Urban Vulnerability and Final Thoughts

This is fresh air. I'm Terry Gross As you head out to summer barbecues, picnics, hikes and other great summer activities You may already be vigilant about ticks because of Lyme disease But there is a potentially more dangerous tick that you may not be aware of called the Lone Star And unlike other ticks, it actively pursues its hosts The lone star is spreading across vast regions of the U. S And the illness it carries, the Alpha Gal syndrome, is spreading in more than thirty countries on six continents, often spread by various other ticks. The Aphigal syndrome is more difficult to diagnose and treat than Lyme disease, and the symptoms are more severe In many cases, the victim develops an allergy to all red meat includluding nearly microscopic particles of it The allergy can become so extreme, it can kill you Milder cases can change your life if you're a meat eater. Or if you have cows or work on a cattle ranch or in the food industry, including restaurants Pest control experts and medical research scientists I've been confounded about what to do In an article in the New Yorker titled The Tick that Hunts downown its hosts, including uss My guest, Burkhard Bilger reports on what we know about how the tick operates, how it has multiplied and vastly extended its territory, how it afflicts the people it feeds on, and the latest ideas about how to limit the infestation and treat people with alpha Gal syndrome Bger is a staff writer for the New Yorker an author of the twenty twenty three book Fatherland about his German grandfather who joined the Nazi party but worked with the French resistance. Burkhard Bilger, welcome back to fresh Air. Your piece was Fascinating upsetting And I'm really glad you wrote it because it's something we should really be vigilant about So the first thing I want to do is let our listeners know how at risk they are by talking about where the ticks have spread and which places have the biggest infestations Yeah, so this is a tick, the lone Star tick that used to be in the southeast, you know, and up through kind of Virginia, up into the fifties, it rarely went north of Virginia. And it has now spread all the way north to Maine to Michigan, as far west as Oklahoma. And if you look at maps of I mean, the best data we have on on where the syndrome is most common come from some military blood samples, three thousand military recruits that were in the early two thousands when they looked at if they had alpha gal antibodies in their blood And if you look at those maps, the epicenter is kind of right where Arkansas, Missouri, and Oklahoma meet. There's a stretch that kind of goes from Missouri down through southeastern Oklahoma, where people forty seven percent of the people who were tested had alpha gal antibodies in their blood. onn the east cooast though, there's also kind of a mini epicenter which is in easastern Long Island around the Hamptons and in Martha's Vineyard, both those places have really high incidence of alphao So how do you know if you've been bitten buy a lone star tick. Well, there's nothing like the bullse eye rash that you get with deer ticks from Lyme disease you really just have to see it and pick it off you or know you've been bitten. In some cases too, people get bitten by these terrible things called bombs colloquially. and that's basically these giant collections, clusters of lone star tick larvae, which can also bite you and also cause the disease. And sometimes people get hundreds of these things on their ankles or on their legs and then they get multiple bites at the same time. Does that make the syndrome even worse I mean, the more bites you get, the higher your antibody levels tend to be and the greater your chances of getting the syndrome. It's a really weird cryptic disease because You know, there are people who have very high antibody levels don't get the syndrome. There people have pretty low antibody levels who do get it There are people who have it for a long time and then suddenly it flares up. It's a very kind of mysterious mysterious disease So if you have to see the tick Or see the bite. What are you looking for I mean, you can identify the Lone Star tick by a little white dot on its back And that's distinctive. But other than that, really, the only thing you can look for after that is some kind of symptoms. Sometimes you'll get a rash, you'll get hives, so you'll start to get shortness of breath, there's lots of different ways in which the syndrome can express itself. So you mentioned hives, rashes, difficulty breathing, the most infamous symptom of alpha Gow syndrome. is an allergy to red meat Which seems crazy How much exposure Do you need? I guess this varies with the person But give us a sense of the range. of allergy to red meat that you might experience with alpha Gl syndrome Early on, I think you've just had one tick