Are you among the legions of Islanders with small insect bites particularly on your feet and ankles? Are you mystified because you can never see these critters even though their bites are like small welts that leave you scratching?
Well, you’re not alone.
The situation is so prevalent that readers have written in to the MVTimes and called it a “mini-plague.” Nurses at the hospital say they are seeing patients showing up at the Emergency Room covered in bites and mystified as to what is causing them. Local pharmacies are reporting that anti-itch balms and creams are flying off their shelves.
Jan Buhrman, Chilmark Board of Health member wrote, “This is a serious issue.”
So what are they? Oak mites is one prevailing theory. Lone Star tick larvae are a strong possibility. Or maybe just an abundance of common sand fleas, or chiggers. By many accounts, whatever is causing them, the red welts are painfully itchy and appear on various parts of the body, they have no clear origin — there is no visible bug or any discernible moment of being bitten.
To try and track down the cause, we reached out to Dukes County wildlife biologist Patrick Roden-Reynolds, Chilmark board of health member Jan Buhrman, as well as Matt Pelikan, wildlife biologist at BioDiversityWorks. In addition, we talked to a West Tisbury resident, who wishes not to be identified. We dropped by an Island clinic, MV Hospital Emergency Room, and Conroy Apothecary. “We sent two people down to the ER today,” was one, unofficial comment. And, at the ER we heard: “Yes, people are coming in with bites.”
As for the cause, Roden-Reynolds was fairly emphatic, paraphrasing: “I have a high degree of confidence that these bites are Lone Star larvae. The time of year is right and these black pepper-sized, six-legged larvae can bite and just fall off.” In general agreeing and addressing the information that people need, Burhman writes: “We need to do a better job of communicating to folks not only what alpha gal syndrome is, but also how to prevent it and identify these bites.”
Taken together, these statements are persuasive that the outbreak of itchy welts is Lone Star larvae being kicked up out of leaf litter and onto those plagued. According to one person, who tested negative for Alpha Gal at MV Hospital: “I was told it was consistent with Lone Star lavae bites and was prescribed a permethrin cream for my skin and some antihistamines, which made me sleep all day.” She still has no idea. And as yet, no tests have positively identified the Lone Star tick as the culprit.
Lone Star or not, what is verifiable is the presentation of the bites. “Typical bites [are] red welts 2 mm in diameter with a central vesicle [blister] and [are] itchy and painful when scratched … Most puzzling [is] the lack of any insect being seen or felt during the act of biting.” This passage echoes many Islander’s accounts, including the author’s. But, that report was written in 2006 by researchers at the University of Kansas about Oak Mites. Many of the reports since, by dermatologists and health officials in Georgia, Virginia, the Chicago area and Pennsylvania, base their findings on this report. In our research, including contacting an official at the Department of Conservation and Recreation, The Times could find no verifiable documentation of Oak Leaf Mites in Massachusetts, or New England. Still, because of the presentation, and no evidence to the contrary, Oak Mites remain a consideration.
The nearest and most recent, reliable report of Oak Mites comes from the University of Pennsylvania Extension [https://extension.psu.edu/oak-leaf-itch-mite], published in April of 2023. It points out the mites favor pin oaks or red oaks. “This mite can produce a pruritic (itchy) rash that is often erythematous (a redness of the skin) and papular (with small, raised, pimple-like bumps). Although they have been reported to feed upon many different insects, it is when they have become very numerous, eliminating their current food source, that they will search for alternative hosts and inadvertently bite humans.” They reportedly can fall from a single tree and blow in the wind in great numbers.
Matt Pelikan, who also referenced the 2006 report, and is often “out in the field,” said, “At some point over the last 6 or 8 years, I started getting bites of a type that I hadn’t previously gotten, mostly after stomping around in grassy areas or areas with a combination of scrub oak and herbaceous vegetation. I was never aware of the biter itself — just really itchy bites that popped up 12-24 hours after I had been out in natural habitat. But, Pelikan, who helped The Times out by reaching out to colleagues also said, “All I really know is: 1) Some new kind of biting critter turned up here within the last few years,” and “2) People are saying and assuming that it’s the oak mite. But common knowledge is often wrong about this stuff, and these days, incorrect or incomplete information can go viral.”
