As country singer Brad Paisley observed in his classic song “Ticks,” “You never know where one might be.”
For many, June is synonymous with traipsing through the forest, lying in the grass and other idyllic outdoor pastimes.
However, this can prove risky in New York, where it’s now the height of tick season amid a statewide uptick in Lyme and other dangerous tick-borne diseases over the last decade, as well as the ongoing Powassan virus scare.
So imagine my shock after waking one Saturday morning in May to find a bloodsucker the size of a garbanzo bean on my groin.
“I always tend to think that the places where you’re most likely to find ticks are the places where you sweat,” Bryon Backenson, director of the Bureau of Communicable Diseases at the New York State Department of Health, told The Post.
Backenson, 54, explained that target areas include “our armpits, under a waistband, under a bra strap, and the groin.”
The veteran epidemiologist — who has been studying tick-borne pathogens for almost 30 years — gave The Post the skinny on what to look out for during the season of the parasitic mites, which runs from spring to early summer with a resurgence in autumn.
It’s safe to say I learned these tips too little too late.
A real tick in the balls
It was 5 a.m. and barely daylight in my Manhattan apartment when I reached down under and felt a pebble-like bump.
Fearing it was cancerous, I shined my iPhone flashlight on the region to discover, to my horror, that the lump had legs. This hanger-on was an engorged deer tick, a disease vector that I normally saw when it was the size of a sesame seed — this was a veritable Zeppelin with a head.
How I contracted this rural bloodsucker in downtown Manhattan was beyond me. Then I realized it must’ve latched on while I was watching my little sister’s soccer game in the town of Red Hook, in Dutchess County, a week ago.
I frantically waddled to the bathroom to get tweezers, whereupon I looked down and saw that the tick was gone.
The next 20 minutes were spent crawling on all fours looking for the bulbous bloodsucker like an Upper East Side socialite searching for her lost pearl earring. I eventually gave up and went to the bathroom to take a shower, whereupon — without my glasses, mind you — I saw a blurry black blob trundling across the tile.
It looked like something you’d find on a tapir in the Bolivian Amazon, and certainly not a denizen of a quaint little town in the Hudson Valley.
One tick over the Lyme
However, this bucolic paradise — a hub for Gothamites’ second homes — is also ground zero for tick-borne pathogens.
It accounts for over 95% of the state’s cases of Lyme disease, a potentially debilitating infection caused by the Borrelia bacteria that’s known for causing a bull’s-eye-shaped rash, fevers, joint aches and, in later stages, cardiovascular and neurological symptoms.
Over the past decade, the state has seen an average of 6,700 new cases of Lyme disease each year with over 8,000 in 2019 alone. Initially associated mostly with Long Island, per the tick expert, this insidious microbe has fanned out to the furthermost corners of the Empire State.
“We’ve watched Lyme disease expand its range further north and further west,” said Backenson, whose team collects up to 20,000 ticks a year for disease research. He said it’s gotten “to the point where you can get Lyme disease in Buffalo, and you can get it at the top of the Adirondacks.”
In fact, the majority of New Yorkers diagnosed with Lyme are residents of Manhattan and Brooklyn — who contract it while traveling to surrounding areas such as Long Island, the Hudson Valley and upstate New York (as was the case with yours truly). It’s also present in The Bronx and Staten Island.
An epidemiological minefield
Lyme isn’t the only tick-borne pathogen one has to look out for, according to Backenson, who says we are now susceptible to a host of bacterial diseases ranging from anaplasmosis disease (whose symptoms include fever, headache, chills and muscle aches, per the Centers for Disease Control and Prevention) to the self-explanatory Rocky Mountain Spotted Fever.
“Rocky Mountain Spotted Fever was the first one [disease] that we were looking at when our program started in 1968-69,” explained the scientist, adding that “we’re now to the point where there’s probably a dozen that you can wind up getting here in New York.”
