Can We Eliminate the Ticks That Carry Lyme Disease?

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Michael Osterholm

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Dr. Michael Osterholm is an expert in infectious disease epidemiology, professor, and director of the Center for Infectious Disease Research and Policy. He's also the host of "The Osterholm Update: COVID-19" podcast, and author of multiple books, including "Deadliest Enemy: Our War Against Killer Germs."

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I want to ask you about Lyme disease. Sure. Lyme disease is a scary one, right? And I mean, so many of my friends in the East Coast have it. It's really terrifying that that part of the country in particular seems to be like really badly infected with these ticks that carry this disease. What can people do to prevent that? And what can we... There's no vaccine for Lyme disease, and I know there was at one point in time, but people were having an issue with, I mean, a good friend of mine, her dad actually got Lyme disease from the vaccine before they discontinued it. What can someone do to sort of protect themselves? Yeah. Well, Lyme disease in and of itself is a fascinating story. I've actually been involved with it since its early discovery in the 1980s, and Minnesota, Wisconsin was a big focus the Upper Midwest. And this is a story that I think you'll find interesting is that even though it was discovered primarily in the Eastern part of the United States, named after Lyme Connecticut, it's a disease that actually probably originated in the Upper Midwest. And I tell you that because it turns out that there is a focus in Northern Wisconsin and East Central Minnesota where there's Lyme disease, there's another disease called anaplasmosis, another disease, Babesia, et cetera, that all seem to have a similar kind of tick human deer kind of component. And back in the CCC days of the 1930s, the white-tailed deer population had been virtually totally depopulated from the Northeast. And so they actually trapped deer in Northern Wisconsin and took them out and deposited them in New York and Connecticut and so forth. Wow. And the deer are actually deer that today their great, great, great, great grandfather came from Wisconsin. Wow. And guess what? When you move deer, you move ticks. In fact, I was involved with a study that the Wisconsin Division of Health did and a colleague of mine, the late Jeff Davis, where up in Northern Wisconsin, this deer would come into the check station and they would actually measure the number of ticks that were attached to the nape of the neck. And they had a thing drawn. And they asked hunters who were driving back to Madison and Milwaukee if they would be willing to check in at a station down there for just a second and then they were going to count the ticks again. And it turned out that as the vehicles come rolling down from Highway 51 from Northern Wisconsin, get on the interstate in 1994 and go to Milwaukee or Madison, the ticks just kept falling off. By the time they got to Madison or Milwaukee, the ticks were almost all gone. Well, guess, lo and behold, where all the Lyme disease and so forth started to show up right along the interstate corridor. Wow. Because the ticks were coming off and then they were getting into the local deer in that population. And so it's exactly what you said, the ticks are moving. They're moving. Okay, they've moved and they're now infected. So I think that this Lyme disease issue is a key one. Lyme disease is really an important disease. It's real, no question about it. The challenge we have is that there's a lot of people that assume that they have chronic Lyme infection. And, you know, the data on that is just really, really not there to support that these people are chronically infected, but they do have an immune response likely that occurs where it sets up this trigger. And so they're sick. They actually have something. But it's not treating it again for the bacteria infection. It's the fact that your own body's immune system, as we've talked about several times today, it starts attacking you. I think it's a similar picture we see with chronic fatigue syndrome, same kind of thing. These people really are sick. They really do have problems. But it's not something you can treat. So when people, I have a challenge because when people take IV antibiotics at extended periods of time for Lyme disease, you know, the data, there's four different studies that have been done where people have had what we call a double blind placebo controlled trial where half got the drug, half got IV, but no drug. And it turned out all four of these studies in Lyme disease, the people who got just the placebo did just the same as the people who got the drug. And I worry that we're using antibiotics a lot there. And this is where I just mentioned earlier about Clostridium difficile. We actually had a patient in Minnesota that died from the IV treatment for what was chronic Lyme disease and wouldn't have been helpful. And so we need a lot