1. INTRODUCTION
The
Housatonic Region's major tick borne illness, Lyme
Disease, was first recognized as a distinct clinical
entity from a group of arthritis patients in the area of Lyme, Connecticut
in 1975. It also became evident that this disease had an extensive
history in Europe throughout the twentieth century.
Lyme Disease is caused by bacteria transmitted to humans by the
bite of infected blacklegged ticks. Typical symptoms include fever,
headache, fatigue and a characteristic skin rash. If left untreated
the infection can spread to the joints, heart and nervous system.
To enhance municipal efforts, in 2008 HVCEO
created a regional Tick Borne Illness Prevention Task Force.
While local groups are already addressing this complex public
health issue, mayors and first selectmen saw that regional
coordination and communication could assist and help to
more efficiently address this health problem.
Photo above courtesy of Russell Cornelius.
To coordinate with the Governor's
BLAST tick-borne illnesses
out of Connecticut proclamation, the ten local governments
in the
Housatonic Region each adopted its own identically worded
proclamation.
See Recommendation on Lyme Disease management
on the HVCEO
Legislative Agenda.
The greatly increasing incidence of Lyme
Disease in Connecticut is a public health crisis. Municipalities
in the Housatonic Valley Region have their individual efforts
to fight the disease and are jointly sponsoring this regional
web page.
Area tick borne illness prevention web resources
include:
--- PowerPoint
presentation by Mark L. Friedman, MD, (26 mb)
to the Task Force at its meeting on January 19, 2011.
--- Town
of Bethel, CT Health Department Lyme Disease Page.
--- Town
of Brookfield, CT Tick Disease Page.
--- Rotary
Club of Housatonic Valley Tick Removal Kit.
Signing
ceremony on 7/16/2009 at Brookfield Town Hall as
Governor Rell endorses legislation validating treatment of
chronic Lyme Disease. This act offers physicians in Connecticut
additional legal protections when treating long term sufferers.
--- New
Milford Hospital Tick Borne Disease Brochure.
--- Town
of Ridgefield, CT Lyme Disease Task Force,
a "non-profit organization of volunteers focused on decreasing
the prevalence of Lyme Disease and other tick-borne illnesses in
our community through awareness-building and education, tick remediation,
and public policy advocacy."
--- Town
of Ridgefield, CT Deer Committee and Report.
--- Town
of Ridgefield, CT Health Department BLAST Program.
--- Ridgefield, CT VNA's Lyme, Chronic Fatigue and Fibromyalgia
Support Group. A professionally facilitated group that
meets the second Thursday of each month from noon to 1pm at the
Ridgefield VNA office. Call Jennifer Reid at 431-0462 for more information.
--- Town
of Redding, CT Health Department Lyme Disease Page.
--- Fairfield
County Municipal Deer Management Alliance,
a group of 18 municipalities formed "to foster a collaborative
multi-town approach to managing the region's abundant deer population
and reducing its impact on ecological integrity, public health (tick
borne diseases) and safety (deer-vehicle accidents)."
Actions
to prevent Lyme Disease range from simple to quite complex. These
include using insect repellent, removing ticks promptly, defensive
property landscaping, and integrated deer and pest management.
Yet tick-borne diseases are still spreading and much more needs
to be done.
Blacklegged
tick is the correct common name
for the tick popularly known as the “deer” tick.
Size relative to a dime is shown above.
Prevention
focus is on the Region's extensive low density residential environment,
as an estimated three quarters of all Lyme Disease cases are acquired
from ticks picked up during outdoor activities around the home.
Tick abundance is closely related to suburban residential landscapes
that support the ticks' animal hosts, particularly white tailed
deer and white footed mice.
2. ABOUT TICKS
Anyone
interested in addressing tick-related illnesses needs to first understand
the tick's life cycle. That cycle has a surprising complexity, as
shown below:
Complex
tick life cycle. Tick larvae feed on one animal, drop to the
ground and molt to a nymph. The nymphs then find and attach to
other animals, engorge, drop to ground and molt to adults.
The adult tick then feeds on a third animal, which in order for
the
female tick to become fertile and complete the cycle effectively,
must be a deer. A blood filled female tick produces a single large
batch of eggs and dies. The humans and dogs depicted above are not
themselves effective hosts in tick breeding, they are accidental
hosts.
They cannot alone sustain the tick population when deer are scarce.
Ticks
are essentially mites that require a host animal for food and development.
As shown above, ticks have distinct stages in their life cycle,
including egg, six-legged larva stage, eight-legged nymph and then
adult. Larvae and nymphs change to the next stage after digesting
a blood meal on their host.
