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Ticks

The Pediatric Infectious Diseases Group at Stony Brook Medicine’s new regional tick-borne disease center, located in the Hampton Bays Atrium. From left, Dr. Andrew Handel, Dr. Dalia Eid, Dr. Christy Beneri and Dr. Sharon Nachman. Photo from Stony Brook Medicine

Stony Brook University is planning to open the first and only dedicated tick clinic in the northeast on Monday.

Supported by doctors from Stony Brook Medicine’s Meeting House Lane Medical Practice and Stony Brook Children’s Hospital, the new regional tick-borne disease center, which is located in the Hampton Bays Atrium, will provide by-appointment treatment for children and adults for tick bites and diagnose tick-borne illnesses.

The timing could be especially important for people with tick bites, as the previous warm winter allowed more ticks and their eggs to survive.

“They are out there, happily laying eggs and the eggs will hatch,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital.

Brian Kelly of East End Tick and Mosquito Control donated the center’s suite which includes a reception area, two exam rooms, two private offices for consults and a nurse’s station, for 10 years.

“Between the beautiful weather in the winter and the nice weather in the summer, ticks are outside,” Nachman said. “I’m thrilled we’re doing it now. There’s no time like the present to move forward and work with the community to get this done.”

Tick checks

Health care providers urged parents, caregivers and anyone who spends quality time in nature to do regular tick checks.

Ticks can be so small that they look like a little freckle. These ticks can harbor diseases beyond the dreaded and oft-discussed Lyme Disease. Other diseases include babesiosis, ehrlichiosis and anaplasmosis.

In general, Nachman urged patients not to send ticks they pulled off themselves into the center.

“It’s the tick that they didn’t see that’s also putting them at risk,” she said. The clinic will determine the type of tests to run based on the symptoms.

For tick bites, as with many other health challenges, time is of the essence.

A tick that’s attached itself to a human for fewer than 48 hours likely won’t lead to an infection. Someone with a tick bite for about 48 hours might get a single dose of an antibiotic. People who had a tick bite for over that period might develop a rash or even facial palsy, in which one side of the face droops for an extended period of time.

Doctors work with patients to try to hone in on the date of a possible tick bite.

“We do pretty good guessing,” said Nachman. “We don’t need to be perfect: we need to be pretty close.”

Ticks are present throughout Suffolk County.

Health care workers urge people to spray their clothing with DEET. While ticks aren’t always easy to see, people can find them by feeling a new lump or bump on their skin.

Removing ticks

Nachman advised people to wipe an area with a tick down with alcohol before trying to remove an embedded insect.

Using a flat edged tweezer, the tick removers should grasp the insect and slowly back it out.

“Don’t grab the tick and yank,” Nachman cautioned. The mouth parts of the tick have an adhesive, which can leave some of the parts inside the infected person.

Nachman, who will be at the center on Mondays, also urged people not to use petroleum jelly or match sticks.

The hours at the center will adjust to the demand. In the winter, when ticks are less prevalent, the center may have more limited appointment times.

One of the advantages of the center is that the health care providers can track patients over time who have been infected.

Doctors can also sign patients up to become a part of a registry. By tracking people who have tick-borne infections, doctors might also address questions that are part of the science of diseases like Lyme.

“There may be better treatments or better tests” down the road, Nachman added.

Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children's Hospital. File photo from Stony Brook Medicine

With COVID-19 pandemic restrictions in the rearview mirror, residents have been returning to the open road and the open skies, visiting places and people.

In addition to packing sunscreen, bathing suits and cameras, local doctors urge people to check the vaccination status for themselves and their children, which may have lapsed.

“During COVID, many people did not keep up with their vaccines,” said Dr. Sharon Nachman, chief of the Division of Pediatric Infectious Diseases at Stony Brook Children’s Hospital. “That has led to a decrease in the amount of children who are vaccinated.”

Last week, the Centers for Disease Control and Prevention issued a health advisory to remind doctors and public health officials for international travelers to be on the lookout for cases of measles, with cases rising in the country and world.

As of June 8, the CDC has learned of 16 confirmed cases of measles across 11 jurisdictions, with 14 cases arising from international travel.

Measles, which is highly contagious and can range from relatively mild symptoms to deadly infections, can arise in developed and developing nations.

Measles can be aerosolized about 60 feet away, which means that “you could be at a train station and someone two tracks over who is coughing and sneezing” can infect people if they are not protected.

The combination of increasing travel, decreasing vaccinations and climbing levels of measles in the background creates the “perfect mixture” for a potential spread of the disease, Nachman said.

Typical first symptoms include cough, runny nose and conjunctivitis.

