Downstream with Benjamin Bender EDITOR’S NOTE: Downstream is an occasional column in this publication. It features articles about environmental awareness and action that can help us be better stewards of our natural heritage. Articles about other important aspects of the natural world also appear here. Benjamin Bender graduated in December 2017 from Penn State University with a bachelor of science degree in Recreation, Park & Tourism Management. He was an intern with Renfrew Insitute for several months in the fall of 2017. Intern report: the Storied past of a Dangerous Disease seems to be a house- Erythema chronicum migrans quarter of the patients had an un- hold name these days. The dangers is a sign of Lyme that refers to the usual skin lesion before the onset of the disease are on the lips of expanding “bulls-eye” shaped rash of joint symptoms.” 2 every outdoors person warning that is often seen as an early sign of Medical professionals considered others of the deer (Ixodes infection. Note that this is not a skin arthritis to be the cause of the scapularis). reaction but rather a manifestation symptoms. They speculated that Most have heard of the bulls- of the under the skin. the arthritis was being transmitted eye rash and the joint pain and Doctors had seen erythema by biting insects because of the other telltale signs and symptoms. migrans in Europe but this case in presence of a skin lesion. Blood But where and when did it Wisconsin was the first case seen in studies conducted at the time were start? Who first described it? How the . The bulls-eye unable to find any definite causal did we get where we are with the rash is also a sign of southern tick- agent. disease today? associated rash illness (STARI), Dr. Douglas S. Lloyd, Commis- Dr. Rudolph J. Scrimenti pub- which is not related to the Lyme sioner of the Connecticut State lished the first occurrence of a sign disease bacteria. Department of Health, pressed in of Lyme disease in 1970: Mysterious Disease in this letter that they should find the “To my knowledge, this is the Lyme, Connecticut cause of the disease before they took first case of erythema chronicum In 1976 the Connecticut State measures to “prevent contact with migrans in the United States. Department of Health released an unknown carried by an Eruption and radicular pain followed Circular Letter #12-32. This letter unknown insect…”2 as it might a wood tick bite. Treatment with to Directors of Health detailed 51 cause panic. benzathine penicillin G (Bicillin) cases of mysterious symptoms in Identifying the Cause 1 was curative.” residents of Lyme, Connecticut and The first person to isolate the its surrounding communities. The bacteria that causes Lyme disease letter states that there were 4.3 was Dr. Wilhelm “Willy” Burgdorfer. cases per 1,000 residents. Thirty- He was a medical entomologist nine of the original 51 were children. from who studied at The symptoms varied between the Swiss Tropical Institute. individuals: “It has been character- His studies there focused on the ized by usually short and mild but Borrelia bacteria that were causing often recurrent attacks of pain and in Africa. swelling in a few large joints, espe- Borrelia duttoni bacteria are cially knees, with longer intervening found in the soft-bodied tick periods of no symptoms at all. No . B. duttoni patients have had permanent injury is a spirochete. It is important to to joints. Although almost half the note that a spirochete is a spiral- Erythema chronicum migrans, the “bull's eye patients had only joint symptoms, rash” commonly associated with the bite of a deer shaped bacteria that causes these tick and subsequent onset of Lyme’s Disease. others had fever, headaches, weak- Image source: www.enacademic.com ness and a skin rash as well. One continued on page 11

