By Stephen Leon
Soon after he began taking Lee Ann Sporn’s introductory biology course in the fall of 2018, Bryan confided to his professor that he frequently felt sick, as though he was fighting a mysterious disease that wouldn’t go away. A freshman at Paul Smith’s College near Saranac Lake, Bryan sometimes asked during class to be excused, which Sporn later learned was due to fevers that would spike without warning.
One weekend he was suffering severe abdominal pain and urinating blood. Worried that he was gravely ill, he sought emergency care at Champlain Valley Physicians’ Hospital in Plattsburgh.
“Tests revealed abnormal liver function,” Sporn said, “but he was released with no diagnosis and no treatment plan.”
Sporn, a biology professor and coordinator of the college’s Human Health and the Environment program, had been doing research on ticks and tick-borne illnesses in the Adirondacks for several years. With her field work in the back of her mind, she began to doubt that Bryan’s doctors were on the right track—they had suggested he might have leukemia—and told him that it seemed to her like an infection.
“I thought of tick-borne diseases because I study them,” Sporn recalled, “but thought this was likely too much of a coincidence, so I let it go.”
That changed when a student in another class she taught gave a presentation on babesiosis, a malaria-like illness caused by a parasite that infects red blood cells. “During his presentation,” Sporn said, “I piped up and said, ‘I think one of my students has that, and he is very sick and is worried that he is going to die!’ I couldn’t keep my mouth shut any longer, so I found Bryan and told him to ask his doctors to test him for babesiosis.”
Sure enough, at the VA Hospital in Albany, Bryan tested positive for babesiosis, and was prescribed a 10-day course of anti-malarials (babesiosis does not respond to most antibiotics). He felt fine afterward and continues to do well.
Sporn later learned that Bryan had been a summer caretaker at Ausable Point Campground, a site where she and her research team had found babesiosis in local ticks in 2017. “Bryan had been sick with babesiosis for over a year, so his illness correlates with what we saw in the field,” she said. “The doctors at (Champlain Valley) had no idea that there was a local risk of babesiosis, or they would likely have tested him for this long ago.”
Bridging the gap
Bryan’s story, Sporn says, illustrates why the research she is doing is so important: It bridges the gap between what health-care providers in the region previously knew about tick-borne illnesses and what they need to know today as the tiny arachnids continue their ominous march northward—and upward into higher elevations.
Before Sporn began monitoring the tick population, they were not thought to inhabit New York’s northernmost counties, except in lower elevations along the shores of Lake Champlain. “In 2014, we had a hard time finding any ticks in the North Country,” Sporn said. “The common lore was that there are no ticks in the Adirondacks.” But that all changed, as “we started to see them at higher elevations and spreading throughout the park.” They are now widespread in the park, except at elevations above 2,000 feet.
According to the National Institutes of Health, in 1996, ticks had an established presence in 31 New York counties, mainly downstate and on Long Island. By 2015, they were established in 61 counties—all but one.
While Lyme disease is just emerging as a problem in the North Country, research into the spread of ticks is valuable not only as a matter of public health, but also as another piece of evidence on how climate change is affecting ecosystems. As Sporn said at a presentation to the Adirondack Park Agency in February, regarding the increase in ticks and tick-borne illnesses in the region, “We can’t prove it, but every indicator points to climate change as the driving force.”
“Warmer and wetter means more days that the tick can find a host and feed and reproduce, and thus become established,” Sporn told this magazine in February.
For the past five years, Sporn, along with teams of students from Paul Smith’s College and stewards from the Adirondack Watershed Institute, has gathered ticks from the field and tested them for infections including Lyme and other human pathogens. Not only have they found ticks in the Adirondacks to be increasingly abundant; the prevalence of infections also has been unexpectedly high.
For one thing, Sporn said, there no longer seems to be a “grace period” before a newly established tick population begins carrying infections, which they pick up from host animals such as deer and mice. And while it used to be more or less standard for approximately 50 percent of any tick population to be infected with Lyme disease, Sporn and other researchers are starting to see higher rates; at one site in Essex county, for example, 85 percent of the ticks collected were infected with Lyme.
Lyme is an inflammatory disease that causes fatigue in humans, and can induce joint pain or worse if left untreated. But Lyme is not the only disease that ticks carry. “We test for five different things,” Sporn says. The one we’re seeing a significant rise in this year is anaplasmosis. It’s probably even more serious than Lyme, because it can be fatal if not properly diagnosed.” So is another tick-borne virus now found in the North Country: Powassan, which can cause encephalitis, an infection of the brain, and can also be fatal.
“It’s one more reason that the field work is so important, so we know what the risk is of acquiring the disease locally,” Sporn asserts. “If you do not know the local risk, it’s very difficult for a health care provider to think that a patient has been exposed to the disease”—just as Bryan’s doctors did not think to look for babesiosis.
Funding at risk
And yet, Sporn’s field work may soon be under threat, as the modest amount of state funding she had received in recent years was left out of this year’s budget.
Mary Beth Pfeiffer, a Hudson Valley-based author and longtime investigative reporter for the Poughkeepsie Journal, wrote her first story on Lyme disease in 2012. When she began covering Lyme, she didn’t realize how many layers there were to the yet-untold story.
