Issues of the Environment: Lyme disease on the increase in Washtenaw County
- Lyme disease is the most reported vector-borne disease in the United States, and it spreads locally in Washtenaw County.
There has been a significant increase in the number of known Lyme disease cases in the county since it was first detected here in 2016.
- Between 2020 and 2021, Lyme cases in county residents tripled, and in 2022 they reached a 10-year high (61 cases).
- In 2023, we already have nearly twice as many cases as 2022, with 112 cases reported in Washtenaw County as of 7/31/23. 70 (63%) of those cases were likely exposed in Washtenaw.
- Spread typically occurs between May and August.
- Potential reasons for the uptick in local cases: a growth in the range of those ticks in Washtenaw County, increased prevalence of Lyme, and a rise in people spending time outside.
- Most cases of Lyme disease can be treated successfully with antibiotics. Patients treated with appropriate antibiotics in the early stages of Lyme disease usually recover rapidly and completely. Antibiotics commonly used for oral treatment include doxycycline, amoxicillin or cefuroxime axetil. Steps to prevent Lyme disease include using insect repellent, removing ticks promptly, applying pesticides and reducing tick habitat. While it is a good idea to take preventive measures against ticks year-round, be extra vigilant in warmer months (April-September) when ticks are most active.
- Tick checks and prompt removal are also important. In most cases, the tick must be attached for 36 to 48 hours or more before the Lyme disease bacterium can be transmitted. The Washtenaw County Health Departmentmonitors ticks and tick-borne pathogens. This allows them to inform community members of risks related to ticks. As funding and capacity allow, they do surveillance work to track ticks and tick-borne pathogens. This work involves identifying tick habitats and conducting tick drags to catch ticks. They then sort and identify species collected and submit target species to CDC for testing. This helps us provide evidence-based information to clinicians, policy makers, and our community. (Source: *directly quoted* https://www.washtenaw.org/1813/Lyme-Ticks)
David Fair: Lyme disease is on the uptick, and other insect borne illnesses are on the radar in Washtenaw County. I'm David Fair and welcome to this week's edition of 89 one WEMU's Issues of the Environment. Now, from 2020 to 2021, the number of cases of Lyme disease in Washtenaw County tripled. Then, in 2022, there were more than 100 cases reported. This year, apparently, it's on pace to be even worse if it isn't already. Our guest today is exactly the right person to talk to about this. Laura Bauman is Washtenaw County's epidemiology program manager. And thank you so much for making time for us today, Laura.
Laura Bauman: Happy to be here. Thank you.
David Fair: Do we know where we are in terms of cases so far this year?
Laura Bauman: Well, unfortunately, they just keep pouring in. So, the last time we polled cases at the end of July, we were already at 112 cases for this year. And I can tell you that the first half of August, we have had a number of additional cases reported.
David Fair: So, is there evidence to tell us what is behind these increases over the last couple of years?
Laura Bauman: You know, we have not had a chance to figure out why we're having such a big increase. We certainly, again..it's very evident that, you know, more people are getting infected. And so, but the question--it's a really great question--of why? Why now?
David Fair: So, are some of the reasons we should potentially consider an explosion in tick populations, more people spending more time out-of-doors or perhaps even climate change allowing for further spread of ticks?
Laura Bauman: Yeah, I mean, all of those certainly are a possibility. And, you know, Lyme is a disease that's absolutely, you know, it's an ecosystem-type disease because for Lyme to show up, you need not only the tick that carries Lyme disease, which is the Blacklegged tick, or also known as Ixodes scapularis, which is the more formal term. But then, those ticks have to be infected with Lyme disease. And the way they get infected is through this process of small mammals getting infected, which are our white-footed mice and our chipmunks. And then, that cycle goes through the deer population and then to the tick population. It's this kind of continuing loop. And then, unfortunately, humans get in the middle of that when we're out enjoying the outdoors. And so, again, any of those parts of that cycle between the ticks, the small mammals and the deer, you know, that can also affect what we're seeing for Lyme disease.
David Fair: So, there are a number of different species of ticks, but you just mentioned it is a specific kind that transmits Lyme disease. Is that the most prevalent tick in our area?
Laura Bauman: Well, it has not been the most prevalent tick until recently. You know, much more common in our area has been the dog tick, which, you know, I just have to say, all ticks are just creepy.
David Fair: And you're not out there personally counting, right?
Laura Bauman: No. We're trying to find them, you know, and we actually, you know, do occasionally send out staff to work with the state health department to do what are called tick drags and actually look for ticks. But anyway, yeah, the ticks that are have been more common in our area, until recently, has been the dog tick, and that is a bigger--is a slightly bigger--tick, easier to see. Again, you know, as the name suggests, you know, we find them on our pets there. Again, they're gross. You know, you find them, you have to pick them off, you know, yourself from your pets. But they're pretty easy to see. And they don't tend to carry any diseases. So, you know, from us, you know, a human standpoint, dog ticks really aren't that much of a concern. But what's happened more recently is we have seen this increase in the Blacklegged tick, the deer tick, which carries Lyme disease, and, you know, they're much smaller. And not only is the tick, the adult deer tick, much smaller, but the nympho tick, which is like the baby tick, so to speak, is minute. I mean, it's like the size of a poppy seed. It's so hard to find. And so, that makes it, you know, really difficult to see when one of these has attached to you.