Whether it is Lone Star larae bites or Oak Leaf Mites, or some other bites, remains undetermined for now. Whatever it is, biologists and health officials will follow the science and we will stay on top of what they find. Roden-Reynolds said, “Sufferers should hope it is Oak Leaf Mites or something other than Lone Star bites. There is no known health concern with Oak Leaf Mites, other than a few weeks of weeks of itchy welts and possible bacterial infection from scratching.”
There is some cold comfort that as the temperature drops so should the “mini-plague.”
For sufferers: Get in touch with the MV Times staff. We’d like to know your stories and will quickly follow up with more information online, in The Minute and/or in the paper.
Corrections: This article originally stated the Chilmark Health Agent is Jan Buhrman. Anna McCaffrey is the Chilmark Health Agent, not Jan Buhrman. Also, an earlier version of this article referred to Conroy’s Apothecary as ‘Conway Apothecary.’
We know these as seed ticks in SC. Not to be messed with but solutions are available: if you see them right away, the old standby of duck tape pressed against the area will take out a LOT of the little things. Also – the shampoos for lice will also remove them but follow the directions. Flea/tick shampoos for dogs will take care of them on dogs. Wash thoroughly.
I had these last year for about 2 weeks.
I’m going on 6 weeks now this year and it’s no fun.
Every time I feel like they are starting to clear up another round sets in. I spend a lot of time walking in the woods and I’ll have to change that up and see if it helps.
I just learned about the Oak mite a few days ago so I feel a little better knowing what it is now.
My feet and ankles are always the worst but I do have them all over my body and I mean everywhere.
All the best to us all.
I removed 13 TINY ticks (only clearly visible using the zoom feature on my smart phone) from my friend’s bum about a month ago. 12-24 hours later their feet and legs were spotted with intensely itchy, weepy welts.
You should stick with the public pickleball courts…….less bugs
Anna McCaffrey is the Chilmark Health Agent, not Jan Buhrman.
I thought they were mosquitoe bites which usually don’t bother me. Theses last for weeks and either reappear or I got bit again. Around my ankles. Never had anything like it before.
After hiking or working in the yard I have also been getting bites from unknown and unseen sources. Small red bumps more like 2mm not 2cm and no visible vesicle. Bites are similar to a chigger bite but seem slightly smaller and less rounded on top. Often around the ankles but also get a few on the chest, upper arms and other areas. Fortunately only have a few here and there but have seen photos posted of people with dozens around the ankles. Sure would like to know what they are.
Interesting thing is there has been a massive plague of mite bites where my sister lives in a suburb of Chicago, where the 17 year cicada infestation emerged this past spring. The explanation is a type of mite that is attracted to the larvae of the cicadas and the description of the bites are exactly what is described in this article – large welts, painfully itchy, and are invisible. They blow in the wind, so just being outside you can get the bites. Are all mite bites the same, no matter what type of mite?
My third year getting bit. Previous two years were manageable. This year, over 90 bites… most beneath the sock line. Sleepless itch for two days. Subsequent blisters and weeks of healing your skin…really bad. Thought it was lone star (doctors don’t know) and now wondering about oak mites.
Carry permethrin. Deet and pants in socks did not work for me.
The bites just appeared on both of my legs and they were SO itchy especially at night. I was up in Aquinnah at the time and took a fall onto our driveway with gravel – hurting my knee badly. I couldn’t wear long pants for a few weeks, just shorts. I don’t know why but I forgot to spray Cutter, which I always do. I do not go near high/low grass areas or into the woods so I wonder if I was bitten when I fell. Maybe even taking the trash out to the bins where there is just little growth around them. I finally saw my doctor after the itchiness subsided but the red spots didn’t fade. He instructed me to apply clobetasol which worked like a charm.
My question is, would applying insect repellent (like Cutter) have prevented these bites?
Correction to my comment: My doctor PRESCRIBED and instructed me to apply the ointment, Clobetasol.