When
approached by a potential host, a tick becomes excited, waving its
front legs in order to grab the passing animal. Ticks cannot fly
or jump; they must make direct contact with a host. Ticks do not
bite and depart but attach and feed gradually over several to many
days.
Dr.
Georgina Scholl of the Fairfield County Municipal Deer Management
Alliance emphasizes the following critical point on the role of
deer:
Other hosts simply will not allow the ticks to succeed
and breed and spread diseases. Only densely populated deer can fulfill
this role. This is the OPPORTUNITY FOR PREVENTION that is afforded
by the tick's dependence on deer.
All other phases of the tick life cycle have multiple alternate
hosts, but this one phase, the fertility of the adult female tick,
depends on just one species, the white tailed deer.
It is precisely because of this dependence on a single key animal
host that Lyme Disease can be so easily prevented just by controlling
the population density of one animal.
In
sum we could leave the complex tick life cycle alone, except for
the fact that there are at least eleven recognized human diseases
associated with ticks in the United States, seven or eight of which
occur in the mid-Atlantic or northeastern states.
Most prevalent in Connecticut are Lyme Disease
and the bacterial diseases Ehrlichiosis
and Babesiosis.
The
bottom line: Humans and ticks don't mix.
3. TICKS IN THE
REGIONAL LANDSCAPE
In
Connecticut and elsewhere in the Northeast the emergence of Lyme
Disease can be linked to changing landscape patterns.
In the mid-1700s ticks were abundant. But then by the later 1800s
ticks were nearly extinct. Between
those times the land had been cleared for agriculture and white-tailed
deer in many areas were drastically reduced or virtually eliminated
due to habitat loss and unregulated hunting.
With the reestablishment of forested habitat and animal hosts through
the latter half of the 1900s, ticks that survived were able to spread.
The risk of human infection increased through the 1960s and 1970s
yielding today's out of control situation.
Today,
the Region's explosive
population growth had yielded a vast pattern of residential
homes in re-wooded areas, as amply demonstrated on this Map
of Greater Danbury Land Use.
Excerpt
from the Map
of Greater Danbury Land Use,
documenting extensive development (red) located in wooded areas.
A
key inducement to this low density suburban pattern of residential
housing "in or near the woods" is the Region's prevalence
of low density residential zoning, as documented by this 2008
Zoning Patterns Overview Map.
While
the resulting low intensity suburban environment is in most ways
very pleasant, there is an unintended consequence: it
supports mammals such as mice and deer that enable the tick life
cycle to thrive.
Our
plight is well reflected in the key conclusion in the 2007 CT Tick
Management Handbook, where the incidence of Lyme Disease is attributed
to five main factors:
--- Increased tick abundance
--- Overabundant deer population
--- Increased recognition of the disease
--- Establishment of more residences in wooded areas
--- Increased potential for contact with ticks
4. DEFENSIVE LANDSCAPE MANAGEMENT
Our
Region's residential landscapes were designed for a variety of aesthetic
and environmental reasons. Fortunately, low cost “tickscape”
practices can be introduced to landscape and backyard management.
Thoughtful yard modifications can create an environment unattractive
to primary tick hosts and may decrease the abundance of ticks that
are present in parts of the yard.
Fewer ticks have been found on well-maintained lawns, except on
areas adjacent to woodlands, stonewalls, or heavy groundcover and
ornamental vegetation.
At
left are woods blending into the backyard. At right is the preferred
sharper definition between areas after "tickscape" intervention.
Source: CT 2007 Tick Management Handbook
While
there is a lot of variation in tick numbers between homes, larger
properties are more likely to harbor ticks because they are more
likely to have woodlots. The blacklegged tick is found mainly in
densely wooded areas, 67% of total sampled, and ecotone, 22% (defined
as the unmaintained transitional edge habitat between woodlands
and open areas).
Fewer ticks are found in ornamental vegetation, 9%, and lawn, 2%.
Within the lawn, most of the ticks, 82%, are located within 3 yards
of the lawn perimeter particularly along woodlands, stonewalls,
or ornamental plantings.
Tick abundance in manicured lawns is also influenced by the amount
of canopy vegetation and shade. Groundcover vegetation can harbor
ticks. Woodland paths also may have a high number of ticks, especially
adults, along the adjacent grass and bushes.
Make use of these "tickscape" improvement
guides:
---
CT Agricultural Experiment Station's Managing
Ticks on Your Property.