bite. Often it takes you know a substantial and if you've got the syndrome, if you've got these allergy antibodies, You might eat a whole burger or a steak and people then suddenly a few hours later, and that's one of the things that's so befuddling about this allergy Most allergies you get a pretty quick reaction. If you eat peanuts and you have a peanut allergy, you will get reactions within an hour or even minutes in some cases with With Alpha Galic can take six hours in some cases If you get more tick bites or if you just happen to be someone who is hypersensitive to these allergy antibodies then you can start to get reactions to very small amounts. Often people then get allergic to dairy products. because it comes from cows. because it comes from cows. I mean, anything essentially that contains the alpha gal sugar molecule or carbohydrate. It's a molecule that All mammals contain, but not primates and not humans. so Most of us eat meat all the time, we eat this alpha gallon doesn't cause a problem. but something about that tick bite somethingomething in it. and we know that the tick bite itself has alpha gal and the saliva, and that puts that in your system But there must be something people think that is also triggering the sensitivity. So it might be a virus, it might be another allergen, it might be something in the saliva that's just priming the system to respond to that So If you then become really sensitized to it, at some point you know, you can start reacting to things like trace quantities of natural flavorings, quote, unquote in products that are really beef extracts or pork extracts. You can start reacting to just a tiny bit of dairy powder in a Doritos' chip. You can start reacting to the tiny bit of beef tallow and the skin cream that you put on your hands. And all the way to some people I spoke to in Missouri and in Virginia If they just walk by someone frying bacon in a pan, the fumes from that. They said made their throat seize up. And there's some debate if that's actually psychosomatic or not. You know, absolutely the your respiratory system is easily triggered by allergens But But there's so little in that fume, is it really doing it? but one way or another, many, many people say that it does trigger them Be fused in any medications. that you wouldn't think about But if you had a really bad case, of alpha gal syndrome you might end up being allergic to. Absolutely. I mean, I think one of the most common one is simply gelatin capsules. You know, if you get ibuprofen or or acetamenophen from gelatin capsules that often has collagen in it from beef or from pigs u And the same thing with a lot of dietary supplements, you know, if you're in the hospital, it gets really scary because you don't really have time to tell You may not have time to tell your doctor or your surgeon what's going on, but like heparin, it's a blood thinner, common blood thin. That's made from beef intestines You have insulin that's made from pig pancreases or canb be. You have estrogen that's made from pregnant mares urine, have vaccines and antienins that are used for snake bites that are often are made with meat. so you know, and the problem when you're getting an injection, especially is that The reaction is intense and immediate. It's not like the hours delayed thing you get with with meat ingestion. I mean, that was how alphaa was originally discovered. It was a cancer drug called Situximab which people who had been sensitized to alpha, Tuximab had alpha gal in it because it was used it was produced with mouse DNA. So it had alpha gal in it And people in the South who were sensitized to alphagal by tick bites, We're having these terrible reactions in clinics all through the south. and In Arkansas, I mean, one patient died while it was being infused into their body. So That's the real danger a lot of people are telling me is The medical establishment hasn't caught up with the fact that a lot of their patients may be more and more sensitive to the drugs they're using I guess we should add lannolin to this too, because that's in a lot of products Sure, yeah. Lannolin. And things from the sebaceous glands of sheep, there's always you know, it's crazy. One woman who was a rancher in southern Missouri said, you know, My son has alpha c al, and it's made me really proud of the beef industry because we are just we've infiltrated every single thing and it makes you realize it's just like the degree in which it has been incorporated, even like drywall sometimes has, you know cow hides in it. know its just it's all around us and we don't even realize it And if you look at the labels, well, you know Sometimes you will. I mean there's an app called fig that people are using who have alpha Gal that will give you you know, a red, green or yellow light based on if it's safe or iffy or definitely not safe But so many things there's