Ticks, mosquitoes may await the pandemic-weary who seek outdoor exercise

Pandemic-weary Americans have begun walking and hiking in recent months to get out of the house while avoiding infection with the novel coronavirus. At the same time, resource-strapped local health departments have been forced to divert money and people to coronavirus-related activities, unwillingly creating openings for outside exercisers to get sick in other ways.

Although woods and trails provide some distance from people, they are home to other dangers - such as ticks that carry bacteria-causing Lyme disease or mosquitoes that transmit West Nile virus - especially now, when bugs are proliferating. These and other insects can pass along potentially serious diseases with a single bite.

Health departments have been spending their budgets and deploying personnel on coronavirus efforts, which hurts their ability to focus on programs that control mosquitoes and ticks, says Chelsea Gridley-Smith, director of environmental health for the National Association of County and City Health Officials.

"Many of the impacted local programs are having staff pulled away to focus on covid-19," she says, referring to the disease caused by the novel coronavirus. "For example, these include training people as contact tracers and doing lab testing for covid-19 instead of for arboviruses," which are those carried by mosquitoes and ticks.

As a result, existing services are strained or on hold, she says. In Georgia, for example, the vector surveillance program is scheduled to end this month because of a lack of funding, and its full-time epidemiologist will move from vector control to coronavirus, she says.

In Ohio, laboratories have been "completely devoted to covid-19 since the first week of March," she says. Cutbacks have hurt surveillance - tracking the bugs and testing them for infectious organisms - as well as control activities, such as using pesticides, she says.

Michael Yabsley, a professor in the University of Georgia's College of Veterinary Medicine who studies vector-borne pathogens and infectious wildlife diseases, has launched an online public survey to determine whether the pandemic has driven more people outside, affecting their exposure to ticks and tick-borne diseases. He hopes eventually to publish his findings in several open-access journals.

"The survey actually grew out of some neighborhood chat, which was pretty cool, and my observation that so many folks were using our neighborhood trails for the first time," he says. "Many of them were not really 'outdoor' folks,' and had limited - or no - knowledge about ticks. And when I asked them about why they were now finding the trails and natural areas, it was related to a need to escape the confines of their home."

He also realized in his own family that he had removed more ticks than usual from his three children during the initial weeks after the shutdown. He believes it is because he sent them out into the woods to play once home schooling was finished for the day - and because he and his wife needed time to get their own work done. "This made me think it may be something happening in other places," he says.

The survey is ongoing, but he says the responses so far suggest that there is an increase in people using natural spaces, especially among children.

"We will have to see how that correlates with increased tick exposure, but it seems to be the trend, he says.

The usual protection advice is just as important today as it has always been - perhaps even more so - which is to cover up, use repellent, eliminate any standing water where mosquitoes breed and be sure to keep up with pets' preventive medications, experts say.

"People are living in a smaller radius than before and tired of being stuck at home," says Sadie Jane Ryan, associate professor of medical geography at the University of Florida. "More of them are going outdoors and getting exposure that they ordinarily wouldn't get. When they leave their house, they aren't thinking long sleeves, long pants, 'tip and toss' [flipping containers of standing water] or bug spray. They are thinking: 'Do I have my mask?' 'When did I last wash my hands?' It's a different checklist."

Also, people are more reluctant to go to the doctor or hospital these days, fearful of becoming infected with the coronavirus. But if they don't seek early treatment for insect-related ailments, they could suffer chronic, irreversible health consequences.

"If you let it go too long, there is a much greater chance of getting long-term chronic effects of Lyme, and that's a big issue," says Erika Machtinger, assistant professor of veterinary entomology at Pennsylvania State University. "Also, keep in mind that some covid symptoms mimic Lyme - such as feeling tired, headaches, body aches, nonspecific malaise, fever - so if you are feeling sick, you really need to go to the doctor."

Ticks and mosquitoes are more than a nuisance. Tick-borne diseases hit a record high in the United States in 2017 with nearly 60,000 reported cases, including 42,743 cases of Lyme disease, according to the Centers for Disease Control and Prevention. Cases decreased in 2018, but are still much higher than they were in the early 2000s, the CDC says.

Lyme disease, first identified in the 1970s in Old Lyme, Conn. - hence the name - is caused by a bacterium, Borrelia burgdorferi, which is transmitted to humans by blacklegged ticks. The disease can cause unrelenting misery if not treated promptly with antibiotics. Symptoms starting with fever, headache, fatigue and a characteristic bull's eye rash. Untreated, lyme can spread to the joints, the heart and nervous system, producing long-lasting, debilitating symptoms.

As for mosquitoes, they are among the most lethal animals in the world, causing millions of deaths every year from such infectious diseases as malaria, dengue, Zika, chikungunya, yellow fever and at least a dozen more. Climate change is enabling them to survive through warmer winters and flourish. In the United States, West Nile virus is the leading cause of mosquito-borne disease, according to the CDC.

In Florida, where the economy depends on tourism, coronavirus cases have been escalating since the state began reopening this spring. "We do know things are getting redirected,'' Ryan says. "Vector control has been put on hold. Still, it's always good to have it, because it's not a good economic or health model when you don't. While you certainly don't want your tourists to come here and get covid, you also don't want them to come here and get bitten."

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