blacklegged ticks has been a key part of his Long Island business for twentyfive years .
“ Over the years , though , things have really changed . Ten to one , it ’ s Lone Star ticks . You find them walking across a hot driveway or a parking lot . People find them in the middle of a gravel driveway . In the past , we ’ d concentrate on the perimeter . Now , to get any type of control , we have to spray the whole property . And they like humans . If you are sitting on a lawn chair by the pool , Lone Star ticks will come looking for you . They ’ re little hunters .”
While Lone Star ticks don ’ t transmit Borrelia burgdorferi , they can pass on the bacteria that cause ehrlichiosis and tularemia , along with other diseases . The Lone Star tick bite is also associated with alpha-gal syndrome — an immunological response to the tick ’ s saliva that results in an allergy to red meat . The saliva causes the human to produce the antibody immunoglobulin E that is specific to alpha-gal , a carbohydrate found in nonprimate mammals . The symptoms , which occur three to eight hours after meat is
Allergist Dr . Russell Settipane , who recently spotted a Lone Star tick climbing his screen door in East Greenwich , says nothing like that is happening in Rhode Island .
“ This is a very rare phenomenon ,” he says , because a Lone Star tick bite does not necessarily result in the development of the alpha-gal syndrome . “ I see maybe two or three patients a year [ for alpha-gal ], but the more educated the patient , the more they have read about alpha-gal , drives the requests for tests . I saw one person , who interpreted a test as possibly positive , and came to me for further evaluation . Looking at this test , I told her , ‘ This is not positive . Did you have a reaction to eating meat ?’ These are the pitfalls of misinformation and misdiagnosis .”
Lyme remains the dominant threat to human health in Rhode Island from ticks . Statewide , Rhode Island had 839 cases of Lyme disease in 2020 , with an incidence rate of seventy-seven cases per 100,000 , according to Rhode Island Department of Health data . Five years ago , at the request of patients and medical providers , Lifespan established the
“ In the past , we ’ d concentrate on the perimeter . Now , to get any type of control , we have to spray the whole property . And they like humans . If you are sitting on a lawn chair by the pool , Lone Star ticks will come looking for you . They ’ re little hunters .” — Brian Kelly ripbs . org ingested , vary widely and can include skin , cardiovascular , gastrointestinal and respiratory responses , says Dr . Erin McGintee , a Long Island-based allergist .
Alpha-gal ’ s association with the Lone Star tick was confirmed in 2011 , several years after hospital patients in the Southeast suffered high numbers of allergic reactions to the antibody drug cetuximab , which contains alpha-gal . This led to the discovery that those patients already had antibodies that recognized the drug . Eventually , investigators isolated the external source — a Lone Star tick bite . Today , McGintee has about 755 patients under her care who have acquired alphagal syndrome .
Lyme Disease Center , the state ’ s only such dedicated clinic , which sees an average of 400 patients annually .
Most infections clear after a short course of antibiotics , says Dr . Timothy Flanigan , co-director of the clinic . The Lyme Disease Center also treats a much smaller segment of the patient population who suffer from prolonged effects , called post-treatment Lyme or chronic Lyme . Currently , the clinic is following patients in a phase two trial for a new Lyme vaccine — the first since LYMErix was discontinued in 2002 — produced by Valneva and Pfizer , to study dosing and immunological response .
“[ LYMErix ] did prevent Lyme disease ,
30 RHODE ISLAND MONTHLY l OCTOBER 2022