no, you know, there's no regulations on that kind of labeling. So The food industry will use natural flavorings all the time and often those are you know that have alphaal in them. They're bee for meat extracts So Has there ever been anything like a potentially lethal meat allergy before spread by? tick or any other insect or anything No, I mean, this this really came out of nowhere. And the scientists I spoke to They all had kind of the same story back in the early two thousand two thousand six, two thousand seven, when this was discovered, it was kind of somewhat simultaneously discovered by an allergist in Australia, North of Sydney and by a group at the University of Virginia led by Thomas Platt Mills, Plats Mills and Scott Commins And they all said, you know, when we first talked to this to colleagues, I said, that's ridiculous. Allergies don't work that way. First of all, sugars don't usually trigger allergies. it's usually proteins. So why would the sugar do this? And second of all Food allergies don't take hours to manifest hours to cause a reaction So you know, there was a lot of skepticism. and even later after it had been established as a disease that had certain parameters and it was accepted A lot of people in the stomach disease world didn't believe it could cause stomach problems, but it absolutely does. And now we know it can cause nausea and stomach knuts and all kinds of problems on that level as well So red meat is the problem, but like poultry, fish, they're okay Yeah, any other kind of meat is fine. You know, a lot of the people I spoke to who had it, there was, you know, a big Alphaal support group in Martha's Vineyard that I sat in with for a couple hours and they all talked about You know, they're trying to get emu meat and ostrich meat because they're red meats, but they don't have alphaal in them They were buying these Xenot transplantation hogs that had been developed for organ transplants that were're deliberately genetically engineered to not have alphao. because alpha gl is one of the reasons that pig organs tend to get rejected by the human body. So company Reivicord designed this pig and then found, oh, boy, there's a whole market for the meat we didn't even realize. And a lot of people who have alfa are trying to get hold of that meat as well. Do most doctors know how to identify alpha Gal syndrome or even know what it is Now it's gotten to the point where they do. you know, there was a study in twenty seventeen that looked at I think one hundred or more doctors' visits and found that only one in ten identified the syndrome correctly And they found at the same time, that same study found that the median time it took. for the syndrome to be diagnosed was seven years. So you're living with this thing for seven years. It's giving you hives, it's giving you stomach cramps, it's giving you shortness of breath. It might even send you to the hospital in anaphylactic shock and you just don't know I mean, there was this one I went to this restaurant in Springfield, Missouri, called a Safe Spoon that was entirely allergen free. all the nine major allergens and no alpha gale And I talked to a guy who had been a salesman and started to have all kinds of, he went to the hospital two or three times with shock. He had two cardiac procedures because they misdiagnosed and thought he had a heart problem before they realized it was a red meat allergy. So it was really Part of the problem with this over the years has been that People are getting the wrong treatment for something that is actually quite simple. Don't eat meat, don't drink milk Is an Epipan effective if you start developing symptoms Yes, it is. I mean, and I think EpipPen is essential if you're if you have anaphylaxis or if you start to get really severe symptoms. Especially in rural areas, it's really important to have Epipen around just in case you go into into a severe reaction So Lyme disease, which is also a tick borne, can be controlled if you take the right antibiotic in a short period of time after being bit So what about Alpha Gal? is outside of like an Epien which can end the episode Is there any kind of antibiotic treatment or other treatment that's effective Well, there's certainly no cure. I mean, you can really get rid of Lyme disease with oxicyillin and doxycyycline, but you can't do that with alpha gal One thing that's, I mean positive about it, I guess you could say is that if you don't eat meat or drink dairy or eat or get bitten by a tick for three or four years, often it'll subside to the point where you can eat meat again Um there's no cure The one treatment that seems to be effective is a drug called Zolar, XOLAIR. has been it was originally approved for asthma and has since been approved for food allergies. And a lot of people who have had severe reactions Alpha gal to and want to prevent going into shock or having another