[Thorpe] Welcome to Beyond the Data.
I'm Dr. Phoebe Thorpe, and here
with me today is Dr. Gil Kersh Branch Chief
of the Rickettsial Zoonoses Branch here at CDC.
Thank you so much for joining us Gil.
[Kersh] Thanks for having me.
[Thorpe] A lot has happened since our session in 2017,
for instance, by the end of 2017 we had more tickborne cases
than have ever been reported here at CDC before.
Why are we having such an increase in cases?
[Kersh] Yes, we have seen an increase in cases, and in fact,
in 2018 we published a report called the Vital Signs report
where we looked at cases of tick and mosquitoborne diseases
over the last 15 to 20 years and something we noticed
about that is that the tickborne diseases are increasing
every year.
Just about every year there's more
than there was the year before.
And, that analysis covered up to 2016, and as you indicated,
those numbers went even higher in 2017.
And most of those tickborne disease cases are Lyme disease.
However, there are a number of other tickborne diseases
that are also increasing year after year.
So we really see tickborne diseases
as an increasing problem in the United States.
As to why this might be happening, of course,
it's going to be many reasons combined.
One is our increased ability to track these diseases.
We're getting more reports that way,
and that's always a factor in the numbers.
However, beyond that, we also think people are getting exposed
to ticks more often when they go outdoors.
We think there is more interaction
between where people live and where ticks live,
so people are getting more exposure to ticks.
And there's also been a number
of new tickborne diseases discovered in the last of 15
to 20 years, so all these elements combined have led
to these increases that we've seen recently.
[Thorpe] And in addition to one of the new in addition
to new diseases, there's a new tick, an exotic tick,
here in the United States.
Where is the Asian Longhorn Tick?
Where is it, and what is CDC doing to find
out what might happen because it's here?
[Kersh] Right, so the story of the Asian Longhorn Tick
in the United States starts in the fall of 2017
where there was a woman in New Jersey who had a pet sheep
in her backyard, and she noticed a large number
of ticks on the sheep.
And they didn't really look like ticks she had seen before,
so she took it to her local county health department.
And they got the New Jersey Agriculture Department involved
and eventually the US Department
of Agriculture identified this is as the Asian Longhorn Tick
which is a tick we didn't have in the United States.
So everyone was quite surprised to see this on this one sheep
in New Jersey, and this lead to some investigation
of where this tick might otherwise be.
And in 2018, it was found in a number of other states
and even week to week we find it in new locations
as people go out and look.
So, it's been identified in 11 states so far,
and these are mostly along the East Coast in New York,
New Jersey, down into as far south as Tennessee and Arkansas.
So, and this is a unique tick
in that it can reproduce very easily and produce large numbers
of ticks that primarily like to feed on livestock.
Although, in Asia, where it originated, it has been found
on people and has been shown to transmit both bacteria
and viruses to people and cause diseases.
So, for these reasons, CDC is concerned about this tick
and what diseases it might transmit here.
So, the things that we're doing
about it are one is it were providing more money to states
to look for this tick and identify where it's located
and how widely its spread.
We're also generating a colony of ticks in the laboratory
that can be used to study whether
or not it can transmit germs that cause disease,
and we're also doing studies to look at different repellents
that might keep this tick away from people and animals.
So we have a number of different attacks.
We're also looking at what bacteria and viruses might be
in the tick, and so far,
the good news is we haven't found any germs
that cause disease in people in this tick in the United States,
but it's kind of early days on that and we'll keep continuing
to monitor that situation.
[Thorpe] That's very fascinating.
A new tick.
Also, I've heard that there's a,
there's a I've been reading about Alpha-gal.
It's a new kind of disease.
It's an allergic reaction to red meat
that might have happened after a tick bite.
What can you tell me about this new allergic reaction Alpha-gal?
[Kersh] Yeah, it's kind of an interesting story
where we're seeing more and more cases of Alpha-gal allergy
which is sometimes called red meat allergy,
and these are predominantly in the southeastern United States.
Although, they've been found these cases are found in Europe
and Australia and other parts of the US.
But people who have this allergy when they eat meat,
they get a severe allergic reaction usually 3 to 6 hours
after they eat the meats.