Conjunctivitis, which includes red, watery eyes, can be a symptom of numerous other infections.

“Many other illnesses give you red eyes,” Nachman said, adding, “Only when you start seeing a rash” do doctors typically confirm that it’s measles.

People are contagious for measles when they start to show these symptoms. Doctors, meanwhile, typically treat measles with Vitamin A, which can help ease the symptoms but is not an effective antiviral treatment.

As with illnesses like COVID, people with underlying medical conditions are at higher risk of developing more severe symptoms. Those with diabetes, hypertension, have organ transplants or have received anticancer drugs or therapies can have more problematic symptoms from measles.

In about one in 1,000 cases, measles can cause subacute sclerosing panencephalitis, or SSPE. About six to 10 years after contracting the virus, people can develop SSPE, which can lead to coma and death. 

In addition to children who need two doses of the measles vaccine, which typically is part of the measles, mumps and rubella vaccine, or MMR, doctors urge people born between 1957 and 1985 to check on their vaccination status. People born during those years typically received one dose of the vaccine. Two doses provide greater protection.

Two doses of the MMR vaccine provide 97% protection from measles. One dose offers 93% immunity, explained Dr. David Galinkin, infectious disease specialist at Port Jefferson-based St. Charles Hospital.

People born before 1957 likely had some exposure to measles, which can provide lifelong immunological protection.

Nachman also urged people to speak with their doctor about their vaccination status for measles and other potential illnesses before traveling. People are protected against measles about two weeks after they receive their vaccine.

Doctors suggested that the MMR vaccine typically causes only mild reactions, if any.

Tetanus, Lyme

In addition to MMR vaccines, doctors urged residents to check on their tetanus vaccination, which protects for 10 years.

“The last thing you want to do is look for a tetanus vaccination in an international emergency room,” Nachman added.

During the summer months, doctors also urged people to check themselves and their children, especially if they are playing outside in the grass or near bushes, for ticks.

Intermediate hosts for Lyme disease, a tick typically takes between 36 to 48 hours from the time it attaches to a human host to transmit Lyme disease.

Nachman suggested parents use a phone flashlight to search for these unwelcome parasites.



Graphic from the Port Jeff village website

The Port Jefferson Village Board of Trustees covered a range of issues during a business meeting Monday, Sept. 19.

With trustees Stan Loucks and Lauren Sheprow absent, the board approved a resolution authorizing the mayor to enter into a contract to purchase the historic derelict home at 49 Sheep Pasture Road. 

With this authorization, Mayor Margot Garant announced the village was moving closer to acquiring that property and presented plans once an agreement is met.

“We will be finally securing that property,” the mayor said. “Once we secure it, I’m going to bring the historical society to the table and the preservation company.” [For more information on this property, see The Port Times Record’s 2019 story at TBR News Media’s website: “Port Jeff historians decry potential loss of historic house.”]

Garant also reported the village is pursuing a granting opportunity to subsidize the development of the Six Acre Park along Highlands Boulevard. The grant application process sets certain conditions requiring an applicant to present a concept plan along with other criteria. 

“That grant will provide funding for the final buildout in terms of plans and material and construction,” Garant said. Trustee Rebecca Kassay, trustee liaison to the Six Acre Park Committee, added that this “could be an enormous amount of money.” 

To satisfy the conditions of the grant application, the board approved a proposal from Hauppauge-based consultancy firm VHB Engineers for $22,750.

The board also voted to reinstate the Parks and Recreation Advisory Council. Based on guidelines from the village code, this advisory council can make recommendations to the board of trustees related to recreational programs, leisure and cultural activities, and parks and playgrounds. 

Garant appointed Beth Capodanno, Gerard Gang, Robert Gross, Jennifer Hildreth, Kelly Juliano, Lois Kilkenny and Rima Potter to serve on this reconstituted council. The mayor appointed as alternates Mary O’Sullivan, Thomas Provencher and Dana Eng.

Deputy Mayor Kathianne Snaden discussed her ongoing work to stabilize the feral cat population villagewide. Coordinating with Jaegers Run Animal Rescue, Snaden requested the board allocate funds for sterilization services and rabies vaccinations to 100 cats per year.

Responding to Snaden’s request, Garant said, “Let’s see if we can appropriate $3,000. It’s a good cause. Lisa [Jaeger]’s a good person, helping in so many ways with all sorts of creatures.”

Snaden additionally reported on an ongoing difference of opinion between the Board of Trustees and the Planning Board regarding active-use space in the Six Acre Park. 

