In the summer of 2015, the City asked concerned residents to attend a City Council meeting to discuss Lyme disease. Based on the outpouring of concern from that initial meeting, the Tick Task Force (TTF) was formed. The TTF worked with the Minnesota Department of Health (MDH) and an epidemiology student from the University of Minnesota School of Public Health to understand the problem, to review scientific literature and develop the North Oaks Integrated Pest Management Program (NOIPMP). The NOIPMP is based on sound best practices that had proven to be effective in other endemic areas. Practices that didn’t show consistent benefit were not incorporated into the program and current content is reviewed regularly to ensure that it is up to date with the latest science.
In 2015, MDH data showed the incidence of tick-borne illness in North Oaks was 5 times those of our immediate surrounding communities. Thankfully, since the implementation of the NOIPMP, that rate has decreased, and according to MDH data, is now similar to surrounding communities despite the heavily wooded environment and miles of trails found in North Oaks (Figure 1).
The NOIPMP recommends several methods to reduce ticks/tick exposure. First and foremost, we recommend implementing personal protective measures and always doing tick checks after being outdoors. To reduce the number of black-legged (deer) ticks and number of tick bites we also advocate the use of landscape practices to reduce tick and host animal habitat adjacent to the home, management or treatment of host animals (mice and deer) and very targeted and judicious use of acaricides (applying the least-toxic pesticides to high-risk tick habitats). The ultimate goal remains reducing the number of cases of disease as much as possible with the resources available and increasing the detection and removal of ticks attached to people and pets. Early detection and removal of ticks increase the likelihood of successful treatment should signs and symptoms of tick-borne illness develop.
One component of the NOIPMP is monitoring. This is important to assess the effectiveness of our program, but also to augment MDH disease surveillance as tick-borne illnesses are under-reported. Monitoring also helps guide our future efforts.
For the 2019 survey that covers 2018, there were 19 cases of tick-borne illness reported (vs 39 in 2017 and 43 in 2016). Diagnoses were across all age groups, although in this year’s survey there was an increase in diagnoses in adults ages 61–65. Cases occurred throughout North Oaks. There were decreases in cases in all zones on the map included in the survey. Seventy-five percent of people were diagnosed with acute Lyme disease, 25% were diagnosed with chronic Lyme. One person was diagnosed with Anaplasmosis and 2 with Babesiosis. Fifty-five percent of those diagnosed with a tick-borne illness believed the tick had been attached for less than 24 hours. Increased awareness of the risk of tick-borne illness in North Oaks resulted in 50% of people reporting that they sought medical care sooner than they would have in the past (Figure 2).
Many households have implemented the landscaping best practices recommended in the NOIPMP, and these numbers have increased compared to last year. There is still room for improvement in removing brush/wood piles from yards and creating a border between the lawn and woods with includes removal of buckthorn (tick habitat).
The NOIPMP advocates several personal protective measures to reduce the risk of tick bites. Greater than 90% of respondents are doing tick checks. Nearly 70% are using insect/tick repellants. More people this year are using tick management products on pets which can be a transmission vector to family members. Similar numbers are wearing light-colored clothing (35%), tucking long pants into their socks (42%), or promptly putting all clothes in the dryer for at least 10 minutes when returning indoors, which is a practice that has been scientifically proven to kill ticks (20%).
As a reminder, ticks are currently active. Be sure to implement personal protective measures now. Although each component of the NOIPMP is important, taking precautions when outdoors is your best protection against disease. This year’s survey showed that 80% of the people who found an embedded tick likely acquired it on their property. Be sure to wear light-colored clothing (this helps you spot ticks more easily), tuck pants into socks (especially if working in tall grasses/tick habitat), use insect repellants (Deet and Picaridin on skin, Permethrin on clothing), place clothes in dryer for 10 minutes immediately upon returning indoors, use tick management products on your pets and continue to perform daily tick checks.
Additional resources are also available at www.cityofnorthoaks.com ~ For residents ~ Tick Task Force. This data was presented at the July City Council meeting and will also be presented at the August NOHOA board meeting.
—Brooke Moore, MD, MPH, and Rick Kingston, PharmD of the Tick Task Force