Last Friday night I had a tremendous itch on my right arm. Awoke Saturday morning with a rash all over my body. Only part that was spared was my face. I went to ER and was diagnosed with tick nymphs. I was prescribed a pill to take care of the itch and permethrin cream. Pill has mostly worked to take care of the itch but body is still covered in rash/raised watery pimples.
I stripped my bed and washed everything in hot hot water. Plus vacuumed the mattress and threw out the vacuum bag. I can see the light at the end of the tunnel but still don’t know where I picked up the nymphs. I wouldn’t wish this on my worst enemy.
It’s awful
I am also suffering with the sudden mysterious onset of at least 20-30 bites, more this year than last year, without walking in the woods.
I would like to know:
1)what the hospital is recommending for treatment, and
2)is this an indication to get tested for Alpha Gal
I don’t want to go the ER or bother a doctor unless it is necessary.
Went to visit friends in Chilmark, then played pickleball at a private court nearby in Chilmark. Later that afternoon, 1 large red welts appeared, followed by numerous small red bumps all over my forearm. Extremely Itchy! I took benadryl. When I got home I took a HOT & SOAPY shower. Bumps disappeared shortly thereafter, and just a tad itchy now. I’m going with Oak Mites, but who knows.
Why can’t a dermatologist get a specific diagnosis on this problem and a treatment. It seems that the body is getting a systemic allergic reaction either from the cause or from the current treatment.
Very perplexing.
I surmise that the bites are causing a systemic reaction, becaluse I seem to be getting more welts even though I have showered numerous times and have basically been sitting inside.
I, too, fail to understand why no analysis has been done of the welts and fluid in the blisters to establish the source of the bites, and a treatment protocol established. I am currently on my fourth round of bites: 1. three summers ago (after sitting on lawn on Chappaquiddick); 2. two summers ago, after walking around expansive outdoor art show in Chilmark; 3. two summers ago, after collecting beach plums in Aquinnah; 4. current round, after not sure what—either attending a garden party or taking a short walk on a path in the woods.
At the hospital today! Over a hundred bites! Thank goodness for modern medicine!!!! Wow! Great article!
Thank you so much for covering this important issue and providing some much needed information.
Two questions:
Can lone star nymphs convey alpha-gal syndrome?
Why permethrin on the bites if there is no indication that the nymph, chigger or mite is still there?
I have had them for about 1 week. I have not been in any wooded areas, fields or on hiking trails. I do have many Oak trees in and around my yard. I have @ 10 random itchy bumps on my torso, back and legs. Extremely itchy and very random. I treat with Tecnu wash and creams. I live in Oak Bluffs.
2cm is almost 1 inch. Most likely 2mm. About 1/12 of an inch
My understanding, after a lot of reading and three years of bites:
Permetharin is a preventative application, or a speculated remedy if bugs are still attached…not as a lotion for the itch or subsequent swelling. Deet did nothing, for me, as a preventative last week while in a meadow, surrounded by oak vegetation, on Chappy.
It is believed the larvae does not carry alpha gal, however by the time the tick has moved onto nymph or adult stage it can be a carrier.
The larvae/seed tick typically falls off the host after its bite, and before the itchy bumps appear…in search of a new host in attempt to make it to its nymph stage. Typically, the tick needs a new host, preferably within its usual environment in order to survive. It is not believed the seed tick will survive in a house.
I believe, only this year, I was able to uncover about 5 or 6 seeds/mites from bites. Much smaller than a deer tick and indistinguishable to my eye…even magnified with my phone. However, when you see it move across your finger tip, you know it’s something.
The oozing blisters, as a result of the bite, do not seem to cause spreading nor do they seem contagious to others. No one in my house has had a single bite during my three episodes.
I did read, lone star nymph bites and oak mite bites are similar, however the lone star tick bites don’t develop fluid filled blisters/bubbles, while oak mite bites do. I am not sure that is true. It seems like any bite, based on bodily reaction, and or allergic reaction, could develop into a blister?
I am currently on day 9 and the fluid in the blisters is subsiding but the bites have weeks, possibly months, to go before they heal…I know that for a fact.