Though some members favored an active-use provision at the Six Acre Park, the Planning Board could not reach a consensus on a formal recommendation, according to Snaden. Garant countered these claims by saying, “I think there are tons of recreational opportunities in this village.”

Kassay reported the Beach Street Community Garden program would take place Monday, Sept. 26, from 6-7 p.m.. This program is free to the public and will focus on fall harvesting. 

Kassay also discussed her continuing work to investigate tick disease awareness and prevention. According to her, the village has been offered tick removal kits through a Stony Brook University-affiliated disease research center. These kits will most likely be made available at the Village Center. [For more on the issue of ticks in Port Jefferson, see The Port Times Record’s July 21 story, “Tick-borne diseases likely to worsen amid warming temperatures.”]

Kassay concluded her remarks by offering to deliver a presentation to the board on a potential revision in the village code for short-term rental properties. This presentation could come as early as mid-October. 

Neither Loucks nor Sheprow delivered a report by proxy.

Warmer winters are likely contributing to the steady rise of tick populations and the spread of tick-borne diseases in the area. Illustration by Kyle Horne @kylehorneart
By Chris Mellides

As winters on Long Island become milder due to climate change, the existing tick problem on Long Island will likely intensify.

Already, municipalities along the North Shore have engaged the public to discuss the dangers of ticks and consider possible remedies. 

During a Village of Port Jefferson Board of Trustees meeting July 5, one concerned resident said, “Another child just got bit by a lone star tick and she can’t eat meat for the rest of her life.”

The meat allergy in question is Alpha-gal syndrome. AGS is a tick-borne disease commonly transmitted by lone star ticks, which are commonly carried by deer, according to the U.S. Department of Health and Human Services. 

The instances of the prevalent Lyme disease have nearly doubled in the years 1991-2018, based on findings from the Centers for Disease Control and Prevention. As the climate becomes warmer, the size of tick populations and the spread of tick-borne diseases are projected to increase. 

Village trustee Rebecca Kassay, whose background is in environmental community outreach, is well aware of the problem that these pests pose to the larger community. She considers recent public interest in tick activity to be worth the board’s attention. 

“As time goes on and as climate change is affecting our area, one of the effects is these more mild winters,” Kassay said. “When there’s not a deep freeze for a prolonged period of time, the ticks don’t have that die-off like they used to and, as that happens, we’re seeing a steady increase throughout Long Island and the Northeast of tick populations.”

Wooded areas and athletic fields are more prone to being havens for these external parasites that are carried by wild animals like mice and deer and typically affect mammals, though other organisms are also fair game to these blood-feeding, eight-legged insects. 

“I’m going to be looking into messaging, making sure that there’s accurate information that gets out to parents,” Kassay said, adding, “What are ticks? What are the dangers of [them]? And how important it is to regularly check for ticks both on their children and themselves?”

Barbara Sakovich, Port Jeff clerk, shared that while the village does not spray for ticks, private homeowners are permitted to spray their own properties.

Referring to the July 5 meeting, Sakovich said in a statement, “Deputy Mayor Snaden, as well as an attendee in the audience, discussed tick tubes and that they can be somewhat effective to manage the tick problem in the mice population.” The village clerk added, “A lint roller can be effective in removing ticks from clothing after being outside.” 

The New York State Department of Health lists several diseases known to be carried by ticks. However, the severity of symptoms has raised a number of eyebrows. Lyme disease is the most common but anaplasmosis, rickettsiosis, ehrlichiosis and tularemia are also contracted via bioactive molecules in tick saliva.

Tick bites affect parents and children alike, and the Port Jefferson Village website recommends that afflicted residents should “call your physician as soon as possible so appropriate preventative treatment can be given.”

“There’s a vigilance and an awareness that needs to be spread and hopefully our community will not be learning about these things through personal experience,” Kassay said. “Rather, [we need] neighbors talking to neighbors and parents talking to parents and sharing this information so that through information we can prevent other children from suffering [from AGS].”

Deer tick. Stock photo

By Leah S. Dunaief

Leah Dunaief

Early Sunday morning, I had a close encounter with a tick. Now I know this is a bonanza season for ticks because we have had so much rain this past spring and there is lush greenery for the ticks to inhabit. Also, we have run articles cautioning readers about ticks and how the symptoms of Lyme disease so closely mimic those of COVID-19. I can advise you further that when you find a tick in bed with you that has already attached itself onto your person, you will experience shock and maybe even the creepy-crawlies.

Additionally, I could feel the lump, but because of its location, I could not see it. So since it was early and I was still more than half asleep, I tried to persuade myself that I could go back to sleep and we could deal with it later. But no, my brain was already on high alert and nudged me out of bed and to a full length mirror. 