They don't always associate it with what they've eaten,
and this allergy turns out to be
against a molecule called Alpha-gal which is found
in mammals, but not in people, or apes, or monkeys.
So it's a molecule that people don't have,
and they get exposed to it.
And they can have reactions to it.
Now most people eat meat and don't have this reaction,
so it was for a while unclear why some people were having
this reaction.
And what the evidence is leading us towards is that ticks,
when they bite people, can sensitize them
to this Alpha-gal, a molecule,
and this sensitization leads them
to have an allergic response later when they eat meat.
And we're doing some studies with universities
and healthcare providers to try
to better understand this linkage between the tick bites
and the Alpha-gal allergy,
and we hope to better understand that in the future.
And also to better monitor these cases which seem
to be growing rapidly.
[Thorpe] Yes, so if people want to know more
about it they can check your website because I'm sure
as you know more you'll post it.
[Kersh] Yes, and we've recently updated our site
to include information about Alpha-gal.
[Thorpe] Yeah, and I was looking at your site
because it's preparation for this.
You have a lot of good information.
I really like the Rocky Mountain Spotted Fever Course.
What else, what else is there for healthcare providers?
[Kersh] Yes, so one of our most popular and useful items
that we have on the website is called The Tickborne Disease
Manual of the United States.
So this is a reference guide for healthcare providers which goes
into a lot of information about the tickborne diseases we have
in the US, gives signs and symptoms
so that providers can recognize these diseases.
And it also has information about where the diseases occur,
so if a patient comes in,
you might wonder what disease could this possibly be
and gives recommendations for treatment and other things.
So this is a handy reference guide for physicians.
As you mentioned, Rocky Mount Spotted Fever,
we've recently produced a clinical training module
for Rocky Mountain Spotted Fever.
Rocky Mountain Spotted Fever is probably the most serious
tickborne disease in the United States,
and it can be rapidly fatal in people who have it.
So it's important that it be recognized early
and the proper treatment given as soon as possible.
For this reason, we've developed a clinical training module
that healthcare providers can get continuing education credit
to understand how to recognize the disease
and treat it properly so that we don't have the fatalities
from it here in the US.
[Thorpe] Yeah.
And I saw this sign posted when I went on a trail recently.
I thought it was great.
It's a great idea.
What else is CDC doing to help increase awareness
of preventing tickborne diseases?
[Kersh] Yeah, so prevention of tickborne diseases is largely
about preventing tick bites.
There are no vaccines for any of the tickborne diseases
in the United States, so what we really encourage people
to do is be aware of ticks and to try to prevent tick bites.
And you can do that by using an EPA registered repellent.
We encourage people to go outdoors,
but when you come inside, it's important to check for ticks.
Showering soon after you come inside is a great idea.
It can wash away ticks are not attached
and also give you a chance to find any ticks that are attached
which should be removed as soon as possible
which you can do easily by grasping the tick with tweezers
and pulling it straight out of your skin.
You don't need any special devices or chemicals to do that,
and we also recommend you can put your clothes in the dryer
for 10 minutes on high heat, and that will get rid of ticks.
So there's some easy steps you can take to prevent tick bites,
but occasionally you will get a tick bite anyway.
And we recommend that you be aware of that.
That if you get ill within the next week or so
that you go seek medical attention
and tell your healthcare provider
that you have noticed a tick bite,
and they can treat it appropriately.
So it's important to be aware of tickborne diseases
to prevent serious consequences.
[Thorpe] Sure.
So if they with somebody else wanted to know more
about tickborne diseases and what else they need to know,
where would you tell them to look for information?
[Kersh] So the best place is our website which is cdc.gov/ticks,
and there you can find information about a variety
of tickborne diseases including The Tickborne Disease Manual,
but also, a lot of useful information for everyone
to understand how to recognize and prevent tickborne diseases.
So it's all on there cdc.gov/ticks.
[Thorpe] slash ticks okay.
[Kersh] Right.
[Thorpe] Thank you so much for joining us Gil.
[Kersh] Thank you.
[Thorpe] And thank you so much for joining us.
See you the next time on Beyond the Data.