scary reaction will take Zolair and In some cases, they'll even take it regularly and start eating meating. I mean, it has not been approved for that, you know, certainly it can be effective If you're bitten by a lone Star Tch What is the first thing you should do You know, there's not a lot you can do. You can certainly take it off and there are procedures for taking ticks off. I mean, I think one thing that people should do when they get bitten is is there's there's a wonderful website called outfigalinformation. org that has a huge amount of instructions and research on that. And there's another one from Australia called Tiara org. au ti a R a and they have a lot about how to treat tick bites and what to do with it. But there's really nothing you can do in the meantime It's interesting, you know, with With Lyme disease, only a percentage of the deer ticks carry Lyme disease. but in alpha Gal, all the ticks have alpha gal in their saliva. So if it latches on and it feeds for a while, I mean, ideally, I think you would get rid of the tick as quickly as possible. and the sooner you can get rid of the tick The less of the alpha gl you'll get in your system, the less likely you're going to get antibodies to it. So that's the first thought The thing with Alpha Gal is All the ticks will have that alpha gale. If they latch on, it will be in your system But it's not clear yet whether you will develop antibodies, and then it's not clear if you will react to those antibodies I talked to this researcher Jeffrey Wilson at the University of Virginia. and he said, Look, if I went to the mall right now in Virginia, which has fairly high rates to the blood on a hundred people twentyw of them would probably have alpha gall antibodies, but only two of them would have the syndrome So You know, if you get it, really the thing would be to monitor yourself, makeake sure you're not having any symptoms if you have any symptoms then you should go get tested by your doctors. Everybody's telling me, don't just get tested as soon as you get tick because it kind of muddies the data in some ways because there's there's, you know Like I said, half the people in Missouri in certain parts of Missouri have those antibodies. It doesn't tell you that much. What we're really interested is how many people who have the antibodies also have the syndrome So if you get bitten by the loan start tick, you shouldn't go right to the emergency room Absolutely not. No, no. You should try and get rid of the tick as quickly as possible and then, you know, have it in the back of your mind. horrible thing, but to, you know, if you're having any reactions and just wait. And if you start to feel yourself having getting hives or having stomach problems after eating meat or any of the other possible reactions, then I would go to the doctor and have them do a blood test shouldhould you Eat meat and test yourself Or just like avoid it out of fear. Like what do you have any suggestions, any advice I'm Boy, you know, I feel like fromom what I'm hearing now If you look at those data from Virginia, you know and from Missouri, becoming such a common thing that I think We don't want to be over cautious. I mean, in a lot of ways That mentality is what got us into this allergy epidemic we've had in this country already. You know, this fear of peeanuts, for instance, and allerg just started saying Don't give your kids peanuts because you know it could develop a peanut allergy. And then lo and behold, would discover that actuallyually the stomach is really good at at kind of habituating itself to the allergens in peanuts. And if you eat peanuts as a child, then it actually helps you prevent having an allergy to it. And if you don't eat peanuts, you might get it through your skin or your breath. So there's a lot of unintended consequences, I think, from overcaution And the same thing with the hygiene hypothesis, which says if we're too clean, we're like keeping our gut biome from developing, you know good bacteria that can fend off allergies and diseases. So I think in a lot of ways, it's best not to freak out immediately as soon as you get a tick bite and just kind of wait and see You make that sound easy. If you're just joining us, my guest is journalist Burkhard Bilger, hisis latest article in the New Yorker is titled The Tick that hunts downown its hosts, including Us. And it's about the Lone Star tick and the illness it carries which is called alpha Gal syndrome. We'll be right back after a short break. I'm Terry Gross and this is fresh air This is Fresh Air. I'm Terry Gross. Let's get back to my interview with Burkhard Bilger. His latest article in the New Yorker where he's a staff writer is titled The Tick that Hunts downown its hosts, including Us. The Tick is the Lone star tick Its victims can develop alpha gal syndrome, which is an allergy to all red meat so severe it