Yep, it was a tick, tiny but unmistakable. Ech! What to do next? I have pulled them off my dogs many times over the years, but this one was smaller and out of reach. I googled “Tickssuck.org,” which told me not to slather it with Vaseline in order to smother it into releasing its hold on me, which I had done with the dogs. Instead it recommended getting tweezers, placing one tip under the head of the tick and carefully extract the beastie. Not wanting to wake the household, I found a smaller hand mirror, a pair of tweezers and a plastic bag to save the tick for diagnosis.

It was not pretty. I was in a convoluted position just to see the spot, and while one hand had to hold the mirror, the other could only fumble around with the tweezers. Somehow, after repeated stabs, I was able to yank the tick free, but I had left the head, the toxic part, still in my skin. I carefully, or so I thought, moved the tweezers toward the plastic bag only to have the tick slip out and fall onto the small bathroom rug at my feet. I uttered a not-so-nice word as I bent down to find the arachnid. After intense scrutiny, I could not find it. I carried the fluffy rug, carefully as you might imagine, out the front door and put it down in the sunlight. I saw nothing and was about to give up when I spied it and this time bagged it.

What did I do next? I sat down back inside my house and considered throwing up. Not a good idea in the living room. I considered going to a hospital emergency room but dismissed the thought in this time of real emergencies. I had the specimen, it was no longer attached, it would make a good story when everyone was awake, and I would wait until the beginning of the week to see a physician.

Monday morning, I tried to get an appointment. “When are you free in August?” I was asked sweetly by the receptionist. There ensued a lengthy exchange about 72 hours being critical for treatment, followed by a couple of phone calls back and forth throughout the day and finally a Tuesday slot. “Yes, it appears the head of the tick is still there, in the center of the red circle,” confirmed the physician who was good enough to squeeze me into his already overbooked schedule. “Would you like to wait until your body extrudes the head, which normally happens with a foreign substance in the skin, or would you like me to anesthetize the area and cut it out?” he asked. “Makes no difference.”

Well, it did make a difference to me, and I opted to wait. I left with two doxycycline and the warning to make sure the red spot doesn’t turn into a rash, to call immediately if it does for a full 21-day prescription, and an order for a blood test for Lyme after six weeks will have passed.

I share this with you to urge you every night to check yourself and your loved ones for ticks.

Many Illnesses Carried by Ticks Share Symptoms with COVID-19

A deer tick is a common type of tick on Long Island. Stock photo

With summer close by and as New York State continues to relax shutdown restrictions, residents will naturally want to get some fresh air. But while open spaces like parks and nature preserves provide a temporary reprieve from the COVID-19 pandemic, they are also home to ticks. These arachnids can carry Lyme disease and other serious tick-borne illnesses. Experts say this is the time when ticks are most active and when their numbers increase. 

“We have already passed a month of tick activity here on Long Island,” said Jorge Benach, distinguished Toll professor of Molecular Genetics & Microbiology and Pathology at the Renaissance School of Medicine, Stony Brook University. “With minimal contact because people were staying indoors due to the pandemic, we have seen less cases.” 

Benach said that could change in the coming summer months, especially with an already large tick count this year. Currently, we are entering the second phase of tick season, which is when the arachnids are in the nymph stage and are harder to spot.

“For some reason Long Island has a heavy population of ticks,” Benach said. “It has the perfect environment for them and they really thrive.”

Three species of ticks call Long Island home. The deer tick can carry Lyme disease, anaplasmosis and other illnesses, while American dog tick can carry Rocky Mountain spotted fever. The lone star tick can transmit tularemia and ehrlichiosis. 

“The lone star tick, we believe, is the most aggressive of the three species, and we didn’t know it existed until 1980,” the distinguished professor said. “And then it somehow found its way to Long Island.”

A 2019 study, headed by Benach and Rafal Tokarz, assistant professor of epidemiology at Columbia University, with co-authors from SBU and Columbia, found prevalence of multiple agents capable of causing human disease that are present in three species of ticks in Long Island.

Another concern this season is that tick-borne illnesses like Lyme disease and anaplasmosis have symptoms that overlap with those of COVID-19, including fever, muscle aches and respiratory failure, but without persistent coughing. 

“It is true that they have overlap in the initial symptoms, but once you get past that first stage it should be easier to diagnose if that person has a tick-borne illness,” Benach said. 

Tick-borne diseases are usually treated with antibiotics. The effects range from mild symptoms that can be treated at home to severe infections that if left untreated can lead to death in rare cases. 

The distinguished professor stressed the need for people to be aware of ticks when they are in certain areas outdoors. 

