During a summer where seemingly all anyone can talk about is ticks, with the rise in tick-related hospital visits and national reports on the Island’s surge in alpha-gal syndrome cases, there is only one health specialist, who works part-time, to investigate the spread of tick-borne illnesses on the Island.
Betsy VanLandingham oversees hundreds of cases out of her Island home office. On a given week, and especially in the summer months, she often works well over her allotted 26 hours.
VanLandingham — an emergency room nurse for 43 years turned public health nurse — is currently the Island’s only infectious disease case investigator, and she’s seen more tick-borne illness cases every year. With the emergence of lone star ticks and rise in alpha-gal cases, the work is ballooning. Ticks are one of the biggest health concerns for the Island, she said.
But as of earlier this year, the source of her funding was rescinded and is running out, raising questions about the ability for her and other tick-related officials on the Island to continue to do this work.
Local health officials, who are calling this an epidemic, say that much more is needed to be done to better understand the problem. The Island already does much more tick-related work than other towns in Massachusetts, but the concern now is about having the right data to map a strategy for confronting the problem in the future.
“It’s exactly the wrong time to stop funding for what we need, which is basic research on the epidemiology of these diseases,” said Dr. Gerald Yukevich, medical practitioner at Martha’s Vineyard Medical, which hosted a tick conference this past Saturday.
VanLandingham is an independent contractor who works for Dukes County under a grant paid for by the Massachusetts Department of Public Health to investigate each infectious disease case on the Island. The department keeps a statewide database of infectious diseases called the Massachusetts Viral Epidemiologic Network (MAVEN), and VanLandingham’s job is to input all the symptomatic and exposure information for Island cases — not just tick-related, but other infectious diseases as well. But she isn’t sure what will happen when her contract ends on June 30; the county reallocated money from other grants to allow her to continue work until then, she said.
VanLandingham’s foray into public health started during the pandemic, when she both worked in the ER and investigated COVID-19 cases. Her job was created out of the pandemic, through federal money, by the Vineyard hospital; they wanted someone to be a close liaison to the boards of health and monitor the situation locally. The hospital kept the position until the pandemic funds ran out.
After she retired from the ER, VanLandingham decided to move further into public health work, and took up investigations of all kinds of diseases through the state department of health. “I knew too much about public health to go back to the ER,” she said.
VanLandingham is paid through a federal-to-state-funded grant, which was targeted to be cut by the federal administration and is due to run out in June 2026. Vineyard towns as part of the Inter-Island Public Health Excellence Collaborative have used a Massachusetts program called the State Action for Public Health Excellence, which aims to improve and strengthen local public health services, to cover any gaps for VanLandingham but isn’t enough to absorb her nor other tick-specific staff in the long-term.
The primary concerns for public health are prevention, and determination of the sources of infection. If someone gets an intestinal infection from food, or is exposed to a certain body of water and develops an illness, for example, VanLandingham investigates the source and determines whether there’s a risk to other people, to prevent further outbreak.
Early on, she realized that all the “very seasoned” workers in the local boards of health didn’t know that much about tick-borne illnesses. Health agents were overloaded with the usual septic and business inspections, she said.
It was only a few years ago that she realized that there weren’t many hard figures on tick-related diseases — such as how many people contracted Lyme disease, or the rarer erlichiosis, Rocky Mountain spotted fever, or tularemia — for the Island. And so, armed with decades in medicine and the knowledge of on-Island providers — physicians, nurse practitioners, and physician assistants at the hospital and medical care clinics — and even off-Island physicians, VanLandingham took on the task.
Now she handles the follow-up for everybody who tests positive on the Island from an office in her house. Most of her work is on the computer, and involves multiple calls to those affected by an infectious disease. That can mean, “How old was that bologna in your refrigerator that you made a sandwich of, and then felt bad, felt sick afterward?” It can also mean, “Do you work outside every day, mow the lawn, and stir up rabbit droppings?” (Rabbit excrement is a source of tularemia.)
The MAVEN network tracks the electronic transfer of all lab results across the state, and then VanLandingham takes each case from the Island and investigates symptomatic and exposure information.
Tests are imperfect, VanLandingham said, so there are a lot of false negative and positive results. Part of her job is to weed through symptoms and determine correlation to infectious diseases.