Meanwhile, the notorious lone star tick is known for spreading the sinister alpha-gal syndrome that can potentially make victims allergic to meat. Originally from the southern US, it has swept over Long Island over the past three decades.
“In 1994, I was collecting ticks in Fire Island, and we ran into two female lone star ticks,” Jorge Benach, a professor of molecular genetics and microbiology and pathology at Stony Brook University, told The Post. “I thought this was a really great find, because this is a southern tick. Between 1994 and today, this tick had thoroughly colonized Long Island. It is the most abundant tick that we have now.”
Perhaps most frightening is Powassan, an incurable and potentially deadly virus known for causing encephalitis, swelling in the brain.
Last month, a 58-year-old Maine man died of complications caused by the disease — the first fatality of 2023 linked to the virus.
Backenson finds this Powassan insidious, because unlike Lyme and other diseases where the tick has to hang on for at least 24 hours to infect someone, it can be transmitted in as “little as 10 minutes.”
Nonetheless, the disease researcher suggests the hysteria is overblown.
While the CDC warns of a nationwide spike in cases, New York State has only seen 30 or so in 20 years, which were mostly concentrated in the lower Hudson Valley and Long Island, he said.
“It doesn’t necessarily seem like it’s something that is rampant or is increasing,” explained Backenson. “We probably have 50-60-70-100,000 tick bites a year and, most of the time, we get one to two cases of Powassan.”
He added, “They make the news, because it’s new and rare, and it’s not something that people are familiar with.”
Smoking gun
There’s no one “smoking gun” for why tick-borne diseases have seen an overall statewide surge, according to Backenson, who attributes various factors, including climate change, warmer winters that have extended tick season so it starts earlier and ends later each year, and also the fact that there are more people in nature than ever before.
“We’ve seen them [ticks] move north into Syracuse and out to Buffalo [areas that were previously too cold for them to survive] and so forth, and I think climate has something to do with it,” the health authority explained. “People are [also] getting out and hiking and enjoying the outdoors a lot more than they used to, which puts them into potential contact with ticks more than they were 20 to 30 years ago.”
Prophylac-tick measures
How do you avoid this diminutive disease IV?
Backenson explained, “The biggest thing, at all costs, is to try and avoid tick habitat. Tick habitat tends to be wooded areas, edges of things, where a lawn meets woods, where woods meet field, where field meets woods. It’s where we go to try and collect ticks.”
When venturing outdoors, he advises wearing long sleeves and pants to protect oneself from getting bitten, and inoculating one’s skin with repellents like Deet or spraying the insecticide permethrin on clothes and hiking shoes.
This is especially crucial for the “aggressive” lone star tick, which unlike other species, actively pursues people like a miniature heat-seeking missile, according to Benach.
“Most of the other ticks wait for somebody or an animal to pass by, and they’re on grass,” he said. “The lone star tick is what they call the hunter tick. They will seek you out. So you can be sitting in the grass, and they’ll come to you.”
Backenson suggests that after going outside, people should throw their clothes into a hot dryer for 10 minutes, because that “heat and that dryness will kill those ticks.”
Most important is checking for ticks, which is no mean feat given that nymphs can be the size of poppy seeds, per the infamous CDC Facebook post showing several on a poppy-seed muffin.
“When you get into taking a shower that night, really go over and check yourself,” said Backenson. He says the most likely hot spots are moist nooks and crannies “where people won’t think to look,” like the armpits, waistline and, of course, the nether regions.
Upon locating an embedded bloodsucker, the CDC advises removing it with fine-point tweezers using slow and steady pressure, making sure to get as close to the skin as possible to extract the barbed mouthparts.
In a ballsy state Department of Health video PSA, Backenson is seen demonstrating proper extrication technique on pathogen-free ticks that he allowed to feast on his arm.
Never, under any circumstance, deploy old wives’ tales or TikTok remedies such as covering it in a cotton ball soaked with “kerosene” or burning it with a “lit cigarette,” per Backenson, who says this can make ticks “regurgitate in order to back out.”
