Mosquito, tick and flea populations are expanding in the U.S. and infecting people with dangerous viruses, bacteria and parasites. In many cases, the person may not even know they were infected, while other people may become extremely ill and die. Several factors are driving this worsening public health problem and include the expansion of high-density population centers, expanded international travel and changing global temperatures and other environmental factors. As an infectious diseases physician practicing in a hotbed of tick-borne diseases I can assure you, the problem is serious and worsening. Many scientists and clinicians are wondering, is it too late to do something about it?
How Do These Pests Make Us Sick?
Mosquitoes, ticks and fleas pass infectious pathogens between humans, between animals or between animals and humans. The pathogens they transmit include viruses, parasites and bacteria. When infected, humans may experience ailments like dengue, Zika, malaria, Lyme disease and plague.
Disease outbreaks occur when humans and pests inhabit the same geographic area and then a pathogen gets introduced. For example, a traveler infected with a dengue virus lands in Miami, a mosquito bites the traveler, the mosquito gets infected with the virus and then bites another person in Miami infecting them. If the cycle continues long enough, the pathogen can become a permanent resident.
One disastrous example of this phenomenon is the 2015-2016 Zika outbreak in Latin America. After the virus was introduced into the region, well over 1.5 million people were infected including thousands of pregnant women. The result was more than 3,500 children being born with either fatal or severely debilitating ailments of the brain, eyes, muscles and other organs. The region’s suffering from this outbreak has been monumental.
Dr. Saravanan Thangamani, is a Professor at the SUNY Upstate Global Health Institute where he studies ticks, mosquitoes and the pathogens they transmit. His team started a free community tick testing program in 2019 allowing people to mail in ticks they removed from themselves, family members or their pets. His team tested the ticks for 16 different pathogens. The program was heavily utilized with the lab receiving over 32,000 ticks over a four-year period. What Dr. Thangamani observed was concerning “In New York, we currently have more than 13 tick species and over one-third of the ticks we receive are carrying at least one human disease-causing pathogen.”
Does The U.S. Really Have A Pest Problem?
The short answer is yes.
The occurrence of pests transmitting diseases to humans in the U.S. has steadily increased over the past decade with ticks being the most common culprits. It is estimated close to half a million people in the U.S. are diagnosed and treated for Lyme disease every year.
Diseases once thought to only occur outside of the U.S. or in returning travelers are on the rise. Diseases like dengue are routinely being transmitted locally in places like Florida and Texas. The parasite which causes malaria was eradicated from the U.S. in 1951, but locally acquired malaria was recently (2023) documented in Florida, Texas, Arkansas and as far north as Maryland.
Dr. Kathryn Anderson is Central New York’s Onondaga County Health Commissioner, a practicing internal medicine physician and has a PhD in infectious diseases epidemiology. She is also expressing concern “Tick-borne diseases are increasing in our area, representing a significant public health threat.”
In Central New York, my physician colleagues and I routinely see patients with highly complicated late-stage Lyme disease. During the spring and summer months patients are hospitalized with dangerous abnormal heart rhythms, significant and debilitating arthritis or inflammation of the brain.
Physicians are also seeing severe cases of Anaplasmosis, a bacterial disease transmitted by ticks. Dr. Zachary Jones, an infectious diseases physician in Binghamton, NY explained “Our patients with Anaplasmosis can be very sick with respiratory failure and multiple organs shutting down. We have at least one death every year.”
Babesiosis is a disease caused by a parasite which is passed to humans by ticks. Once restricted to New England, the disease has now popped up in Wisconsin, Illinois, Oregon and Texas. The disease can be especially severe in older adults and those with poor immune systems. Approximately 1-2% of hospitalized patients will die of organ failure and shock.
Lyme disease represents a huge public health problem because the battle for many patients is not over even after the initial illness passes. Post-treatment Lyme disease syndrome occurs in up to 10% of patients and causes persistent symptoms including brain fog, fatigue and pain syndromes. The chronic and unrelenting symptoms experienced by patients cause great suffering and have been associated with mental health issues and increased rates of suicide.
Dr. Kristopher Paolino is an infectious diseases physician in Syracuse, NY and his outpatient practice is almost exclusively patients with Lyme disease or post-treatment syndromes. He laments the lack of proven therapies at his disposal “The lack of viable treatment options results in desperate patients trying unproven and potentially dangerous treatments, often with significant out of pocket costs.”
Dr. Brian Fallon studies how Lyme disease impacts the brain and co-founded the Clinical Trials Network Coordinating Center for Lyme and other Tick-borne Diseases at Columbia University. “The primary goal of the Clinical Trials Network is to identify treatments through research that are effective for the long-term effects of Lyme and other tick-borne diseases,” Dr. Fallon explained. He credits the Steven & Alexandra Cohen Foundation for funding the network and other tick-borne disease initiatives with over $88 million dollars in giving to date.
The U.S. Has A National Strategy
The U.S. Department of Health and Human Services and the U.S. Centers for Disease Control and Prevention recently released a national public health strategy aimed at fighting diseases transmitted by pests. The strategy represents the work of more than 15 federal agencies and their experts including the Food and Drug Administration, National Institutes of Health, and entities within the Department of Defense, Department of Agriculture, and others.
The national strategy goals are very similar to other infection preparedness initiatives and include: 1) improving our understanding of who is at risk, 2) developing better diagnostic tests, 3) developing tools to prevent infection, 4) developing treatments and 5) improving overall public awareness of the problem. Of course, there is always a plea for improved collaboration and innovation.
What the National Strategy recognizes, and what scientists, clinicians, and patients have been saying for years, is that when it comes to preventing, diagnosing, and treating diseases transmitted by mosquitoes, ticks and fleas, we need to do better.
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