5. "BLAST" PROGRAM
AND PERSONAL PROTECTION
During
2008 Ridgefield received a grant from the CT Department of Public
Health for a program of Lyme Disease prevention and education. The
resulting BLAST Program, led by Jennifer Reid, was designed to be
shared with other communities.
"B" stands for bathing soon after spending time outdoors. A recent study
showed that people who did not contract Lyme disease were more likely
to shower or bathe within two hours after spending time in their
yards.
"L"reminds
everyone to look their bodies over for ticks daily and remove them
properly. Speedy removal helps avoid disease transmission.
Remove ticks carefully by their mouthparts with tweezers and save
them in a plastic bag for identification. Contact your local health
department for tick-testing policies and notify your physician if
you have any concerns.
Expanding
rashes should be reported to your physician in a timely manner.
The painless erythema migrans (EM) rash can often go unnoticed and
will eventually disappear while the infection remains. Other early
symptoms include fatigue, headache, fever and achy muscles and joints.
"A" encourages you to become educated about repellents and apply them
appropriately. Studies have shown that applying 30-40% DEET-based
repellant to skin is effective at repelling blacklegged (deer) ticks.
Application of 0.5% permethrin-based insecticide to clothing is
highly effective at repelling ticks. Clothing treated with permethrin
can be washed several times and still retains its repellant properties.
"S" stands for spraying the yard to reduce tick abundance.
Homeowners should consider the benefits of applying pesticide to
the perimeter of their yards.
Studies have shown that even one application of pesticide at the
right time of year and in the best location can reduce blacklegged
tick populations by 85 – 90%.
Complete information on tick management is available in
electronic format through the Connecticut
Agricultural Experiment Station's CT 2007 Tick Management
Handbook (8.52 mb) .
"T" reminds everyone to treat your pets. Local veterinarians
offer a variety of methods for protecting animals from tick-borne
diseases. Dogs and cats increase one’s chances of exposure
to Lyme disease.
Pets can carry ticks in to the home on their fur. Pet owners should
be cautious about sleeping with their pets. Make everyone in your
family a Lyme fighter this year.
Additional
introduction is on the BLAST
Program page at the Ridgefield Health Department.
BLAST banner on Brookfield's Route 133 in 2008.
BLAST dissemination activities have included presentations with
health educators, manned displays, outreach to medical personnel,
municipal involvement, advertising and publicity.
Valuable web ready resources were produced by this innovative program
for free use by all parties. They are available for download below:
BLAST BROCHURES:
English.doc
-- Spanish.doc
BLAST FLYERS:
General
Flyer.doc -- Grade
School-young girl art.doc -- Middle
School-young man art.doc -- Spanish
Lyme Prevention.doc
BLAST GRAPHICS:
BLAST
Logo.doc -- Checkers
the Dog.jpg -- Dash
Lyme Figher.jpg -- Green
BLAST Word.doc --
Lyme Fighter Lacy.jpg -- Lyme
Fighter Dad.jpg -- Lyme
Fighter Logo.jpg -- Lyme
Fighter Mom.jpg --
Lyme Fighter Nana.jpg --
Lyme Fighter Tiny.jpg
BLAST POWERPOINTS:
-- BLAST
for Grades K thru 2 PowerPoint
--
BLAST for Grades 3 thru 5 PowerPoint
--
BLAST for Grades 7 thru 8 PowerPoint
--
BLAST for Adults PowerPoint
--
Alternative to Spraying PowerPoint
BLAST PROMOTIONAL:
Business
Card.doc -- Lyme
Awareness Certificate.doc -- Display
Photo.jpg -- Ridgefield
Health Business Card Magnet.pdf -- Ridgefield
Health Pencils.pdf --
BLAST PUBLIC RELATIONS:
Contact
Request Letter to Churches.doc -- Basic
Message.doc -- Newsletter
Article.doc
BLAST SOURCES:
Banner,
Yard Signs.doc -- Brochure.doc
-- Magnet,
Pencil.doc -- CDC
Info Card.doc -- Public
Info Guide.doc -- CT
DPH Lyme Disease Prevention Handbook.doc --
DEET
Brochure.doc -- Lyme
in Rhyme Children's Book.doc --
Pesticide Brochure.doc --Tick
Check Stickers.doc -- Tick
ID Card.doc -- Tick
Management Handbook.doc -- T
Shirts.doc -- Weston
Westport Brochures.doc
6. STATISTICAL INDICATORS
A good data base is important for prevention efforts. People want
to be both convinced of the scope of the problem and have baseline
data for assessing effectiveness of prevention strategies.