Repellents and wearing long-sleeve pants and shirts can be good deterrents for ticks. Other tips include walking along the center of trails, washing and drying clothing when you come home and keeping pets from areas that could be tick infested. 

Benach said there is a misconception that humans get ticks from dogs. Instead, it is more likely one gets a tick from being in the same space as your dog.

“You should be checking yourself, and if you spot a tick get it off as soon as possible,” he said. “If you develop any symptoms or illness contact your doctor.”

Lyme disease starts with a circular rash where the ticks bite. Stock photo

By David Dunaief, M.D.

Dr. David Dunaief

Ah, summer is upon us. Unfortunately, this means that tick season is getting into full swing.Thus, it is good timing to talk about Borrelia burgdorferi, better known as the bacterium that causes Lyme disease. This bacterium is from the spirochete class and is typically found in the deer tick, also known as the blacklegged tick.

What do deer ticks look like? They are small and can be as tiny as a pencil tip or the size of a period at the end of a sentence. The CDC.gov site is a great resource for tick images and other information related to Lyme disease.

If you have been bitten by a tick, the first thing you should do is remove it with forceps, tweezers or protected fingers (paper) as close to the skin as possible and pull slow and steady straight up. Do not crush or squeeze the tick, for doing so may spread infectious disease (1). In a study, petroleum jelly, fingernail polish, a hot kitchen match and 70 percent isopropyl alcohol all failed to properly remove a tick. The National Institutes of Health recommend not removing a tick with oil (2).

When a tick is removed within 36 to 48 hours, the risk of infection is quite low (3). However, a patient can be given a prophylactic dose of the antibiotic doxycycline, one dose of 200 mg, if the erythema migrans, or bulls-eye rash — a red outer ring and red spot in the center — has not occurred, and it is within 72 hours of tick removal (4). Those who took doxycycline had significantly lower risk of developing the bulls-eye rash and thus Lyme disease; however, treatment with doxycycline did have higher incidence of nausea and vomiting than placebo.

What are the signs and symptoms of Lyme disease? There are three stages of Lyme disease: early stage, where the bacteria are localized; early disseminated disease, where the bacteria have spread throughout the body; and late stage disseminated disease. Symptoms for early localized stage and early disseminated disease include the bulls-eye rash, which occurs in about 80 percent of patients, with or without systemic symptoms of fatigue (54 percent), muscle pain and joint pain (44 percent), headache (42 percent), neck stiffness (35 percent), swollen glands (23 percent) and fever (16 percent) (5).

Early disseminated disease may cause neurological symptoms such as meningitis, cranial neuropathy (Bell’s palsy) and motor or sensory radiculoneuropathy (nerve roots of spinal cord). Late disseminated disease can cause Lyme arthritis (inflammation in the joints), heart problems, facial paralysis, impaired memory, numbness, pain and decreased concentration (2).

How do we prevent Lyme? According to the Centers for Disease Control and Prevention, we should wear protective clothing, spray ourselves with insect repellent that includes at least 20 percent DEET and treat our yards (3). Always check your skin and hair for ticks after walking through a woody or tall grassy area. Many of us on Long Island have ticks in the yard, so remember to check your pets; even if treated, they can carry ticks into the house.

Diagnosis of Lyme disease

Many times Lyme disease can be diagnosed within the clinical setting. When it comes to serologic or blood tests, the CDC recommends an ELISA test followed by a confirmatory Western blot test (3). However, testing immediately after being bitten by a tick is not useful, since the test will tend to be negative, regardless of infection or not (4). It takes about one to two weeks for IgM antibodies to appear and two to six weeks for IgG antibodies (5). These antibodies sometimes remain elevated even after successful treatment with antibiotics.

The cardiac impact

Lyme carditis is a rare complication affecting 1.1 percent of those with disseminated disease, but it can result in sudden cardiac death due to second- or third-degree atrioventricular (AV) node conduction (electrical) block. Among the 1.1 percent who had Lyme carditis, there were five sudden deaths (6). If there are symptoms of chest pain, palpitations, light-headedness, shortness of breath or fainting, then clinicians should suspect Lyme carditis.

Does chronic Lyme disease exist?

There has been a debate about whether there is something called “chronic Lyme” disease. The research, unfortunately, has not shown consistent results that indicate that it exists. In one analysis, the authors note that the definition of chronic Lyme disease is obfuscated and that extended durations of antibiotics do not prevent or alleviate post-Lyme syndromes, according to several prospective trials (7). The authors do admit that there are prolonged neurologic symptoms in a subset population that may be debilitating even after the treatment of Lyme disease. These authors also suggest that there may be post-Lyme disease syndromes with joint pain, muscle pain, neck and back pain, fatigue and cognitive impairment.