I am not sure how my ankles are always so bad with the number of bites and resultant blisters while the upper leg bites are manageable with no blisters. In each case I have had socks and shoes on…how are the ticks/mites penetrating the socks when my legs are undefended?
Let’s hope the medical profession can get out in front of this. It is likely this is going to impact many more of us sooner rather than later.
I was recently tested positive for alpha gal with a value of 1.14 which is classified as borderline. If I stray into eating something containing milk related ingredients I get small individual hive spots in various places including my lower legs. So it’s a challenge considering whether or the itching is from hives, Oak Mites, biting Lone Star Nymphs, or any other kind of tick. If it’s a tick, that’s easy to confirm visually, especially using an Iphone with a Macro Lens. It is also my understanding that Lone Stars need to bite another animal to get Alpha Gal into their guts. If that is true then the bite of newly hatched Lone Stars emerging from nests would presumably not contain Alpha Gal which is a relief to know.
This is my third year of experiencing these bites. Our property abuts Felix Neck. The first time I experienced the bites was in the late summer of 2022 when I was itching and noticed poppyseed looking ticks that our dog was carrying inside to wherever he slept…our bed, his bed, the furniture. Up close I could see tiny legs. I collected some and sent them off to “Tick Check” in PA to be tested. They were identified as Larvae Lone Star tick, fully engorged with blood. The results were negative for all of the 15 pathogens they were tested for except Rickettsia general species which is associated with Rocky mountain spotted fever. Both last August and this one I again have received the extremely itchy bites, but have not seen any poppyseed-sized larvae or other visable culprit. Maybe they were larvae not yet engorged and so invisable to the naked eye? Bites are all over. I have not developed any other adverse reactions other than severe itching. I was already taking zyrtec which may or may not have helped me.
A friend recommends InsectShield socks, treated with permethrin.
She states that she has had no bites since wearing these whenever outdoors, with pants tucked in (the new Vineyard fashion statement?)
.
You can order the socks at the InsectShield.com website (Amazon is sold out of these!).
I read in the Times Aquinnah community notes last week that the town has made these or similar socks available for $1. This looks like a good ounce of prevention.
Perhaps all of our town health agents can look into bulk orders of such socks for the public to purchase. It seems like more such socks might be needed than a single retail business can keep in stock.
Further to Insect Shield:
I learned last year that all Sheriff’s Meadow employees are equipped with permethrin-impregnated Insect Shield work clothes.
At their FAQ page Insect Shield states:
“How did permethrin originate, and how is it used?
Permethrin has been successfully used in the United States as an EPA-registered product since 1977, with an excellent safety record. Permethrin is used in lice shampoos for children, flea dips for dogs, and various other products, some of which are regulated by the FDA. The Insect Shield process uses a proprietary formulation of permethrin in a system, and the resulting repellency is so tightly bound to the fabric fibers of each garment that it lasts through 70 launderings. The process designed by our researchers specifically for creating Insect Shield products and the proprietary formulation that is used are quite different from permethrin-based technologies employed in other industries.”
They also provide a lot of background information and how-tos at the website, on these and other pages:
https://www.insectshield.com/pages/thomas-mather
https://www.insectshield.com/blogs/blog
https://www.insectshield.com/pages/faqs
I rented for a week in Chilmark and this is the second year I’ve gotten these mysterious bites all over my body. My son found the tiny Lonestar nymphs on his feet, dozens but didn’t get a single bite himself. Nobody else in the house got bitten. Only me, this year and last.
I went to my doctor here in Connecticut and he started googling it, and I said, I didn’t come here to watch you google things.
I tried all sorts of steroid creams last year but finally found the best treatment was the good old fashioned calamine lotion that your great great great granny used to recommend from her rocking chair, purchased from Conroy’s for… wait for it… $3.29. Last year and this year I found that if you soak your bites in this and just wait for a bit, the calamine lotion will stop the itching. You’ll have to apply it every three or four hours but eventually, despite the welts, it’s manageable and they will go away.
Full disclosure: no I don’t own stock in a company that makes calamine but I do own a rocking chair.
Patrick is on vacation this week, so I am answering in for him.
