. Telford reiterated Mr. Poole’s point about the importance of daily tick checks. “Halfway through the time of feeding, is when it starts to spit infectious material into the host. If you pull a nymphal deer tick off within 24 hours, there’s a very good chance you won’t get infected. And as the CDC has said, taking two tablets of doxycycline after recognizing a tick bite dramatically reduces chances of infection. An adult tick is easy to spot: it takes seven days to feed. Chances are pretty good you’ll find it before three days pass.”
A shot in the arm
Vaccination is rarely discussed in the battle against Lyme and tick-borne disease. Lymerix had a promising start in 1998, but due to subsequent class action suits over arthritic side effects and limited demand, SmithKline Beecham — now SmithKline Galaxo — withdrew it from the market in 2002.
“The fact is, Lymerix works.” Mr. Telford said, emphatically. “We’ve had 10 years of follow up since it was taken off the market, with no complications of people vaccinated. The vaccine has been proven, in a peer-reviewed scientific publication, to reduce the incidence of Lyme disease. The hypothesis that some parts of vaccine might cause arthritis has since been debunked. It was withdrawn voluntarily because they weren’t making much money and they were being faced with class action law suits. If they start over, you won’t see a vaccine for at least 20 years. Why not take the old one and re-approve it and re-deploy it? I just got back from the International Conference on Lyme Borreliosis in Boston, four days with the top Lyme disease scientists in the world. I floated this idea at the conference and support was remarkable.”
Tick so facto: deer=ticks=disease
Mr. Telford makes no bones that his primary short-term objective is to significantly reduce the deer population on the Island. Studies have shown that as many as 94 percent of female ticks acquired their blood from deer.
“I’ve found over 300 ticks on one deer,” Mr. Telford told the group Friday. “Multiply that by 2,000 ticks for every deer-fed female tick, you get a sense of how crucial this is. It’s no coincidence that the concentration of Lyme [disease] is where you have deer habitat and human habitat, and there are strict limitations to hunting. This is the genesis of the rapid increase of Lyme disease in eastern Massachusetts. Except for cars, deer have no predators.”
Putting a finer point on it, Mr. Telford reminded the up-Islanders that Lyme disease is only one of many potential poxes that are carried by deer. “You have to remember it’s not just Lyme out there,” he said. “The Vineyard is also the hotspot nationally for tularemia and Rocky Mountain Spotted Fever (RMSF). One of the things that makes the Vineyard ripe for tularemia is the southward facing portion of the Island is salt-spray influenced and the bacteria live longer in those environments. For the Vineyard to account for a tenth of all cases nationally is pretty remarkable.
The Lone Star tick has established populations on Cuttyhunk, Nashawena, and Prudence Island. They bring their own little community of pathogens with them. I found a few specimens here but we don’t have year-round populations as yet. They’re nasty, they have eyes, unlike deer ticks that are blind, they can see you and come after you,” he said, his voice echoing off the knotty pine walls in the subsequent silence.
In later conversation with The Times, Mr. Telford said culling was done on Monhegan Island in Maine by Fish and Wildlife sharpshooters and Lyme disease almost disappeared. It’s being done in Naushon by coyotes and Lyme disease is dropping significantly. He stressed that, to reduce tick-borne disease on Martha’s Vineyard, the deer population must be culled.
The first step in deer reduction on the Vineyard is finding out where they are, and how many of them live here. Thomas Millette, professor of Geology and Geography and Director of the Geoprocessing Laboratory at Mount Holyoke College, was on hand to show the results of a census that he began in January of this year. Mr. Millette’s specialty is developing instrument systems for airplanes and satellites that do environmental imaging. He criss-crossed the Island in an airplane mounted with a thermal imaging camera, shooting during a cold snap to maximize the contrast of the ground temperature and body heat of the deer. “Once we had the answers, I was shocked,” he said.” You do have an enormous deer population.”
Mr. Willette drove the point home by showing deer density maps of the Island, created by Chris Seidel at the Martha’s Vineyard Commission, using his data. The maps were gradated, the darker the color, the higher the deer density. The arresting images showed the Island awash in dark colors and pocked with black areas that indicated 50+ deer per square mile. The results did not include the abundant deer population on Chappaquiddick because the ground wasn’t cold enough to get the needed contrast.
“On Martha’s Vineyard we have somewhere between 47 and 53 deer per square mile. If you had told me that before we did it, I would have laughed at you,” Mr. Millette said. “In rural western Massachusetts where I live, we have 19 deer per square mile. Give credit to Mass Wildlife (Massachusetts Department of Fish and Game), their estimate of 50 per square mile was on the money,” he said.
Rodney Bunker of Chilmark said that there was an ample supply of Island hunters, but not enough access to hunting land. A landowner in attendance said she didn’t realize she had to give permission in writing, and vowed to do so. Mr. Poole said that the MVBOH could help connect hunters and willing landowners, and suggested both sides write him at MVBOH.org.
“Hopefully these maps will help convince more people on the Vineyard that deer culling has to be done,” said Mr. Telford.