“I never really viewed it as an investigative story,” Pfeiffer remembers. “I was quite surprised at what I found—I found that it had all of the markings of an investigative story. I found government incompetence. I found people who couldn’t get their insurance to pay for care. I found conflicts of interest, wastes of taxpayer money” … and she found that “the ways that we were monitoring and treating Lyme disease were not effective.”
Pfeiffer, whose 2007 book “Crazy in America” drew national attention to the treatment of the mentally Ill in American prisons, began training her investigative eye on Lyme disease, and learned, among other things, that ticks were spreading northward and westward more rapidly and in greater numbers than many people—including doctors—were aware. In 2018, she published her findings in the book “Lyme: The First Epidemic of Climate Change,” which includes this passage: “The ticks that carry Lyme disease are, like spiders, arachnids, not insects. Although they cannot fly or jump, they are, for all practical purposes, climbing mountains, crossing rivers, and traversing hundreds, even thousands, of miles to set up housekeeping.”
Pfeiffer echoes Sporn with the warning that health care providers need to know where the ticks are—and which pathogens they might be carrying. In “emergent” areas, she says, “doctors are not aware of how common it is. And so when patients present with symptoms that could be Lyme disease, doctors may not automatically think Lyme disease because they haven’t been told that ticks are present and that Lyme disease has arrived.”
“They don’t know to look for Lyme disease,” she adds, “and they certainly don’t know to look for babesiosis.”
As her book title makes clear, Pfeiffer agrees with Sporn that a warming climate has played a major role in the spread of tick-borne diseases—but adds that there are other factors.
“There is a consensus in the scientific community that climate change is driving the movement and survival of ticks,” she says, explaining that ticks can emerge and thrive in new places that are “warmer, wetter, and more humid than they used to be.”
But: “Climate change isn’t the only thing that has enabled this epidemic,” Pfeiffer says. “We live in an environment that in many ways is out of balance. We live amid fragmented bits of nature, and that is very much what our suburban areas are on and around.”
Amid the development, suburbs typically preserve elements of nature: lawns, parks and green spaces, and some wooded patches in between the houses. Many predators (such as foxes) prefer deeper cover, but to deer and mice, the relative lack of predators allows them to enjoy the suburbs’ abundant food and shelter. Some of these areas, Pfeiffer says, have too many deer and “way too many mice. … Mice are the key right now that infect baby ticks when they get their first blood meal. … Mice are the number one driver and supporter of the expansion of ticks.”
More research needed
And that expansion continues northward into the more wild regions of the Adirondacks, where data collection, Pfeiffer says, is essential to understanding the scope of the problem of tick-borne diseases—and making a plan to confront it.
She draws a parallel with malaria in the United States, which we all but eradicated in the 20th century. “We have a basic infrastructure in place to deal with mosquitos, and it goes back to the malaria epidemic that we had in the early 1900s. We don’t have the same infrastructure in place to control the growth and movement of ticks. And that’s what we need.”
Professor Sporn conducts her tick research in the spring and fall; this past spring, with potential funding tied up in the New York State budget process, she says she worked on her own time to not miss a cycle. “This was not the year to let our monitoring effort stop,” she says.
Sporn has received private donations, including a Cloudsplitter Foundation grant, to continue work in the fall.
Previous funding for the research had come through the New York State Senate Task Force on Lyme and other Tick-Borne Diseases. For the past two years, Betty Little, the region’s Republican senator and a member of the task force, has secured $75,000 in line items in the state budget to support the work.
This year, there was no line item for Sporn’s research. While overall state funding for tick-borne disease research was down, politics might be one reason behind the absence of money for a North Country Republican’s district. This year Democrats—usually the more activist party when it comes to the effects of climate change—took over the Senate majority.
“I think it’s fair to say that it was a political decision,” Sporn says. “And I was asking for such a small amount.”
“That’s crazy,” says Pfeiffer of politics possibly playing a role in the loss of funding for research in the Adirondacks.
In late June, the New York State Senate authorized $250,000 to address tick-borne illnesses; all of the money went to downstate organizations. A Senate press release credited Democratic Sen. Jen Metzger, who represents the Hudson Valley and Catskills regions, for her “strong advocacy” in securing the funding. A spokesperson in her office did not comment on the absence of funding for Sporn’s work, and suggested calling the governor’s office.
A statement from Little’s office noted that overall funding for tick-borne disease prevention and research dropped by 75 percent—even though the overall budget grew. “My hope was that this would be an issue to transcend Albany politics and resources would be available, especially to continue projects such as Dr. Sporn’s at Paul Smith’s College,” Little said in the statement. “Dr. Sporn is very dedicated, but she can’t do this without financial resources.”
For her part, Sporn is feeling a little isolated. She realizes that downstate districts overall have higher incidences of Lyme disease, but that doesn’t mean they contracted it at home. “It’s reported where they live, not where they acquired it.”
“We’re a rural area with a low year-round population density. We’re a little blip on the map,” she says, but there are 2 million to 3 million people coming in annually as tourists. “So I feel that the North Country is being overlooked.”
And no one calls from the CDC to ask about her research. “Here in the North Country”—what they call an “emergent” area—”the incidence rate is rapidly accelerating. And no one is watching but me.”