Below are some data resources on Lymes Disease, tick prevalence
and deer population:
--- 12/2008
CT labs no longer required to report Lyme Disease.
---
Statistics at the National
Centers for Disease Control and
Prevention, including reported cases by state 2003-2007.
---
Tick census conducted in Newtown
11/2008 and in Redding
11/2008.
---
CT Department of Public Health's Lyme Disease Statistics Page.
--- Lyme Disease Prevention Among Connecticut Residents, 1999-2004.
---Results
of Lyme
Prevention Focus Group, Ridgefield, CT July 2008.
The
above chart is an excerpt from the
2009
Community Health Report Card for Western CT
7. DEER MANAGEMENT
Southwestern
Connecticut is fortunate to have had in place since 2004 the Fairfield
County Municipal Deer Management Alliance. Visit the
Alliance web site for much valuable information on deer management.
The purpose of this group is "to foster a collaborative approach
to managing the region's abundant deer population and reducing its
impact on ecological integrity, public health and safety."
Note that the Alliance does not itself manage deer populations.
Rather, it aims to study, educate, inform and raise awareness of
the benefits of a balanced deer population and to share the current
state of the art with those towns or institutions that want to use
this method of preventing tick borne diseases.
HVCEO volunteers as the financial manager for and auditor of Alliance
funds.
Source: 2007
CT Tick Management Handbook
As shown below the Alliance offers Nine
Short Statements on the Role of Deer in the Lyme Epidemic.
These were authored by Dr. Kirby Stafford, State Entomologist
and Vice Director of the Connecticut Agricultural Experiment
Station and who wrote the 2007 CT Tick Management Handbook.
Dr. Peter Rand, Co-Director of the Maine Medical Center's
Vector-borne Disease Laboratory, also contributed. Both
are scientific advisors to the Deer Management Alliance.
1)
Deer are the single most important, key animal host in the tick's
life cycle. Without deer there would be few if any ticks. (From page 52 of the CT Tick Management Handbook and from Dr. Anderson's
studies on Narragansett Bay islands and Dr. Rand's study on Monhegan
Island).
2) Reducing deer densities to below 10 to 12 per square
mile has been shown to prevent ticks from perpetuating their species
successfully. (From Dr. Stafford’s
Testimony to the CT General Assembly on March 10, 2008).
3) Reducing deer densities to below 10 to 12 per square
mile has been shown to substantially reduce tick numbers and human
Lyme Disease. (Stafford Testimony 3/10/08).
4) There is more than enough scientific evidence already
demonstrating the dramatic effect of sufficient deer reduction on
tick populations. (Personal communication-
referring to the 6 studies described in detail on page 56 of the
CT Tick Management Handbook, and more described by Dr. Rand from
mainland Maine in his testimony: “deer reduction was highly
positively correlated with tick abundance").
Plus,
two studies described and graphed in the DEP booklet: Managing
Urban Deer in Connecticut, on pages
3 and 4. More
deer reduction studies are described in the Cornell guidebook on
Community Based Deer Management: A Practitioners' Guide: http://www.cce.cornell.edu/store).
5) Deer are key to the reproductive success of deer ticks (Page 52 of the Tick Management Handbook 2007). Dr. Rand has “demonstrated
the quintessential role of the deer host in the maintenance of deer
tick populations.” (Testimony to the CT General Assembly April
2008).
6) Lethal management options for deer are effective at reducing
tick populations. (This is on page 56 of
the revised edition CT Tick Management Handbook 2007).
7 ) In the absence of deer there are few if any ticks. This
is because while adult ticks may occasionally feed on opossums,
raccoons, dogs, coyotes, etc., these animals play only a minor role
in the ecology of the tick and will support few ticks. (From page 52 and page 55 of CT Tick Handbook).
Ticks latched on to head of deer
8) Areas without deer have been shown to harbor few ticks
and little or no infection by Lyme Disease spirochetes [a category
of corkscrew-shaped bacteria]. (From pages
52 and 56 of CT Tick Management Handbook).
9) An Integrated Tick Management approach combines several
methods, including managing host animal populations, to provide
least toxic control of ticks for the prevention of tick-associated
disease. (Table 3 page 45 of CT Tick Management
Handbook).
Links
of interest:
2010
Economic Impact of Deer Over
Population by Fairfield County Municipality
YouTube - Dr. Kirby Stafford of the CT Agricultural
Experiment Station:
Deer herd reduction and lyme disease
Ridgefield,
CT Deer Committee and 2005 Report
8. STATE AND NATIONAL RESOURCES