VanLandingham sees more and more tick-related cases every year, especially after the emergence of lone star ticks, which only started to appear on the Island recently, and brought both new disease and the much-detested alpha-gal syndrome. She doesn’t investigate cases of alpha-gal because her focus lies in illnesses, and alpha-gal is an allergy, though she said that information would be helpful for the Island. There aren’t enough staff or resources to investigate those cases currently otherwise. The hospital reports that positive tests, which can be re-tests of the same person in one year, of alpha-gal are up from just two in 2020 to 523 last year.
“The rate at which alpha-gal has ballooned up over the past couple of years, we know that tick-borne illnesses in the same way [have] increased,” VanLandingham said.
In Dukes County from 2020 to 2024, there were 784 cases of Lyme disease, 113 of babesiosis, 60 of anaplasmosis, 25 of ehrlichiosis, 22 of Rocky Mountain spotted fever, and 17 of tularemia. There was also one case each for Borrelia miyamotoi and Powassan virus.
VanLandingham, though paid for only 26 hours a week, gets three to four cases a day from the Island sent to her via the statewide network, especially in the warmer months, when foodborne and tick-borne illnesses are more prevalent, and each case can take up to four hours.
Without her work, VanLandingham said, there’d probably be pressure on the hospital to provide what she does.
“I hope that I’m providing enough education for patients and physicians to basically take care of people who are affected by these illnesses,” VanLandingham said. She also hopes to convince people that the only way to decrease the amount of illness on the Island is to decrease the host population, which can include deer and other animals.
The contract epidemiologist for the county, Lea Hamner, is also running out of funds. Hamner started in July 2023 after a decade of public health work for the COVID-19 response, the opioid crisis, and other outbreaks.
Hamner’s contract, also paid for through the rescinded funds, includes only eight hours a week on the Island, but focuses solely on ticks. (She also works 32 hours a week on the Cape for Barnstable County.) Hamner helps the towns and medical practitioners understand the “big picture” and “nuance of tick-borne diseases,” and provides advice on how to avoid tick bites as well as signs and symptoms of illness, she said.
Once that chunk of change allotted to her work is gone, she’s not sure what that will mean for tick work on the Island. Hamner said she plans to front-load her hours to work mostly on the Island until that happens, but she has a smaller contract than VanLandingham, and isn’t sure she’ll even be funded up to June 2026. The loss of the two public health experts would put more on the plate of already overworked health agents, she said.
“Their roles are extremely important and complimentary,” Brice Boutot, health agent for Edgartown, said. “Betsy’s work is acutely case-by-case, assisting patients and figuring out if their symptoms are from past exposure or current illness through testing. Lea generates epidemiological reports based on aggregate data, informing initiatives to better understand and combat illness on a regional level. The tremendous value of Lea’s depiction of trends would be far less informative without Betsy as boots on the ground.”
Boutot said that when, not if, the funds run out, health agents across the Island will have to maintain the quality and quantity of work they do identifying and mitigating illness. “Ultimately that work would fall on all Island health departments, but the value of having a select few highly experienced specialists working across town lines cannot be overstated.”
The work of public health officials, especially local ones, is as varied as public health is, which makes them “master generalists” and “quick-study specialists,” Hamner said. The space she occupies for the Island isn’t one that’s been filled before. Whenever there’s money, tick work is prioritized by the hospital and boards of health, but that won’t be the case soon, she said.
“The state government is going to have to make a lot of hard decisions” as the federal government cuts are felt, Hamner said, though she doesn’t think the state will be able to prioritize work on ticks.
“We’re going to need our community, honestly, at this point, to step up and fund it, because there’s no one coming to offer us help, not right now,” she said.
“Their work and their roles are important to us,” Alex Lam, West Tisbury health agent, said. “I don’t think that there’s any one town in particular, or any town for that matter, that’s opposed to doing whatever they can to assist their positions and keep them where they’re at. What that entails, I’m not fully sure, but we’re happy to have them on our team.”
Wildlife biologist Patrick Roden-Reynolds, who works closely beside VanLandingham and Hamner, said that all tick questions eventually lead to what is the importance for humans and those answers come from the two women.
“I can talk about tick ecology, biology, disease ecology, but when it comes to disease trends in humans, who gets affected and why, what symptoms or treatments to use [that] all come[s] from the surveillance work that Lea and Betsy do,” Roden-Reynolds said.
