New York cut a million-dollar investment to battle Lyme and other tick-borne diseases to zero in the new budget passed last week.
The funding aided numerous projects, including researching infected ticks in schoolyards, education and outreach programs, and studying environmentally sound ways of eradicating ticks in Hudson Valley neighborhoods.
Lyme infected almost 10,000 people in New York in 2017, according to the New York State Department of Health (NYSDOH). However, infection rates for Lyme tend to be ten times the reported number, according to the U.S. Centers for Disease Control (CDC), suggesting 100,000 people are being infected a year in the state. The highest rates of Lyme are in the Hudson Valley and Capital regions, according to the NYSDOH.
Researchers in the affected programs were also trying to address babesiosis and anaplasmosis, less wide-spread tick-borne diseases often causing more severe illnesses.
Democratic state Senator Jen Metzger, whose district includes some of the worst-hit parts of the state, is well-aware of the extent of Lyme’s reach. She’s had it five times.
“My father-in-law has had Lyme — I think he’s had it six times,” she said. “I have other friends who have gotten it numerous times, and I have had friends who have suffered really long-term effects of it as well.”
Metzger was lucky to be tipped off by the iconic bulls-eye rash with four of the infections, she said. One infection came without the rash, as is commonly the case, and it progressed until she was experiencing such a high fever and such severe neck and back pain she went to the hospital, where she was given antibiotics though an IV, she said.
“Everyone is at risk, really,” Metzger said. “You can get it in your garden, you can get it mowing your lawn…it’s not like you need to be an active outdoors-person to get it.”
Pets often brought infected ticks into homes, and farmers in the region were at particular risk, she added.
The million-dollar line item was included in the state Senate’s proposed budget but was not in the state Assembly’s or Governor’s versions and never made it into the final budget passed March 30.
Republican state Senator Sue Serino, who chairs the Senate Taskforce on Lyme and Tick-Borne Diseases, released a statement saying she was “truly shocked” by the omission, which she called “simply irresponsible.”
“We have an obligation to protect the health and safety of New Yorkers, and this budget bill fails to do that,” according to Serino, who decided to vote against the bill.
Metzger pointed to predictions Lyme and other tick-borne illnesses would get worse with Climate Change.
“We really have to be looking ahead and investing in public health to address these issues,” she said.
Cornell University received over $300,000 from the state in the last two years to research tick-borne diseases and educate the public on their dangers, funding which has now been cut off.
The university’s Cooperative Extensions used the funds to start the Tick Outreach and Surveillance Project.
Researchers based in Long Island collected and tested ticks for infectious diseases in schoolyards in an attempt to define the risk for young children, who have one of the highest rates of infection, said Cornell Community Integrated Pest Management Coordinator Jody Gangloff-Kaufman.
The project started last fall, when only deer ticks are out, and funding was cut before researchers could study tick species that would emerge in the spring, Gangloff-Kaufman said.
The project will continue “in a limited way” without the funding, she said, but researchers will not be able to test the ticks for disease — only count them.
Cornell was also using the funds for outreach, creating an awareness campaign and distributing tick removal kits with tick-identification cards, magnifying glasses and tweezers to New York counties, Gangloff-Kaufman said.
“[Outreach] will continue as much as we can,” she said.
Almost $200,000 of the state funding went to the Cary Institute for Ecosystem Studies in Dutchess County for “The Tick Project.”
The Tick Project’s total budget is $8.8 million, but Cary Institute Disease Ecologist Rick Ostfeld called the state money “instrumental” in carrying out its goals.
The project was testing out two tick-killing methods in about a dozen Dutchess County neighborhoods, Ostfeld said. One was a native fungus that kills ticks “and almost nothing else,” and the second involved luring mice and other tick-carrying mammals into a “bait box,” where they would brush against a wick containing fipronil, the tick-killing agent in Frontline. Proven safe for pets, fipronil will kill the ticks on the mouse without harming it or affecting other mammals, Ostfeld said.
Ticks attach to small mammals such as mice in their nymph and larval stages, where they can acquire Lyme, then pass it to humans when feeding later in their larval stage or in their adult stage.
Ticks can also acquire babesiosis and anaplasmosis when feeding on mice, diseases “entering sort of epidemic phases” in the region, Ostfeld said.
Babesiosis is also carried by the deer tick and can cause flu-like symptoms, as well as anemia and blood clots, and, in rare cases, death. New York saw 697 reported cases of babesiosis in 2017, with the highest rates in Dutchess County, according to the NYSDOH.
Anaplasmosis can cause high fever and headache and can also be life-threatening. Almost 1,200 people were infected in the state in 2017, with the highest rates in Columbia County, according to the NYSDOH.
The Tick Project’s five-year experiment testing the fungus and the bait boxes could be curtailed because of the budget cut.
“What may happen is that we are unable to carry out the project as long as we think it is important to carry it out,” Ostfeld said.
The budget cut affecting The Tick Project and other research around the state would have consequences, he added.
“In essence, the decision to not spend that million dollars could mean we’re going to spend more on healthcare costs, and, in all likelihood, more people will be getting sick without this investment in strong research,” he said.
A 2015 study by John Hopkins University found Lyme cost the U.S. healthcare system up to $1.3 billion a year in return doctor’s visits and follow-up testing alone. The figure does not include the initial treatment of the disease, much less things like lost worker-hours.
Though not knowledgeable about the state’s budgetary process, Ostfeld said the cut was “particularly hard to fathom.”
“It strikes me as very strange that it would’ve been canned at the last minute,” he said.
Patricia Smith, president of the national Lyme Disease Association and a member of the recent federal Tick-Borne Disease Working Group, said the cut was “a terrible thing.”
“Of course, it isn’t just New York,” she said. “No one is willing to appropriate funds to do anything about this epidemic that is just out of control, and I don’t understand the thinking behind that.”
Since 1990, Lyme has been reported in all 50 states, according to the CDC, and is found in Canada, Europe and Northern Asia.
When asked if any state or international governments could serve as a good template for dealing with Lyme, Smith responded none were addressing the problem well.
“Nobody really seems to take the bull by the horns,” she said.
Coordination between states and the federal government was needed, Smith added, and “if they made it a priority in the states, then perhaps the federal government would sit up and take notice of this issue.”
Sen. Metzger said she would be looking at different ways to make up for the budget cut, and said a federal plan was needed, also suggesting interstate cooperation between northeastern states most impacted by the disease.
Lyme first made itself known in 1975 in Lyme, Connecticut, and has since spread around the globe. The highest rates are still seen in the Northeast, and the disease has also spread in the upper Mid-West, with Wisconsin officially reporting 3,000 cases in 2017, according to the CDC.
Lyme and other tick-borne diseases will get worse with climate change as their range spreads and warmer weather makes their winter die-offs less severe.
Lyme causes a variety of symptoms often confused with other diseases. Among confirmed patients, 71 percent develop the bulls-eye rash, 28 percent experience arthritis, nine percent experience facial palsy and two percent develop meningitis or encephalitis, according to the CDC, though these rates are inflated because of the way data is collected, and because those with these symptoms are much more likely to seek medical care.
There is also incredible controversy over “chronic Lyme,” which advocates say can debilitate patients for years or decades after antibiotic treatment has stopped. The disorder has had a hard time entering accepted medical thinking, but a John Hopkins study last year found symptoms including severe fatigue, joint pain, headaches, and severe cognitive and psychological problems in patients formerly infected with the bacteria causing Lyme.
About half the ticks collected in the Hudson Valley are infected with Lyme, according to the NYSDOH.