Thick tick testing
Ticks usually have to be dug in for around 36 hours to transmit disease, and they can feed for up to 10 days before dropping off, which was was likely the case with my Stage 5 clinger.
In general, the longer the tick’s attached, the greater the chances of transmission.
As a precaution, I got my scrotal stowaway tested at the MedZu Labs in Amherst, Massachusetts, which offers pathogen testing to the public with results going into their nationwide tick-surveillance database.
Patients simply fill out a form on TickReport.com and sign up for one of three testing plans.
These run from the standard $100 DNA test — encompassing Lyme and Lyme vectors — to the $200 comprehensive exam that spans nearly every species and disease imaginable, which I chose because I wasn’t taking any chances.
I put my bloated little buddy in a glass container with a damp piece of paper towel to keep it alive (what can I say, I’d grown a bit attached to the guy and, clearly, vice versa).
As it was too chonky to fit comfortably in a normal envelope, I Fed-Exed the sucker to the lab in a plus-size parcel and awaited my diagnosis.
Three days later, my test can back positive for Lyme.
It seemed ironic that after all the bloodsucking creatures that’ve bitten me in exotic locales — 35 leeches at once in Borneo, veritable bee beards of mosquitos in Vietnam — my potential parasite-borne pathogen was transmitted via an animal that lived several hours from my apartment in New York.
Whose Lyme is it anyway?
Fortunately, the tick test isn’t the canary in the coal mine that some may think.
“Personally, I’m a little ambivalent about that, and I think us as a department probably are, too,” said Backenson. “It can be a false alarm or a false sense of security.”
He explained, “If that tick is negative, that doesn’t necessarily mean that was the only tick bite that you had. And if that tick is positive, it doesn’t necessarily mean that you were infected.”
Indeed, blood tests at Northern Dutchess Hospital in Rhinebeck, NY, near my family’s country house revealed that I was Lyme-free. As is typical, doctors prescribed me a 10-day course of the antibiotic doxycycline as a prophylactic measure while awaiting my results.
I’m not out of the woods.
My general practitioner told me during a follow-up appointment Thursday to monitor myself for signs of Lyme — heart palpitations, joint aches and the target-shaped lesion known as erythema migrans — over the next few months.
If unchecked, Lyme can lead to debilitating long-term complications such as facial palsy, irregular heart beat, arthritis and inflammation of the brain and spinal cord, per the CDC.
A family friend who owns a dairy farm in the Hudson Valley claims he’s still suffering from nervous system and locomotive issues from Lyme he may have contracted over 30 years ago.
Long-term strategies
As of yet, long-term strategies for eradicating tick-borne diseases have yet to be proven effective and have included everything from immunizing host mice to erecting “4-poster deer self-treatment” bait stations that slather deer with insecticide.
In 2016, Staten Island began a measure to vasectomize the deer populations, to, among other goals, combat tick-borne diseases.
Many of these methods are difficult to enact logistically with the CDC deer-baiting study noting that 4-posting is “not suitable for broad scale (e.g., county-wide) use and can be expensive to install and maintain long-term.”
The same holds true for spraying areas with insecticides, which may work against air-borne bloodsuckers like mosquitos, but doesn’t always penetrate the leaf-litter where ticks reside, according to Backenson.
“To control ticks at that sort of broad geographic level is very difficult, and I don’t think we’ve been able to find a really good solution yet,” he said.
Far more promising are new vaccines, including mRNA Lyme disease vaccines developed by Moderna, Pfizer and Valneva, which could be available as early as 2025.
Meanwhile, epidemiologists at the Yale School of Medicine are working on a vaccine that targets proteins in tick saliva, forcing them to detach prematurely before the window of transmission.
“If we could get that working, it could give protection against a number of different tick-borne disease just by knocking at the vector itself,” said Backenson of the potential “Holy Grail” cure.
Until then, “we’re stuck trying to pay attention” and “check ourself for ticks,” he said.
Otherwise, people won’t be the only ones “having a ball” this summer.