Roden-Reynolds, director of the Martha’s Vineyard Tick Program, said as far as he knows no one group does as much outreach in Massachusetts as their group. “I’ve never heard of any other group doing educational tick surveys for residents either,” he said. However, at the current staff level, they’re already at capacity for the work they do.
Hamner called herself a “resourcer,” as much of what she does includes bringing science to the community and the community to science. She’s connected many researchers to the Island, which has one of the highest Lyme disease infection rates in the country, in the hope that the research eventually benefits Islanders here. However, much like VanLandingham and Hamner, a lot of the researchers are facing cuts as well. “A lot of the work I’ve been doing got thrown a wrench,” Hamner said.
One such opportunity is a project by Hamner and Scott Commins, an expert on alpha-gal, that would follow Vineyard and Nantucket hunters — who are highly exposed to ticks, unlikely to cut meat out of their diet proactively, and also needed to address the deer population — to understand who develops the syndrome and why, who goes into remission, how tick-borne infections might affect the allergy, and what can be done to prevent it, Hamner said. The project is now in a “holding pattern” because of federal cuts to the National Institute of Health, she added.
There are still so many questions about Lyme disease, and especially about alpha-gal, Hamner said, and there needs to be more research.
“Public health can always be improved, so there is always more work to be done,” said Boutot. He added that VanLandingham, Hamner, Stephanie Barth –– another contract public health epidemiologist –– and biologist Roden-Reynolds, whose funding comes from the state, are on the “cutting edge of this issue that has impacted Martha’s Vineyard in a unique way.”
With all the tick efforts on the Island, there’s a hope to get a full strategic plan on how to combat ticks, but as questions still loom and funds start to dry up, Hamner has her concerns: “How do we sustain whatever we created, let alone that we need to do more?”
There is a fund through Martha’s Vineyard Community Foundation that supports the tick program’s activities that cannot be covered by grant funding: https://endowmv.fcsuite.com/erp/donate/create/fund?funit_id=1095
Thank you for writing this article about our work. Our team is passionate about addressing the complex problems that are ticks & tickborne conditions on this island. We hope we can continue to do so and expand our work to meet the clear need.
In addition to the MV Tick Fund link in the article, I want to share that Dr. Scott Commins (preeminent Alpha Gal Syndrome Expert at UNC) has an Alpha Gal Allergy Research fund: https://give.unc.edu/donate?f=346049&p=medf&s=medfot21scfu39. Dr. Commins is the one to discover AGS was due to tick bites, and he has continued to move this important science forward ever since. We were poised to submit a grant proposal to the NIH but with funding being as unstable as it is, we are hoping to speak to anyone interested in financially supporting our Hunter study. To speak more about the project, I can be reached at lhamner@oakbluffsma.gov.
Maybe invite RFKJr. out to Chilmark to roll around in one of our fields.
Don’t panic. Trump is going to make a deal with the ticks and they will agree to stop biting people. It will be a wonderful achievement worthy of the Nobel prize in medicine. Just think of how wonderful it will be when trump eliminates Lyme disease, babesiosis, anaplasmosis, ehrlichiosis, Rocky Mountain spotted fever, tularemia, Borrelia miyamotoi and Powassan virus. All with one great beautiful deal.
I can understand cutting this research funding as we all agree Trump needs to pay back his billionaire supporters. Our children are not as important as making sure our billionaires have extra jets.
Most of the people flying around on big jets To Davos and everywhere else in the world lecturing us on climate were Democrats who oppose Trump. One scheduled cut next year for undisclosed amount and our children are dying. Please!
Shame on the federal administration and people in power who are cutting this vital research. Cutting NIH funding is a slap in the face to the taxpayers and small business operators who fund this country through federal tax payments. This is not “making America healthy”; it is just the opposite.
I invite every lazy Trump hating personal here to research waste and abuse by the NIH
Don’t blame Trump and RFK, blame politicians and NIH management for abusing taxpayers to further their agendas
Two points to remember
1. Governments waste and spending of money they don’t have affects poor disadvantaged people way before people in wealthy enclaves
2. Private concerned citizens can always contribute their own money to causes they support instead of demanding everyone’s money be used
John-I would like to see every lazy sycophantic trump supporter show us the waste and abuse in the NIH rather than just blame democrats There is waste and fraud in all branches of government and industry. Some people seem to think that all that stuff hasn’t been happening for decades. A few things to consider
The president has been convicted of 34 felony charges of fraud
The president has spent $60,000,000 on golf outings this year.