can be lethal You say that the descriptions that you heard of people who have alpha Gl syndrome sound like scenes from horror films I have to ask you to describe what you've heard Yeah. I mean, they're like these s almost like horror films about bodily possession or contamination. You know, there's this one woman who was six months pregnant Is he in her My husband had actually met in a steakhouse where she was a waitress and But one night, She's sleeping and he wakes her up and in the dark, she sees him lubing over her and he says, somethingomething's wrong with me. Can you come to the bathroom with me? And she says, What's going on? And She says S somethinghing's wrong with my face. and they go into the bathroom and she turns on the light. The whole left side of his face is totally misshapen and swollen. You know, I spoke to a sheep farmer in Oklahoma called Clark Giles and He you know, it said that he got to the point when he was birthing sheep. He had to like wear respirator masks, like something kind of blue velvet or something, you know to be able to stand it. And then if he was driving by a restaurant and there was and they were doing open grilling. He said it was like, His head would start to ring like cicadas in summertime and he would start to be shortness of breath. or all these kind To me, they felt like horror scenes because it's this unexplained attack coming from out of nowhere based on something that's totally normal and totally quotidian in your life. and suddenly it's toxic to you So How do the ticks travel? Do they travel on their hosts? Do they just kind of march across blades of grass like soldiers? I mean, the Lone Star tick is an interesting tick. I mean, it's funny talking to entomologists. I talked to a lot of entomologists and Georgia and Virginia and Martha's Vineyard and kind of all over the country and kind of almost to a person They hated Lone Star ticks. I mean, most entomolog just have a certain love for their study subjects, but when it came to lone stars, they just hated them. I mean One woman, Holly Gaff in Virginia told me, lookook, they are the bullies of the tick world. They will beat you up and take your lunch money. They are a tick. doesn't just kind of quietly amble out onto a blade of grass and kind of wait for somebody to walk by and then latch on and get a little blood and then drop off This is a tick that will hunt you down that will actually try to seek out a blood meal as they call it And they've been known to do things like Patrick Rodin Reynolds, and Martha's Vineyard, the biologist that I went tick collecting with He told me, lookook, I've been hearing about these ticks crawling down from the dunes along the beach and getting onto the blankets of sunbathers and then biting them while they're sunbathing. This is a tick that is bold, it's resilient, and it's bloodthirsty. so they're particularly good at spreading the syndrome And as I said, their numbers are increasing across a lot of states across the country So before the nineteen seventies, it was rare for Lone Star Ticks to cross the Mason Dixon line And now they're as far north as Maine, as far west as Oklahoma. So what has caused the migration? to Is it just like increasing populations or Competition for food? Does climate change have anything to do with it? Yeah, I think climate change has had a big part of it. It's certainly They like warmer temperatures and they were, you know, originally their home territory was the southeast. And When I talked to ecologists about that, they said, Well, it's not as simple as simply warmth. I mean, it's actually they want wet, moist places. That's what they really need. And so part of what's going on is they're migrating in areas that have become warmer and wetter Um So you get that. I mean, a big part of it also has been You know, the reforestation of the East Coast of America. That's, I mean, a lot of Farms in the last hundred years and former farmlands have turned into forests now and loneestars can do well in those. And a lot of the kind of patchy suburbanized areas that used to be partly industrial or partly farmland and partly forests and now are kind of you know the houses with little trees around them or little patches of nature preserves, those are kind of ideal for lone star takes. So it's kind of a combination of climate and land use that's really made a difference. And if you add Deer on top of that, you get kind of a perfect storm of of situations But how have they migrated? How do they travel I mean, they travel, they have lots of hosts. One of the things about ick that makes them such incredibly good disease vector in the modern world is They'll feed on anything that has blood. They'll be on white footed mice, they'll be on shrews, they'll be on raccoons, on possums. You know, their main host in this country is deer. We have thirty six million deer wandering the