- Credibility:
The Hudson Valley is a hot spot for Lyme, and for the eight-legged menace that carries it: Ixodes scapularis, also known as the blacklegged or deer tick.
Our region is also a center for Lyme expertise. One of the brightest lights in investigative journalism on Lyme disease is a longtime Hudson Valley local: Mary Beth Pfeiffer, a 30-year veteran reporter for the Poughkeepsie Journal,and author of a prizewinning series on Lyme called “No Small Thing.”
Pfeiffer now has a book out, published this April by Island Press, based on her work for the newspaper. In Lyme: The First Epidemic of Climate Change, she builds a case that—thanks to the warming world—all our maps and figures for both Lyme disease and the ticks that carry it are destined to be out of date before they’re printed. Ixodes is on the march, expanding rapidly into habitats once thought too cold or mountainous to support large deer tick populations. Everywhere it goes, it brings disease and suffering along for the ride.
Ticks On the Move
In an excerpt published in Aeon, Pfeiffer writes about the rapid spread of deer ticks from south to north along the Hudson Valley, a story indelibly inscribed in local tick DNA:
In the Hudson Valley of New York State, a team from the University of Pennsylvania used Ixodes DNA to draw a family tree of blacklegged ticks, much the same way that people use saliva swabs to search for distant ancestors in their genetic code. Studying ticks collected at four locations from 2004 to 2009, the researchers recreated a 125-mile upriver tick migration, similar to that of the colonial Huguenots and Livingstons three centuries earlier. The tree begins in southernmost Yorktown, where the tests showed the ticks residing, give or take, for the previous 57 years. Then, 17 years later, these eight-legged pioneers climb the next rung north, to bucolic Pleasant Valley. Eleven years pass, and they settle in Greenville, in the foothills of the Catskill Mountains, and, 17 years later, emerge in northernmost Guilderland, where Dutch settlers from New Netherland had settled in 1639. While other DNA literally crept in along the way – mate-searching ticks do follow their hearts – by far the most dominant strain at each point along the march was the one from southernmost Yorktown. The DNA data, the researchers wrote, ‘strongly support a progressive south-to-north expansion’. Defying the odds, the ticks had moved to places where it had long been colder and snowier. And they did just fine.
Changing climate isn’t the only culprit to blame for the spread of the Lyme-carrying tick. Also at fault: Rich people. At least, that’s what environmental sociologist Brent Kaup thinks.
In a recent study of ticks in the DC suburbs of northern Virginia, Kaup argues that the concentration of homeownership among the upper classes has created lots of prime tick habitat. The Outline’s Sam Worley writes:
While New Deal reforms and the postwar housing boom enabled an uptick in homeownership among all income brackets, Kaup argues, later deregulation slowed home-ownership rates for all but the upper classes — who preferred, in Virginia as elsewhere, large houses on large lots separated by stands of forest to maintain nominal values of “nature” and “privacy,” a micro-ecosystem uniquely appealing to hungry ticks.
It’s All About Ecology
Nestled in the heart of the Hudson Valley, in prime Lyme territory right up next to the Connecticut border, is our own Cary Institute of Ecosystem Studies. It’s a small private research center in Millbrook that has been at the forefront of the effort to tease out what makes ticks, well—tick.
Doing science on an ecosystem scale takes time. Cary researchers have been watching tick populations in their own backyard since the 1990s, tracking them to see how they respond to changes in the landscape. A complex picture has emerged: Tick populations follow a boom-and-bust cycle, responding to wild swings in the local mouse population.
The story goes something like this: Oak trees have a good year, and produce masses of acorns. The following year, rodent populations surge, providing an abundant source of hosts for new ticks. Two years after an acorn bumper crop, the population of Lyme-infected tick nymphs goes up as well.
In places where forests support large populations of predators that eat mice, like bobcats, foxes and opossums, there are fewer infected ticks.
The worst-case scenario, says Cary scientist Richard Ostfeld, is a year in which the mouse population spikes and then crashes:
“If fluctuating acorn crops cause rodent populations to spike and then crash, the spring following the rodent crash would be especially risky. There would be lots of infected nymphs and fewer rodents to provide blood meals. Ticks would seek other hosts, like people. Risk increases in areas lacking predators and mammal hosts that are efficient at killing ticks, such as opossums.”