Ultimately, it comes down to the IDSA (Infectious Diseases Society of America) arguing against chronic Lyme but in favor of post-Lyme disease syndromes, while the ILADS (International Lyme and Associated Diseases Society) believes chronic Lyme exists.

Regardless, the lingering effects of Lyme can be debilitating. This may be as a result of systemic inflammation (8). Systemic inflammation and its symptoms can be improved significantly with dietary and other lifestyle modifications.

But to throw one more wrench in the mix, the CDC recommends that physicians look beyond Lyme for other possible diagnoses before diagnosing someone with chronic Lyme disease (9).

Prevention is key to helping stem Lyme disease. If this is not possible, treating prophylactically when pulling off a tick is an important step. Contact your physician as soon as you notice a tick. If you have a bulls-eye rash and it is early, then treatment for two to three weeks needs to be started right away. If it is prolonged and disseminated, then treatment should be for approximately three to four weeks with antibiotics. If it has affected the central nervous system, then IV antibiotics could be needed.

References:

(1) Pediatrics. 1985;75(6):997. (2) nlm.nih.gov. (3) cdc.gov. (4) Clin Infect Dis. 2008;47(2):188. (5) uptodate.com. (6) MMWR. 2014;63(43):982-983. (7) Expert Rev Anti Infect Ther. 2011;9(7):787-797. (8) J Infect Dis. 2009;199(9:1379-1388). (9) JAMA Intern Med. online Nov. 3, 2014.

Dr. Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com or consult your personal physician.  

A deer tick is a common type of tick on Long Island. Stock photo

North Shore communities have found a partner in the battle against ticks and the diseases they carry.

“This new partnership is another example of local governments working together to save taxpayer dollars and protect the public health of our residents.” 

— Steve Bellone

On March 6, Suffolk County Executive Steve Bellone (D) announced the SuffolkSHARE Public Health Partnership. A part of the county’s shared services initiative, the new partnership will leverage the efforts of 10 local governments and the Suffolk County Department of Health Services to research and combat ticks and tick-borne illness, according to a press release from the county.

“This new partnership is another example of local governments working together to save taxpayer dollars and protect the public health of our residents,” Bellone said in the statement. “By taking collective action, we are expanding education, collection, and analysis to ensure that we have the information and resources at our disposal to deal with these illnesses head on.”

With the new partnership, towns and villages will be able to strengthen their efforts to combat ticks in ways that were previously prohibitive due to high cost and limited resources, according to the release.

The new partnership draws on efforts that include collecting data and procuring materials at lower costs while tracking progress over time. These processes are already underway by the Suffolk County Tick Control Advisory Committee, which researches and combats ticks and associated illnesses. According to the county, each year approximately 650 Suffolk residents contract a tick-borne illness, including Lyme disease.

Eight villages and two towns will work in conjunction with the county, including Asharoken, Northport, Head of the Harbor, Old Field and Belle Terre, according to the press release.

“Having the ability to work with other local governments and Suffolk County on this issue will give us the opportunity to address it effectively and affordably.”

— Bob Sandak

“Protecting public health is a priority for the Village of Belle Terre, and mitigating the risk of ticks and tick-borne illness is an important mission,” Bob Sandak, the Village of Belle Terre mayor, said in a statement. “Having the ability to work with other local governments and Suffolk County on this issue will give us the opportunity to address it effectively and affordably.”

Recently, Belle Terre moved to allow deer hunting within the village, citing that New York State is the only governing body that can restrict hunting. Sandak said at a Jan. 15 village meeting, where the possibility of deer culling in part with Port Jefferson Village was discussed, that in the near-mile radius of the village boundaries, there could be as many as 300 deer. It was expected that culling could bring the number of deer down to approximately 50.

The Department of Health Services will provide resources and guidance when it comes to ticks, while the county will facilitate testing of samples, collection of data and additional analysis. The cooperative procurement of corn, tickicide and other materials, as well as municipalities working together to collect samples to have them analyzed will happen at a cheaper rate due to consolidation, according to county officials.

The county health department and Suffolk County Department of Public Works Vector Control Unit will consult with villages launching their initial efforts at tick mitigation, tick-borne illness mitigation and deer mitigation, which may include municipalities sustaining a four-poster (also known as a deer feeder); using environmental controls, such as landscaping; and utilizing birth control. The participating local governments will assist the Department of Health Services with community education regarding the risk of ticks and how to avoid bites, tick collection for testing and health monitoring of residents.