country. and In the story I describe them as a fleet of mobile blood banks and it really seems that way. They just are all over the place And these ticks can just you know, hitch a ride, offtten they'll congregate on the head of the deer and they'll just travel around and then drop off and and find another host. So They're very mobile And then deer themselves are mobile. I mean, one of the things about deer is they've been known to swim out to barrier islands. That some of the way they brought ticks to places like Martha's Vindard and other islands along the coast is they swam out there. So they they know if people are around and they hunt down people to feed on them. How do they know that there are people around I mean, like a lot of These kind of insects, they consense carbon dioxide. I think that's a telltale signature. and they will kind of hone in on home in on that. So that's one thing. I think they also just go along paths and places where there's a lot of foot traffic and that it's know when there's a creature nearby and they'll jump on it. So one of the places in the North with the greatest infestations Is Marthur's vineyard? And you know, that's the place where the Obama's summer It's beautiful It's scenic I mean, the ticks don't appreciate all that And it's an island, so it's like harder to get to How did Marthur's Vineyard become like a gathering place for so many of these ticks? Well, I think you get a lot of necessary conditions once. I mean, you have place that used to be farmland and you know in the nineteenth century and then gradually got more and more Reforestation, people built their homes there. Then you have deer which were not around at the turn of the century of the last century. and now have grown to there's five thousand deer on this little island, eighty eight square miles and there's five thousand deer. So it's infested with deer And so and then you have lotots of other little mammals, you have White fooded mice, you have the short tailed shrew, there have all these potential hosts for the Lone Star tick and other ticks. So Martha Z' just kind of a natural little It's like a perfect little environment for these guys And, it's an interesting thing As I was looking into this pest research you know, We often assume that Th these animals discriminate or there's some sense of of different social groups get them. with bed bugs, for instance, there was this assumption that, oh, this is a symptom of poverty, that people are getting bedbgs because their houses aren't clean or something to that effect. And that turned out to be quite the opposite, in fact, people were getting bedbgs because they were coming in through luxury hotels, people who were traveling. And so the first infestations of bedbgs in New York City, for instance, were wealthier people, people who were well to do. and only later did it go on to subways and in movie theaters and spread to the poor I'm going have to end this interview right now. Sorry But I mean, and I feel like with ticks, it's a little bit the opposite prejudice because Lyme disease, you know is named after Lyme, Connecticut, which is a posh town in Connecticut. and the first people where you heard about having it were kind of wealthier people in their summer homes. And the same thing with Martha's vineyard, we kind of assume there's There's a bias somehow in this beast that's choosing the wealthy. And in fact, it's not true, of course. You know a lot of people I visited who had this were in poor farms or working class folks in Missouri and Arkansas and those kind of places But you can say that a place like Martha's vineyard and the Hamptons You know, a lot of these homes have lot of land around them and they have beautiful forests nearby and they make a point of kind of keeping a natural character. And those are the places that ticks love. They love these edge habitats. They love places that are transitions between grass and forest. And so in a way What we think of as really posh, beautiful landscaping is a perfect tick habitat Let me reintroduce you and then we'll talk somewhere. if you're just joining us. My guest is Burkhard Bilger. His latest article on the New Yorker is titled The Tick That Hunts downown its hosts, including Us. It's part of the New Yorker's body issue We'll be right back after a break. This is fresh air This is fresh air. Let's get back to my interview with Burkhard Bilger. His latest article in the New Yorker is titled The Tick that hunts downown its hosts, including uss. And it's about the lone St tick and the illness it causes, which is called alpha gal syndrome When you made your trip to Marthur's Vineyard To learn more about the Lone Star Tch You went out with Patrick Roden Reynolds, who is the island's public health biologist How did you protect yourselves? I mean, the ticks were looking for you, human blood But you were out looking for