more research in this area to figure out what are these people getting? What is it that we can shut off so that they don't have this chronic Lyme disease picture knowing that it's not actually just you had to treat them more? Treatment's not going to help them with the antibiotics anymore. And so I think that that's an area that we just need a lot more work in. And the numbers are growing, as you know. Yeah. So we don't know what's happening? We have enough data to say your immune system is really cranked up. Your immune system is just like... Reacting to something. Yeah. It's like rheumatoid arthritis, a lot of things. Thank God for our immune system. It's what fights off all the bad things we have. But sometimes that immune system gets turned on too much. And then it takes on us. And it goes back to the coronavirus. That's why a lot of these people are dying right now, is this over vigorous immune response. And Lyme disease is kind of that same inciting event where we have evidence now that you could be infected with the bacteria. But if we treat you, it's like every other bacteria. You can really get rid of it. But you still have this chronic illness that's occurring. And what I think is hard is that we see people who have this, who are desperate to have somebody understand what they have. And they end up going to people who take real advantage of them. And to charge them an arm and a leg for things that are not going to help them. And what we need is a lot more research on what is actually going on and what kind of drugs can we use to reverse this immune system disorder. I have a friend of mine who's a UFC fighter, Jim Miller, and he's got Lyme disease. And it's pretty bad. He takes a stack of pills. I don't know what he takes every day. What do you think someone is taking? And what benefit would they get from that? I couldn't tell. I'm not without knowing what's there. But again, more often than not, if he's been adequately treated, it's not that the bacteria is still growing in him like it might be for a lot of people. It's an autoimmune response. It's autoimmune, which is real. I mean, that's the other thing is I think these people just want to be legitimized and said, I'm really sick. And it's not something I'm mentally ill about, whatever. But then we've got to figure out what it is that you have. And I know. So we really don't know. We don't know yet. We don't know. But this is where we need a lot more research about this in terms of what is it that's making these people like this. And this is really important. And is there anything they can do to eradicate the ticks? You know, this is another thing you'll find interesting. In Minnesota, prior to the arrival of the first white man, the Native Americans burned much of our state all the time. The prairies for much of the territory, and even in northern Wisconsin and northern Minnesota, we had the classic pine forest firewood wiped through. And with that, it would open up so much of the forest that you'd have a very different kind of mammals, population, deer, et cetera, et cetera. And with the suppression of fire, what's happened is we now have, instead of having these old growth forests, we have all this younger non-pine or any kind of, like the oak trees of the upper Midwest are all disappearing because oak trees need sunlight. And fires, what kept, they were very resistant to fire. And so the old oak forests and so forth would survive because of fire. Whereas today, with no fire, you know, the elms and the maples and everything else comes in and the buckthorn and all that kind of stuff and takes over. So, what's happening is, in our state of Minnesota, is we have a really good example of this, is we're losing our moose. And the big primary reason is brainworm. Brainworm, it's a type of parasite that's common in white-tailed deer but causes no problems. In moose, it actually causes a brain infection and it kills them. And guess why it's happening? Because the deer range has moved farther and farther north in Minnesota. I'm sorry. Yeah. It has moved farther and north in Minnesota because of lack of fire because the forest is changing. So, now, where there only used to be moose, we're seeing deer and moose. And where that intersection is, we're starting to see moose develop this brainworm infection because it's from the deer. So the tick population has changed too and it's largely due to the fire, lack of fire in many places. In the Northeast, never used to be like it was. We had fire all the time that would clear out these areas and it was just a part of natural everything. So, one of the challenges we have with ticks is they're here. We're not going to change how we live, suburbs and trees and all of that. Do controlled burns eliminate a lot of them? They do because what they do is they just don't eliminate the ticks. But what they do is they eliminate, for example, the white field mice or all these different species that are important to the ticks. And then they bring in different species that will be there. So I mean, this is a big debate