It cost U.S taxpayers $5,000,000 for him to take a joy ride around Daytona speedway.
Private citizens donated nearly $25,000,000 to the ” we build the wall” scam only to find out that Steve Bannon and his cabal of crooks pocketed most of the money. Three of the top 4 conspirators were sentenced to prison after either pleading guilty or being convicted .Bannon admitted to fraud but was pardoned by trump before trial. No problem, right ? Donale all you want. to whatever you want–
And of course, Andy is wrong with his assertion about who does what with their private jets– It has nothing to do with this topic, and it’s none of his business if Al Gore wants to go to Darvos in his jet.
It’s heartbreaking to see cuts in funding for such important work. Thank you MV Times for keeping us informed. When is this political madness going to end?
Listening to a friend today who is a Democrat, and voted against Harris, they think the reason the Republicans are winning elections is because rents and groceries are too expensive and the Democrats refuse to fix it.
Somehow people who voted for this administration need to see a correlation between their rent and loss of crucial funding for science, education, and national security.
There are 3 Lyme vaccine trials currently underway. The Pfizer one that was suspended here due to record-keeping issues. https://www.pfizer.com/news/press-release/press-release-detail/phase-3-valor-lyme-disease-trial-valneva-and-pfizer A second one from Moderna using mRNA https://trials.modernatx.com/study/?id=mRNA-1975%2F1982-P101 . A lyme vaccine for dogs is already in use and is being tested for human use https://www.merck-animal-health-usa.com/nobivac/nobivac-lyme/nobivac-lyme-vaccine
This is kind of funny, but not in a ha-ha way. In all the many decades now of being victim to the explosion of tick-borne illnesses, I’ve never seen locals do much of anything serious to reduce the ever-expanding tick population and their new and improved diseases– other than argue about “it’s the deer, it’s not the deer, it’s the mice or moles or skunks or racoons, and poor Bambi, and how about birth control?” We’ve been through administrations both democrat and republican, and still, the local government has done nothing serious to reduce ticks and the illnesses they bring. We were told to use toxic chemicals and tubes on our property and clothes and stay out of high grass areas, but watch out for your pets, and blah, blah, blah. And every summer you see visitors trampling through fields and woods, oblivious to the danger. Obviously, all of this can be blamed on Trump. It’s his fault the island has done nothing to reduce the ticks. And while you’re at it, hey, may as well blame Netanyahu.
Jackie-What can local governments do about this? I like the idea of genetically modifying the white footed mouse to deal with Lyme. Last year,researchers at MIT announced they had made a significant breakthrough on that front. https://vineyardgazette.com/news/2024/11/07/scientists-make-leap-creating-lyme-resistant-mice . There is a substantial body of evidence that the warming climate is helping the ticks out. Local governments do not have the resources to carry out advanced scientific research or cool the planet down.All they can do is offer us advice as to how to avoid them The increase in ticks and the associated diseases are certainly not the fault of trump or Netanyahu.–Your comment bringing Netanyahu into this borders on anti-semitism.– The article is about trump defunding the research that may help . I think it’s reasonable to question that poor decision. I don’t get the rationale behind it, other than that we know trump loves the undereducated. He is also cutting budgets for the medical community that help us when we do contract these diseases. The only real power we have over the ticks is to vote for people who support the scientific research that may be able to solve this.
It is possible, with our warming environment, that this is an unsolvable problem and people may be faced with lifestyle decisions. Hosing yourself down with insecticide every time one goes outdoors doesn’t seem like a healthy alternative.
Giving up and accepting a plague is not part of our DNA, I hope. Making the Vineyard less hospitable to ticks shouldn’t be as daunting as stopping the ocean from encroaching on billionaires’ homes. Removing or substantially reducing a food source and host (not counting us) has never even been tried, although moving off-island solved my personal tick issues. There is a reason why the island is a particular hot spot for tick illnesses, and although I’d like to blame all the “tolerant” liberal left (humans are occupying colonizers of tick habitat, you know) it’s not liberals’ fault any more than it is Trump’s. The Trump rants are entertaining, though.
Reducing the tick population does not require government funding, votes, a democrat administration, or TDS.
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