them. It's funny., you know, I've never been all that paranoid about ticks. you know, when I was growing up, I grew up in Oklahoma and I remember Primal horror of being an eight year old and pushing your fingers through your hair and finding a giant bloated tick in your headir. So I knew that feeling You know, the only thing back then was Rocky Mountain spotted fever as a possibility. and we knew that was very rare and we weren't so worried about anything else. It was just gross to have a ticken. All of a sudden, when I was in Martha's vineyard, there was a sense of, wow, this could transform my life. I mean, the people I'd spoken to who had Alpha Gal syndrome, I mean it really had changed everything they did, how they socialized. They couldn't go to barbecues anymore. They often couldn't go to parties. couldn't go to outdoor restaurants And I suddenly had this sense of wow, this could, you know, I love meat. I'm a very enthusiastic carnivore. And the idea of this illness striking me was pretty upsetting. I did what Roden Reynolds did and what kind of everybody I spoke to who spends a lot of time in these areas does, and that is I wore Perermhrin soaked There's a company called Insect Shield that sells these that's been doing it for the military for decades But it's essentially Ordinary looking clothes, socks and pants and shirts or kind of impregnated with this pesticide that's based on a toxin found in chrysanthemum flowers. That's hyrethrin and chrysanthemum, But is permhrin is kind of a synthetic version of that. And so My whole body was cloaked in this stuff and Patricks was too. And if a If Tick were to crawl onto my pants, I mean, it could go maybe six or eight inches and then it would be poisoned to death So you don't put the repellent on your skin. You wear clothes that are soaked in it Why is it done that way as opposed to what's typically done, I think, which is put it on your skin? Well, I think a lot of the things that are good on your skin, sprays like Det and soth don't really work with ticks that well. They may put them off a little bit, but they're not really effective. mean I think permethrin is the one thing that they've found Absolutely will kill the tick and prevent it. So that you know, the people like Patrick who are out there every day, I mean, he's done I think, four or fifty yard checks in Martha's venyard looking for ticks. He doesn't take any chances. So he has socks, he has pants, he has has pants in in the cuss of his socks Everything is coated in this stuff except for his cheeks and his hands, basically. So you're talking about buying pre soaked clothing Can you like buy a big vat? of this stuff and soak your own clothes in it. Yeah, yeah, you can do that. And also when I went to the insectield ory in Greensboro, North Carolina. In this warehouse it just had giant piles of clothes. And I said, what is that? And they said, Well, people all over the south in tick areas are sending us their clothes and we soak their own clothes Pmethin for them and send them back to them. So that's another, you know service that they have Does it smell No, and it's, you know, again, it's been used by the military for decades. So it's very safe. and I think they've done all kinds of crazy tests with high concentrations and still haven't had negative reaction. So it doesn't smell, it doesn't really cause any irritation. I talked to one guy in Missouri, a hunter who said that When it's like ninety degrees and highly humid and he's sweating into his Permethrin shirt, sometimes he'll get a little bit of a rash. I mean, that's about as bad as it. as it gets, I think So I'm going to spell Pmhrin for anybody who wants to look it up and do more research. Uh It's P E R M E T H R I N per Methrin That's right. So what if we attack the ticks with it? What if we spread Pmhrin like throughout a place with a major infestation Yeah. I mean, everybody I spoke to said, lookook, that's a nonstarter. I mean, you can do that to a degree like if you're about to have a lawn party you could go out and You know, spray permethrin on your lawn And there was a woman, Holly Gaff I talked about oldld Dominion University in Virginia. She developed this thing called the tickbot It's kind of a Romba type device that kind of goes around your lawn on its own and kind of drags a Pmethrin soaked sheet and kind of congradually cover your lawn that way and get rid of the ticks But it's a quick stopgap measure. It's not going to be long term because You know, there's millions of these ticks and they're in the forest around you, they're in the yard next door. There's kind of no way to spread enough Pmethrin to really kill all the ticks to a point where you can really protect yourselves from them What are some of the proposals now for how to get these ticks under control I mean, I'm not sure we'd ever completely eradicate them. that might be impossible, but