in Minnesota right now. I mean, we're losing all these moose to brainworm. Ironically, the moose for population is expanding dramatically in Isle Royale. Why? Because there's no deer out there. And so they're not getting brainworm out there. So people have said, you know, we're going to lose our moose. Well, it's the deer. So fire actually has helped the moose. In areas in northern Minnesota where there's been a lot of fire, the moose population is growing because the deer are not there because exactly those mammals, those rodents and so forth are very different in burnt out areas than they are in non-burnt out areas. Well, they do control burns in some states. I had a friend who was hunting in Washington State a couple of years ago and he said it was really weird because there's these massive fires in the distance that were actually being controlled. They do it on purpose. Yeah, which is a lot better than having the out of control fires where you have so much fuel. Yeah. And you know, if you haven't had a porous fire in 85, 100 years in an area, the fuel in there is huge. And so actually they do that in northern Minnesota too. They're doing control burns. And the prairies, of course, we do control burns all the time. But the problem with the East Coast is you're dealing with a lot of these sort of almost residential areas that have all these ticks. Yeah, you can't. And there you can't. There we have to find ways that that's where we really have to have vaccines and treatments for these diseases. We're like, get rid of the ticks. So what we have to do is figure out, I mean, wouldn't it be incredible if we have a cocktail vaccine for, you know, Babesia, for Lyme disease, for animals, that's what we need. Is there any kind of an animal that eats ticks? Birds. Yeah, birds will eat them. But not enough. Not enough. They're doing very well, thank you. Ticks do very well. And that's another issue. You know, for some of the larger mammals, as you know, tick predation can get so heavy, particularly in certain times of the year that really literally takes a lot of blood out of these large animals, even though they're so big. Yeah, it went down a rabbit hole the other day online. And I saw this one deer that was covered in these frisbee-sized patches of ticks. That's exactly it. They were all swollen. And they're full of blood. Oh, so disgusting. And it happens day after day. So it is a hit on them. It's a real hit on them. I'm going to pull up a picture of that, just to freak people out that are watching online. Just they need to see this. Yeah, yeah. It's pretty amazing. It's one of those things, though, when you talk about ticks and you talk about Lyme disease, most people, their eyes glaze over. They don't even care. It's not affecting me until someone in your family has it. There's a guy that I know who was a former UFC fighter, Marcus Davis, who he put, his wife got Lyme disease and he spent hundreds of thousands of dollars trying to help her and do something about it and treatments and all these different things for it. Yeah. It's a real challenge. It's a challenge. And this is another area, again, when you think of the amount of money we lose in just lost time, let alone pain and suffering, what an investment to make in this. I mean, this is the kind of thing. This is where infectious diseases really need to run us on. I mean, we can do a lot here. We pulled up a chart of the United States where they showed the areas that are affected by these ticks and what percentage of ticks carry Lyme disease they've tested. And some places in the Northeast, it's in the 60%. Oh, exactly. Yeah, it is. It's huge. And it's growing and it's growing. I mean, you understand how wildlife has changed. I mean, look at, to think that we have all these wild coyote populations in New York City now. I mean, it's amazing how every single city in the country. Yeah. You know, what the rats aren't doing, the coyotes are taking off. And it's a challenge. I mean, these are infectious disease issues too. They're very real. Yeah, they have coyotes in Central Park. They do. Yeah, absolutely. They have them in the Bronx. They have them in... I mean, it's weird. It's weird to see because this is something that just didn't exist before. Look at this. Oh, there it is. I mean, I'm looking for a good one. That's okay. Yeah. That's okay. That's not the best I've seen, but it's gross enough. Yeah, it is. It gives you a good sense of it though. Yeah. Dan Flores, who has been a guest on the podcast before, has a great book called Coyote American. It sort of details how this came to be and how these coyotes have... Oh, look at that. All over that poor deer. Oh, look at that. Look at the eye. Look at the eye in the fawn. Yeah. Yeah. They're disgusting. Yeah. But coyotes, about how when they got rid of the wolves and they tried to do the same to the coyote, they just actually expanded their territory. They're sneaky, very clever little animals. Adoption. Yeah. Just like microbes, adaption. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah. Yeah.