AMHERST, Mass. – The recent popular success and high demand for a tick testing service provided to Massachusetts residents by the Laboratory of Medical Zoology at the University of Massachusetts Amherst has led LMZ director Stephen Rich to extend the program, despite loss of state funding, by offering towns a co-pay model.
During tick seasons in 2014 to spring 2015, Rich estimates the LMZ tested about 3,200 of the blood-sucking arachnids extracted from people and pets on Cape Cod and across the Commonwealth, for up to eight different disease-causing pathogens including the most common: Lyme, Babesia and Anaplasma. Testing not only helps families and physicians identify pathogens people have been exposed to, it also allows public health officials to map the distribution of pathogens and several different tick populations.
A one-time state subsidy that ended in June paid for 100 ticks tested from each of 32 participating towns, helping people with the $50 cost. This high volume allowed LMZ to process in batches and save money. The fact that every town took part at the maximum level underlines the need, Rich says. “We get high praise from almost everyone who uses the service,” he adds. “We don’t get people saying they didn’t get their money’s worth.”
Now, just in time for the peak tick fall season from late October to mid-November, the LMZ is partnering anew with 23 Massachusetts towns to extend the program over the next year at a cost of $30 per tick. Towns have agreed to split the per-tick cost, so 100 residents will pay $10-$15 as a co-pay with their town, Rich says.
“We hope this model will be affordable for both individuals and towns and that it will turn out to be sustainable over the long term, so the lab can continue its important public health surveillance work at the same time we provide individuals and physicians with information to help them with treatment. I’m hoping we can reach a goal of 100 towns participating in the co-pay program by December 2016.”
For now, all 15 Cape Cod towns in Barnstable County will take part, along with six Franklin County towns, Charlemont, Conway, Hawley, Heath, Leyden and Shelburne. They are joined by Westford in Middlesex County and Cuttyhunk Island in Dukes County, the LMZ director says.
Phoebe Walker, director of community services for the Franklin Regional Council of Governments, adds, “The towns of the Cooperative Public Health Service health district got a lot of benefit from participating in tick testing. Our boards of health were interested to learn about tick borne diseases present in Franklin County, and that the active tick season is far longer than initially thought. These lessons help us better target educational messages to our rural residents. In addition, we learned from the tick testing program that young children are one of the most affected groups, which led our health district to install tick safety signs at day cares, schools and parks across our ten towns.”
As a result of LMZ’s work, Rich says we know many new facts. For example, data from the Cape let’s him tell public health officials, “We see high tick bite incidence over long duration, many months, in Barnstable County. Also, the pathogen Anaplasma is not seen much in Franklin County but is often observed in Barnstable. And on the Cape, mid-November is the peak for ticks submitted, a much later season than most people think. Without statewide surveillance we never would have known that.”
The lab asks people where on their bodies they found ticks. LMZ reports that 18 percent of bites were on the upper leg and thighs, 13 percent on the head, 13 percent on the ankles, 11 percent on the back and 8 percent in the groin. Further, Rich says that more than 80 percent of ticks sent in from Nantucket were unfed, which means people there are vigilant and remove ticks before they attach. By contrast, in Franklin County only 50 percent of ticks are unfed, so not as many people are looking sharply for them.
Another benefit of tick testing is increased public awareness, Rich says. “It’s all theoretical until parents find the first tick on their child, and then they panic. They call us, they ask for a live chat with us. In an instant, they can’t get enough information and they can’t wait five minutes to get that tick tested. They are suddenly paying intense attention, and we can use that as a moment to teach them and help change their behavior so they may not have to send another tick to us again.”
In fact, of 608 TickReport users surveyed, 70 percent said the experience changed their behavior, checking themselves and children more often, using repellent more often, avoiding certain outdoor areas, tucking their pants into socks and taking other precautions.
Rich’s hope for true statewide tick surveillance may take years to accomplish, but it would not be unprecedented. When mosquito-borne illnesses such as yellow fever and malaria were discovered 100 years ago, states immediately began massive tracking, not only of diseases but of the insect vectors. Today, Massachusetts towns together spend $11 million a year to track mosquitoes, West Nile virus and Eastern equine encephalitis, which infect only a handful of people compared to the thousands who get Lyme disease and hundreds who get Anaplosmosis and Babesia.
“Our idea for statewide tick surveillance is built on a different way to think about funding public health initiatives,” Rich acknowledges. “Usually we look to the state to pay the entire bill for surveillance or educational campaigns but there is a different solution. Everyone understands the benefits of buying local and sustainable products; we’ve extended that rationale to build communities of practice that use the local, sustainable approach to build public health capacity for communities that need it but may not be able to afford to go it alone.”