10 Downstream: the Storied past of a Dangerous Disease continued from page 10 diseases. Spirochetes have tiny they were indeed spirochetes be- flagella that move, allowing the cause of the way the bacteria moved bacteria to “swim” and travel translationally (the motion by which throughout the host. a body shifts from one point in All forms of Borrelia are space to another) and rotationally. spirochetes, though not all tick- Dr. Burgdorfer and his colleagues borne illnesses are caused by ordered blood samples from patients spirochetes. Rickettsial bacteria, showing Lyme arthritis to be tested. such as the ones that cause He used direct fluorescent antibody Rocky Mountain spotted fever, testing to identify the presence of are more likely to be shaped the bacteria in the patient’s blood. like small rods and are easily bacteria as seen through a micro- Genetic testing of the bacteria discernible from spirochetes scope. Photo credit: CDC/Photo: Janice Haney Carr determined the spirochetes were by a trained eye. spotted fever ( rickettsii) Borrelia. They named the new To detect bacteria in a tick, it is in New York State. There were species B. burgdorferi after the dissected. The hemolymph, roughly 124 cases reported, eight of which man who discovered it. the blood of the tick, is collected, resulted in death. Officials suspected The Spread of an usually by removing a leg. The the dog tick, Dermacentor variabilis Ancient Bacteria hemolymph is smeared on a micro- as the main vector. Sampling of the Despite the only recent discovery, scope slide and chemically stained. local tick populations did not yield studies have shown that the B. The stain highlights the cells being conclusive results. The percentage burgdorferi is prehistoric. The Yale viewed in the sample, allowing the of the infected dog tick population School of Medicine examined the viewer to see them more clearly. Dr. seemed insignificant. genetic makeup of the bacteria to Burgdorfer used this method to find These tests led to a search for see how the disease could have dis- the spirochetes in that were another culprit. The other tick tributed itself around the country. causing the relapsing fever in Africa. species with a large presence in the They believe that the bacteria has Dr. Burgdorfer’s areas of infection was the deer tick. existed for thousands of years and Breakthrough Discovery The Rocky Mountain Lab received spread from the East Coast west- Dr. Burgdorfer came to the the first deer ticks for dissection in ward to Wisconsin. United States in 1951 to work at the 1979. This was the first time Dr. The range became fragmented Rocky Mountain Laboratory in Burgdorfer had worked with at some point, most likely due to Hamilton, Montana as a Research Ixodies scapularis. Dr. Burgdorfer deforestation, leading to the inde- Fellow. His research focused on found R. montana in these ticks, pendent emergences of Lyme ticks and tick-borne . but this form of Rickettsia does not disease in multiple places. He extended his fellowship to affect humans. continued on page 12 continue his research and became By 1981 Dr. Burgdorfer was still a United States Citizen in 1953. looking for harmful In 1954 he began doing national strains of Rickettsia in defense-related work that focused the deer ticks. There on the “rapid identification of were spiral-shaped pathogens that may be used against bacteria in the digestive the United States.” system, or midgut of an After the germ warfare work, eastern deer tick from Dr. Burgdorfer continued research Shelter Island, New on various tick-borne pathogens, York, on the Long including virus, Island Sound. rickettsiae, , and spiro- He realized almost chetes that caused relapsing fever. immediately that these He also worked with and the were spirochetes. He black plague, and with mosquitoes examined them under and yellow fever. a dark field microscope From 1971 to 1976 there was a and watched them Dr. Wilhelm “Willy” Burgdorfer, inoculating ticks in his laboratory in spike in cases of Rocky Mountain move. He knew that 1954. Image source: nih.gov

11 Downstream: the Storied past of a Dangerous Disease continued from page 11 Warmer temperatures and mild walking on you. Placing your winters allow more ticks to survive clothes in the dryer and tumbling throughout the year. them on high heat for 10 minutes There are more hospitable places will kill any ticks still on them. for the mice and ticks to live. Exotic At your home you can mow your invasive species such as Japanese lawn and trim weeds, especially next barberry (Berberis thunbergii) also to walkways, to reduce contact with play a major role in tick survival. ticks. Underneath a Japanese barberry is a If a tick does become embedded microclimate with elevated relative in your skin you remove it with humidity. The humid microclimate tweezers. Do not rely on the notion Prevalence of blacklegged ticks that cause Lyme provides a nice habitat for mice and that household products such as Disease. Image source: www.health.pa.gov ticks. Ticks can dry out, which causes soap, petroleum jelly, peanut butter There is also evidence that Borrelia them to die, but the humidity allows or anything of the sort will make burgdorferi exists in Europe. them to stay hydrated over the the tick retreat. Methods like these Range expansion of the deer winter or during hot, dry periods. only kill the tick while it is embedded tick is a major reason why Lyme and make it harder to remove with cases are on the rise. White-tailed tweezers. Burning the tick can make deer (Odocoileus virginianus) the tick expel its gut contents back populations provide blood meals into the wound, increasing risk of and mating areas for the ticks, infection. but are not good reservoirs for the In Conclusion bacteria. It is good to know the history of The name ‘deer tick’ almost draws the dangerous disease that affects our attention away from a more Pennsylvania and is still a real threat important reservoir of the disease. Even the tiniest of deer ticks can bite and infect to our health. The discovery of the The deer mouse (Peromyscus humans with dangerous bacteria. disease and studies of its spread maniculatus) and the white-footed Protect Yourself from Ticks are only parts of solving the overall mouse (P. leucopus) are major Lyme disease and deer ticks are problem. vectors of B. burdorferi. The ticks a growing problem but there are Diagnosis and treatment are pick up the disease from the mice measures you can take to defend still difficult. There were 7,400 and become infected, carrying the yourself from them. According to reported cases of Lyme disease in bacteria in their digestive system. the Center for Disease Control and Pennsylvania in 2014, 84 of which 3 Some researchers view acorn Prevention (CDC), treating your were reported in Franklin County. crops as a major factor in Lyme clothing with permethrin spray and It is important to consult your disease occurrence. The acorns using insect repellant containing physician if you suspect you have provide food for both the deer and 20% DEET is a good way to protect Lyme disease. You can find a list of the mice and can bring them all to- yourself from a tick bite. signs and symptoms on the CDC gether, which spreads the ticks and Always check your body for website: www.cdc.gov the bacteria. ticks and check your clothing too. continued on page 13 Climate change is also a factor Wearing light-colored clothing can in the spread of Lyme disease. aid in seeing any ticks that may be

