Thomas Mather, also known as the “TickGuy,” is professor of Public Health Entomology and the director of the University of Rhode Island Center for VectorBorne Disease and its TickEncounter Resource Center. TickEncounter has become perhaps the nation’s leading tick bite prevention resource, and its Get TickSmart messages are increasingly being used by communities and individuals nationally to help “solve the tick problem.”
PBN: Where is public awareness when it comes to Lyme disease, compared to where it needs to be?
MATHER: There’s quite a bit of awareness about Lyme disease but there’s also quite a bit of misinformation and misinterpretation and application of the available information, both about the diseases caused by ticks and about ticks, tick bite protection and tick-borne disease prevention. Unlike other biting bugs that you can hear coming like mosquitoes, until found, ticks seem to fail to raise consciousness, and that results in poor mental linkages between when or where you encountered the tick and the anxious need to get it off your skin. So prevention for most people starts after a tick bite when it really needs to start well before. In most people’s consciousness, tick bites won’t happen to th, until they do.
PBN: How commonly do Rhode Islanders contract Lyme in suburban environments, playing or working in their yards?
MATHER: Hard statistics are difficult to come by but there’s no question that, one, there are more ticks in more places than ever before, and, two, that there are plenty of disease-carrying ticks in rural, suburban and even some semi-urban environments throughout the northeast, including Rhode Island. There are studies that suggest some 75 percent of Lyme disease cases are contracted in and around your own yard or neighborhood. I’d say you’re more likely to encounter disease-transmitting ticks in a suburban Rhode Island backyard than hiking the Appalachian Trail. Click to view 20 years of tick risk maps in Rhode Island.
PBN: What is the status of the debates revolving around testing and treatment and protocols coming from the CDC?
MATHER: The debate still seems to be raging, but this is an area subject to misinterpretation of published reports and even individual test findings. A very recent paper published in the journal Clinical Infectious Diseases cited that in 2008, approximately 3.4 million Lyme disease tests were conducted in the U.S., with so called two-tiered testing (ELISA/EIA + Western blot) accounting for about 62 percent of assays. CDC typically recommends reserving the more expensive two-tiered testing for patients with signs and symptoms of disseminated disease. In this study, the reported estimated frequency of infection was about 12 percent which translated into an estimate of 288,000 infected source patients in the U.S. which was 10 times higher than the number of cases reported to CDC in 2008. The authors indicate that the low percent positive values in the study do suggest that many clinically unwarranted tests still are being performed, such as testing at the time of tick bite, when detectable antibodies would have yet to develop.
PBN: How many people that you know personally have had Lyme, and have you ever had it yourself?
MATHER: In my line of work, I know or hear from hundreds of people that state they’ve had or have Lyme disease. Even the TickGuy had Lyme disease back in 2002. I was treated with antibiotics and recovered quickly. To this day, my IgG antibody titers are still positive. Does that mean I still have Lyme disease? I don’t believe so. While I’ve got my share of aches, I’m pretty certain they’re due to lifestyle and not Lyme.
PBN: How successful would you deem efforts to mitigate disease exposure by having yards sprayed with insecticide?
MATHER: I think backyard tick control can work well to reduce risk but there are a few variables packed inside your question that need unpacking. Successful tick control depends on the active ingredient of the product and the application method. Timing of the application is another important variable. The poppy-seed-sized nymphal deer ticks have just one cohort per year so you only have to kill them once. Nymph deer ticks begin emerging in mid-May and are in peak season in Rhode Island right now. The current industry standard is a synthetic pyrethroid, most commonly bifenthrin, applied twice – in mid-May and mid-June. In studies we’re conducting, we collected an average of 0.8 nymphs in southern RI yards treated using bifenthrin by TickSmart certified pesticide applicators in 2013 compared with an average of almost 90 nymphs per yard in neighborhood-matched untreated yards. We’ve also been evaluating natural products but in smaller plot studies. Unfortunately so far, only one natural product formulation (EcoSmart Eco PCO) has come anywhere close to the 98.5 percent efficacy of the bifenthrin treatments. To be a “green alternative” products would still have to reliably kill some ticks and not all of them do.