According to the press release, North Haven, Saltaire and Shelter Island already operate four-posters. The deer feeders brush tickicide onto the animals to keep them free of ticks.

“While tick-borne illnesses remain a major concern amongst our community, we continue to look for new and innovative ways to protect the public’s health,” said Michael Levine, Village of Old Field mayor, in a statement. “Thanks to the work of County Executive Bellone and the creation of this new partnership, we will now be able to asses tick conditions, develop a comprehensive plan to combat this public health issues, and educate our residents on ways to stay safe.”

Students learn about life cycles while helping to curb Long Island’s growing tick population

Fifty bobwhite quails are being raised at Mount Sinai Elementary School to be released at a park in Ridge. Photo by Kyle Barr

Mount Sinai Elementary School fourth-graders are raising quails to help curb the tick population.

As part of a seven-year program, teacher Kevin Walsh works with students to raise a group of 50 bobwhite quails from eggs in a classroom incubator, then transfers them to a large pen located in the corner of the courtyard under heat lamps. The young students watch their project grow before their eyes and learn about the natural process of life.

“We teach the kids about food chains, about ecosystems, predator-prey relationships and the needs that all our creatures have to survive,” Walsh said. “We teach kids how to properly carefor living animals. It carries with them later in life.”

Mount Sinai Elementary School fourth-graders are in the process of raising 50 bobwhite quails. Photo by Kyle Barr

As similar as the quails are to one another, the fourth-graders who raised them said they could be distinguished by their look and personality.

One is named Michael Jackson, another Brittany, Roadrunner, Scooter and Beyoncé. The kids curled their fingers through links in the mesh fence and called the quails by name to see if they would touch their hands.

“They claim they can tell them apart,” said Walsh as he watched them, laughing. “I’m like, ‘Are you sure?’ They all look the same to me.”

The school received the quail eggs in April and watched the quails hatch inside their classroom incubator. By the end of this month, the quails will have reached the size of a grown man’s fist. By the time they are released in July at Brookhaven State Park in Wading River, the teacher said he expects them to double in size.

“Back when I first started last July, one of the first things I saw out here was [Walsh] standing in the courtyard tending to the quails,” said principal Rob Catlin, who is finishing his first year at the helm of the elementary school. “He’s out there seven days a week. In summers and on Memorial Day weekend — he’s coming in to check on them.”

Quails, as birds who stay close the ground, are a natural predator for ticks, whose population has swelled in recent years. If the problem wasn’t already as front and center as it was for Walsh, two years ago he was infected with Lyme disease, and for days was cooped up in his home suffering pains and a fever.

“We teach the kids about food chains, about ecosystems, predator-prey relationships and the needs that all our creatures have to survive.”

— Kevin Walsh

The disease can be debilitating and infectious, and causes severe headaches, joint aches and tiredness, especially if not treated immediately. Left untreated the disease can potentially cause paralysis in the face, heart palpitations and memory issues.

“Luckily I got the meds really quickly, but I haven’t been that sick in a long time,” Walsh said. “I had aches, pains, a high fever and was sweating like crazy. This project has taken on a more personal meaning since then.”

Superintendent Gordon Brosdal said without Walsh there would be no quails.

“It’s near impossible to find a guy as dedicated as Kevin,” Brosdal said.

Walsh recalled moving to the suburbs of Long Island from the city, and how his mother called his father at work, excited to learn their new home came with a flock of chickens. She later learned they were a flock of brown speckled bobwhite quails.

With changing times, Long Island’s quail population has changed, too, seeing a severe decline due to loss of habitat and excess predation.

“The quail like open landscapes – really sunlit areas,” Walsh said. “And a lot of the places left on Long Island are wooded, heavily forested or turned into developed land.”

Local biologist Eric Powers said household cats have also made a huge dent in population.

“It’s pretty simple math — one plus one,” Powers said. “You add cats to an environment and they just decimate the local ground dwelling animal population, particularly the birds.” 

Mount Sinai Elementary School teacher Kevin Walsh shows off one of the 50 bobwhite quails his class is raising. Photo by Kyle Barr

Walsh receives his quails every year through a program developed by Powers back in 2002 for the dual purpose of rejuvenating the local quail population while curbing the rising tick problem, which gets worse every year with a lack of natural predators.

The Centers for Disease Control and Prevention reported the number of illnesses related to ticks, mosquitos and fleas have tripled from 2004 to 2016, with 69,313 diseases reported from ticks in New York state in that time. In 2013, the CDC estimated that nationally there were 300,000 cases of Lyme disease annually, which is carried by deer tick.

Brosdal’s daughter Erika suffered through the pains of Lyme disease when she was 13 years old. As a father, watching his daughter lay in pain on the couch was heartbreaking.