David Fair: Our Issues of the Environment conversation with Washtenaw County Epidemiology Program manager Laura Bauman continues on 89 one WEMU. So, what's our best protection? What's the best methodology for trying to prevent getting the bite in the first place?
Laura Bauman: Sure. So, it's, first of all, awareness. You know, it has been, until recently, we didn't have to think about it as much in our area because, you know, and until it's really been the past five or ten years that we've started to see more transmission here locally in Washtenaw County. And so, again, just being aware. When you're out hiking, when you're camping, those types of things, you need to think about, "Are you going through brushy areas? Are you in an area that you could be exposed to ticks?" And if so, then you need to take precautions and a number of things can be done: certainly wearing DEET, which, you know, is a good repellent, can help, some people use clothing that's been treated with permethrin, which can really prevent the ticks from attaching and coming onto your person, and then also, if you have been in an area that potentially there were ticks doing good tick checks afterward. One of the important things to know about Lyme disease is that that tick needs to be attached to you for 36 to 48 hours to transmit Lyme disease. And so, if you find the tick within, you know, a couple hours, even within that day that you've been on the hike and remove it, then it's not going to transmit Lyme disease.
David Fair: Should we be taking those ticks somewhere for identification, so that scientists, health professionals, better understand what we're dealing with, or do we just get rid of them after we take them off our bodies?
Laura Bauman: Sure. So, one easy way to find out.... I mean, certainly you can Google take a picture of the tick and Google and see if you can kind of see like, "Hmm. I wonder." You know, there's some different markings on the ticks you can look for. But, at the same time, if you take a good picture of the tick, you can send that into the state health department, and they can turn that around for you and let you know what type of tick that is. So, it's, again, can be really helpful to know, especially if, you know, maybe you've just pulled a tick off your kid and you're like, "Ugh! What kind of tick is this?: And so, take a picture of it and then, you know, if you want to hold on to it just for a little bit, you can put it in a little plastic bag or somewhere where it's, again, not going to, you know, get away or and then, again, just, you know, send an email of that picture up to the state health department, and they'll let you know what type of tick it was.
David Fair: Once again, this is Issues of the Environment on 89 one WEMU, and we're talking with Washtenaw County Epidemiology program manager Laura Bauman. Laura, this is also the season for mosquito-borne illnesses--West Nile virus among them. Are you on the lookout for other particular insect-caused illnesses through the rest of the summer and fall?
Laura Bauman: Absolutely. So, you know, as you said, we are entering West Nile virus season. You know, typically, West Nile has now been around for two decades in Michigan. And so, we've learned that if there's going to be human cases of West Nile, people are going to get exposed in August and September. You know, I typically tell people that weekend, I mean, it's those days right around Labor Day that seem to be, the most, exposures happen a lot if we're going to see West Nile cases. And, again, I think that it may be, too, that, you know, we've had kind of the whole summer that the virus kind of builds up in the ecosystem. And then on Labor Day weekend is this lovely, kind of sometimes kind of last hurrah of the summer. People are out with friends, maybe out, again, boating, hiking, camping, maybe they're doing yard work. But, again, it's that late August, early September that people, again, just need to be take precautions against mosquitoes.
David Fair: Well, there's a lot of creepy crawlies out there, but I don't want anyone to think that the overriding message is stay indoors. It's not about that at all. It's just about being aware and protecting yourself, right?
Laura Bauman: Absolutely. And, you know, the other thing, certainly, prevention is key as always. But then also, you know, the awareness that if you have been, again, hiking, camping and within, you know, a week or two after that you've been enjoying the outdoors, you're like, "Oh, I'm not feeling so well," or you notice a strange rash, please don't hesitate to contact your health care provider because early treatment of Lyme is really important. It's a 10-to-14-day antibiotic treatment. And one of the things we've been noticing with cases of Lyme disease that have been reported to us this year so far is over 10% of people have been hospitalized. And this is typically when they've missed those early signs of Lyme disease and haven't gotten on treatment. And, unfortunately, Lyme disease can end up causing meningitis and other more severe outcomes. So, again, I just really encourage people to call your doctor and to check in if you think you may have been exposed to Lyme.
David Fair: Well, thank you so much for the time and sharing the information today, Laura. It's always appreciated.
Laura Bauman: You're welcome. Thank you.
David Fair: That is Washtenaw County epidemiology program manager Laura Bauman. She's been our guest on Issues of the Environment. If you'd like more information on ticks and Lyme disease, visit our web site at WEMU dot org. We'll get you linked up everywhere you need to go. Issues of the Environment--tt's produced in partnership with the office of the Washtenaw County Water Resources Commissioner, and it's a regular Wednesday feature on your community NPR station. I'm David Fair, and this is 89 one WEMU FM Ypsilanti.
Non-commercial, fact based reporting is made possible by your financial support. Make your donation to WEMU todayto keep your community NPR station thriving.