1/2 inch [ Life stages of the blacklegged deer tick. Most humans are infected with bites from ticks in the immature nymph stage. Image source: www.cdc.gov

12 Downstream: the Storied past of a Dangerous Disease continued from page 11 Taal Levi, Felicia Keesing, Kelly Oggenfuss, Richard S. Ostfeld, “Accel- erated phenology of black legged ticks under climate warming.” Feb. 16, 2015. Cary Institute. “Lyme Disease.” Retrieved Dec. 12, 2017, www.caryinstitute.org. Aug. 2, 2017. Cary Institute. “Acorns and Lyme Disease.” Retrieved Dec. 12, 2017, www.caryinstitute.org. Aug. 2, 2017. Roy-Dufresne, E., Logan, T., Simon, J. A., Chmura, G. L., & Millien, V. “Pole- ward Expansion of the White-Footed Mouse (Peromyscus leucopus) under Climate Change: Implications for the Spread of Lyme Disease.” 2013. Williams, S. C., & Ward, J. S. “Effects of Japanese Barberry (Ranunculales: Berberidaceae) Removal and Result- ing Microclimatic Changes on Ixodes scapularis (Acari: Ixodidae) Abun- dances in Connecticut, USA.” Renfrew Institute intern, Ben Bender, collects Environmental Entomology. 2010. water samples for analysis. Bender is the author Centers for Disease Control and of this article on ticks and Lyme Disease. Photo Prevention. “Ticks.” Retrieved Dec. by Melodie Anderson-Smith. 12, 2017, www.cdc.gov. June 1, 2015. References Centers for Disease Control and Prevention. “Lyme Disease.” 1) Rudolph J. Scrimenti. “Erythema Retrieved Dec. 12, 2017, Chronicum Migrans.” Arch Dermtol. www.cdc.gov. Oct.26, 2016. 1970. University of Illinois Extension. “The 2) Lloyd, D. S., M.D., M.P.H. Circular Trick to Perfect Tick Removal.” [Press Letter #12-32 [Letter to Connecticut release]. Retrieved Dec. 12, 2017, Directors of Health]. Hartford, Con- http://web.extension.illinois.edu. necticut. 1976, August 3. July 23, 2009. 3) Pennsylvania Department of Health. Burgdorfer, W., Ph.D. “Willy Burgdorfer “Lyme Disease and Other Tick-Borne Oral History” [Interview by D. Boggs]. Diseases.” Retrieved Dec. 12, 2017, Retrieved Dec. 12, 2017, http://www.health.pa.gov https://history.nih.gov. Oct. 2001. Connecticut Department of Public Health. “A Brief History of Lyme Disease in Connecticut.” Retrieved Dec. 12, 2017, http://www.ct.gov Hoen, A. G., Margos, G., Bent, S. J., Diuk-Wasser, M. A., Barbour, A., Kurtenbach, K., & Fish, D. “Phylo- geography of Borrelia burgdorferi in the eastern United States reflects multiple independent Lyme disease emergence events.” Proceedings of the National Academy of Sciences of the United States of America. 2009.

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