The Limits of Medicine
Wherever Lyme disease goes, uncertainty and controversy follow.
Pfeiffer’s long and thorough digging on Lyme has made her a fierce critic of the standard medical approach to the disease, the MinnPost’s Ron Meador writes:
Pfeiffer reduces the American medical establishment’s consensus to four “myths” that are scientifically indefensible but have withstood nearly three decades of worthy challenge: that Lyme is overdiagnosed; that tests for its presence are reliable; that the disease is hard to get; that it’s easy to treat and therefore not chronic.
In a recent essay for Scientific American, Pfeiffer argues that Lyme is a disease starved for the funding and research it deserves, and that patients are being ill-served by official medical guidelines for diagnosis and care:
This lack of progress is not a random development. It is, rather, the product of a false image of Lyme disease, embraced by health officials and repeated in reviews of the medical literature, as an illness that is easy to diagnose and readily treatable. That picture should long ago have given way to a more nuanced view that acknowledges flaws in diagnostic tests and the limits of short-course antibiotics to cure the disease.
For doctors looking to do right by their suffering patients, the landscape of Lyme can be bewildering. In a compelling essay for the New York Review of Books, Seattle-based pediatrician Rachel Pearson writes about the frustrating experience of treating “chronic Lyme” patients—people whose symptoms cannot be traced back to any straightforward diagnosis, but who are convinced Lyme is the only explanation.
Chronic Lyme is as nebulous as gender, an identity as much as a biological category. It describes a constellation of enduring symptoms—joint pain, fatigue, muscle pain, brain fog, fevers, blurry vision, and much more—occurring in a person who attributes these symptoms to an infection with Borrelia burgdorferi, but who may have no plausible laboratory, clinical, or epidemiological evidence of exposure to the bacterium.
Pearson clearly has more faith in the official approach than Pfeiffer does, but also wants to respect the very real suffering of her patients, whether or not their maladies can be traced to a tick bite. Some chronic Lyme patients have been helped, she notes, by “intensive treatment with placebos.” But she finds that approach somewhat patronizing, and the prospect of simply “listening” doesn’t sit right with her:
I fear it is insulting to both physicians and chronic Lyme patients to suggest that these patients just need to be heard. Presumably, they want more than that. Like everybody else, they want to be cured.
A Lyme Vaccine?
With Lyme and other tick-related diseases becoming an increasingly urgent public health issue, it’s shocking that there isn’t a vaccine already.
Well, there is one—or at least, there was. In 1998, the FDA approved LYMErix, a vaccine with an effectiveness rate of between 76 and 92 percent. Unfortunately for the vaccine’s maker, SmithKline Beecham, LYMErix’s entry into the market coincided with another epidemic: Vaccine panic.
Vox lays out a story of sensationalistic media coverage, public panic, and a class-action lawsuit brought by people who believed the vaccine had given them arthritis – despite the fact that research found that arthritis incidence in Lyme-vaccinated patients was no higher than in the general population.
In the end, it wasn’t the lawsuit or the FDA that killed the Lyme vaccine. It was capitalism. Sales plummeted in the wake of the bad publicity, and the manufacturer pulled it from the market.
Vox laments the loss:
Vaccines can be a hard sell because people need to take them when they’re healthy, and no vaccine has zero risk of side effects. But when we take a vaccine, we’re not just protecting ourselves—we’re protecting those around us, and ensuring a less infected future. The LYMErix vaccine was optional, and anti-vaccine fears have left millions without the option to take it at all.
A glimmer of hope on the horizon, for those who want the Lyme vaccine back, is a French company called Valneva. This year, CNBC reports, Valneva is beginning Phase 2 clinical trials on a new Lyme vaccine. Still, it will probably be five years before the vaccine is commercially available.
While we wait for science to give us better options, the best advice for dealing with ticks in the Lyme-infested Hudson Valley is the same as it’s been for years: Cover up, use repellent, check your body often, and keep a tweezer handy.
Tick-related illness is a deep topic, locally and nationally. There are so many questions we’d love to dig into: the state of research and treatment funding, how Lyme interacts with coinfections, how other tick-borne illnesses are spreading in response to ecology and a changing landscape. We are seeking to fund a robust newsroom for the River to pursue stories like these, and to knit issues of vital local importance to the national dialogue.
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