Yes, Insect Shield socks are the way to go. Patrick and I wear them whenever we are in the field looking for ticks. We also wear permethrin treated pants and shirts, but this time of year the socks are the best defense against lone star larvae which are everywhere this time of year. Patrick has been surveying ticks for two years now and has never been bitten! Permethrin treated clothing works.
You can order socks rom Insect shield, as Kate noted. They are also sometimes available at Brickmans in VH and Basics in OB. Get them and wear them at least during August and September, it can save you a lot of misery. And yes, the larvae can cause the alpha gal allergy. in fact, the allergist from NY who has seen over 1000 cases thinks the larvae may be the main source for alpha gal.
The Island Boards of Health are trying to arrange a bulk purchase of socks from Insect Shield
to distribute on the Island. I don’t know the details or where it stands but you will likely be hearing more in the near future.
My guests and myself were bitten many times over the holiday weekend! They primarily bite during the night and too many bites to Be spiders! How do you get rid of them? I’ve laundered all the sheets multiple times and I’m still getting bit! My friends aren’t getting bit anymore because they left the island!
Brooke, the world would be a better place if everyone owned a rocking chair! 😁
Last week I broke out with about 2 dozen little itchy spots on my feet and legs. I remember seeing a tiny very fast-moving insect (what I thought was a tiny spider) running across my hand. I brushed it off. Visual ID says it was a chigger. I had recently done some weed whacking of tall grass at the back of my lot.
The important and unanswered question is, can the nymphs cause AGS. The only thing I can offer is my experience. I was severely bitten by the nymphs in both 2017 and 2018 and suffered with brutally itchy welts that lasted weeks. In and around that same time I started having very odd and completely new gag reflex issues. The reflex was being triggered from normal every day things like brushing my teeth or taking pills. This was totally new for me and concerning enough for me to discuss it with my doctor, dentist and ENT, all with no clue as to why. In 2020 I was bitten by two adult lone stars and the gag reflex ramped up to a level where turning my head could trigger it. Then came the steak, the anaphylaxis and the diagnosis. I am highly reactive to all mammal products, more so than others I know with AGS. I believe the nymphs gave me low levels of alpha-gal causing my initial issues, the adults put it into high gear. If you have been bitten by the nymphs, monitor yourself for odd changes to your body, particularly in the gastric areas. Treat your clothes, spray your feet, check for ticks, every time you step off the pavement.
I wonder when it will be safe to work in my woods taking vines off the trees? Perhaps a scientist/botanist would be able to let us know.
After experiencing HUNDREDS of incredibly itchy bites on my ankles and legs from both Lone Star nymphs (poppy seed size) and what I believe to be oak mites (invisible to my eye) last summer, this year I have invested in both Permethrin and Picaridin with great results!!! Insect Shield offers an expensive ($100) but effective “mail in 5 lbs of your own clothes” Permethrin treatment which WHICH LASTS THROUGH 70 WASHES. After wearing those clothes I still got just one oak mite bite in July so I purchased Picaridin, a white lotion, which I rub on to my feet and legs each morning (it lasts 14 hours and repeals ticks and mosquitos). This combination of preventative care has resulted in NOT EVEN ONE tick or oak mite bite through the last 7 weeks – even after daily walking and biking in the up island woods. I plan to keep up this successful regime until our island medical community comes up with some answers and solutions!
My boyfriend and I have been suffering from these bites the last few days. After the walk I started itching badly at 3am the night after we went for a walk in the forest on chappy. I had worn shorts. My legs are completely covered in red welts with puss in the middle. Most of my bites looks like little blisters. More bites have appeared over the days. My boyfriend wore jeans and has far fewer bites. We think they are chigger larvae based on what we have read. They are microscopic and decompose your flesh, hence the blisters. When they are big enough they fall off and go away. Whatever they are, it’s important to wash all your clothes. Chiggers can get through clothes, they are that small.
We read that Lone star tick larvae don’t spread alpha gal. We don’t think it’s lone star tick larvae. Much more likely to be oak mites or chiggers. It’s the season for chiggers and it’s the right humidity and environment for them. This is based on our internet research. Tea tree oil calmed mine down a bit. Hoping to stop discovering more bites soon! Ouch!!
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