“She couldn’t breathe,” Brosdal said. “It affected her so terribly – she was an A-grade student until that happened, and then she had to read everything twice. I give her a lot of credit — she’s 44 now and has two master’s degrees and she’s a high school psychologist.”

Brosdal said the quails have an important job to do and “can do a lot of good.” 

Powers said multiple schools participate in his program and will release the quails in parks all over Long Island. If any school or group is interested in raising quails, Powers can be contacted through www.yc2n.com.
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Tips and tricks when handling ticks
By Desirée Keegan

According to Stony Brook Southampton Hospital, over 900 calls were received from people seeking advice from its tick helpline in 2017.

A free tick kit provided by Stony Brook Southampton Hospital includes tweezers, a magnifying glass and sanitizing wipes. Photo by Desirée Keegan

If a tick is found on your body, there are ways to safely remove it:

• Tweezers are the best tool and should be placed as close to the skin as possible — grabbing the tick’s head.

• Pull upward with a slow and steady motion and try to avoid breaking the tick in half. If the head snaps off, know disease transmission is not possible without the entire body.

• Disinfect the bit area with rubbing alcohol or soap and water and contact a physician. Consider placing the tick in a baggie or pill vial.

• Pay attention to your health in the weeks following.

There are also ways to reduce your exposure, like checking for ticks daily, especially under the arms, in and around the ears, inside the belly button, behind the knees or between legs and on the hairline and scalp.
Remove and dry clothing on high heat as soon as possible to kill ticks. They can’t be drowned by washing. You can create a tick-safe yard by mowing frequently and keeping leaves raked. Also be sure to treat dogs and cats.

One tick can carry multiple pathogens. Deer ticks or blacklegged ones have no white markings, are brown or black in color and are very, very small. Both nymph and adult stages can transmit diseases like Lyme and babesiosis.

For more information on handling and treating ticks or for a free removal kit visit www.eastendtickresource.org or call the helpline at 631-726-TICK (8425).

Long Island is an ideal environment for many species of ticks, specifically the deer tick.

By Matthew Kearns, DVM

I commonly get the question, “What month can I stop using tick preventatives?” My answer is always, “That depends.” It used to be that somewhere around late October/November until late March/early April one could stop using flea and tick preventatives. However, with changing climate conditions and parasite adaptation this is no longer true.

The tick life cycle contains four stages: egg, larval, nymph (young adult) and adult. After the larval stage hatches out from the egg, it must feed and go through a molt between each successive stage. Ticks are sensitive to environmental changes throughout their life cycle but, ironically, are most resistant to temperature changes. It has to be below 35°F for ticks to even “overwinter.”

Overwinter is a term that refers to a process many species use to pass through the period of the year when “winter” conditions (cold or sub-zero temperatures, ice, snow, limited food supplies) make normal activity or even survival difficult or near impossible. During the overwinter period all activity nearly completely ceases until conditions become more favorable. If conditions become more favorable (above 45°F) ticks will set out in search of a host.

To kill a tick temperatures must be consistently below 10°F for many days in a row. If the tick is able to bury itself in the vegetation below a layer of snow, even below 10 degrees may not kill them. It is pretty routine even in January to have one or two days that are in the 20s during the day, dropping to the teens or single digits at night followed by a few days in the 50s.

Ironically, as resistant as ticks are to colder temperatures, they are much more sensitive to higher temperatures and humidity (or lack thereof). Eggs will desiccate, or dry out, and die during hot dry periods. The other life stages are at risk for dehydration due to increased respiratory rate in an effort to thermoregulate (control body temperature) and questing (looking for hosts).

Hotter, drier temperatures mean less vegetation. Less vegetation causes multiple problems for ticks: less protection from the elements and less vegetation for hosts.

The white-footed mouse is the primary host for the larval stage of the deer tick. This mouse survives on vegetation, and less vegetation and less resources for the mouse means a subsequent decrease in the mouse population. A decrease in population means less hosts. Less hosts, less ticks survive from the larval stage to adulthood. Fortunately, and unfortunately for us, the northeast United States rarely sees prolonged droughts. Even if we have hot, dry periods during the summer, we usually make up for it in the fall. It is an ideal environment for many species of ticks, specifically the deer tick.

In summary, it is my feeling that the tick season is 9 to 10 months out of the year. You may be able to stop applying preventative during the months of January, February, and March (this depends on temperature), but the rest of the year ticks are active.

Dr. Kearns practices veterinary medicine from his Port Jefferson office and is pictured with his son Matthew and his dog Jasmine.