we can try to minimize the infestations So what have you been hearing about ways to do it I mean, there's there's two basic avenues that I've seen or maybe three. I mean, one is you know, the kind of magic bullet would be a vaccine, a human vaccine against tickborne illness. And it could be that there's some common denominator of these tickborne illnesses that a vaccine could treat. And I know there's some work going on to try to find something like that. The other one is, you know, a vaccine for deer that that you could widely give to deer and then when the ticks are on them, the ticks don't grow to full adulthood and don't multiply You know, an example of that, a version of that that worked really well in this country is in the fifties and sixties when we had this terrible screwworm infestation. sccworms are this awful, awful thing, worse than lone Star ticks, if you can imagine. Basically blow fly maggots that burrow into flesh and kill animals. They killed millions of deer and cows in the United States And then in the fifties and sixties, This huge program happened where they bred literally billions of blow fly sterile male blow flies and airdropp them all over the southern United States. And eventually The blowflies died out and screworms weren't a problem. And then they did that through Mexico, Central America, all the way to Panama Lately, they they've made their way back to Mexico, so screw rooms are kind of a new problem. But that idea that you can kind of control the source of the ticks, you know, or the pest is I think that's a possibility with with Lone Star ticks as well. Probably the most practical, the most immediate solution to the problem in places like Martha's Vineyard, but really across the country, I think, is just killing deer. And it sounds brutal, but the truth is that we have such an overpopulation of deer. It's been true for decades They're disastrous for the environment. They're beautiful, but they're actually eating a lot of native species. They people call them ecosystem engineers because they really transform a landscape but not necessarily a good way So we have way too many deer. I mean, they've gone up from I think a few hundred thousand at the turn of the last century to thirty six million So The idea is really to go through and get these down to a manageable level on an ecological level, but also in a place like Martha's Vineyard to really reduce them to Almost nothing or a fraction of what they are now So there's the big campaign now to start to kill maybe three or more thousand deer on Martha's vineyard. What was that look like Like who who would be shooting them And what would you be doing with all of those dead deer? Yeah, it's interesting. I mean You know, I think the model on a very, very small, talkal about microcosm, the smallest scale is Monhegan Island off the coast of Maine where it's a much, much smaller island and they had a deer tick problem and lyme disease problem. And they brought in one professional sharpshooter who came in and basically killed all the deer on the island. But that was, I think, less than a hundred deer. In Martha's Vineyard on Martha's Vineyard The idea is you would get local hunters to do the killing T takeake Free Marthur's vineyard, the group I was talking about is already planning to build a new processing facility for their carcasses. and then you would take that processed meat and you would give it to food pantries and other people And you would just start this massive hunting campaign to try to rid the island of deer Kind of hard to imagine, but I think it's going to happen Do you think there'll be objections to it This is like mass slaughter of deer I feel like that's been a debate. that's been ongoing for four decades, but it also feels like Alphigel may finally be the thing that solves this or brings it to an end because On a place like Martha's Vineyard, people love their deer. They love the look of it. you know, they love having these animals around them. and yet they are just As Lah Hamner, this epidemiologist I spoke, she said, this is an existential crisis. If we don't, population under control. peopleeople will leave this island and they won't come back. people were saying, you know our grandkids aren't coming back now because to visit us because they're afraid of getting bitten So I think they've finally gotten to the point where the island there is on board. And I can imagine that same process happening in other parts of the country Well, let's take another break here. If you're just joining us, my guest is Burkhard Bilger, his latest article in the New Yorker is titled The Tick That Hunts downown its hosts, including Us We'll be right back. This is fresh air This is fresh air. Let's get back to my interview with Burkhard Bilger. His latest article on the New Yorker is titled The Tick That hunts down its hosts, including Us. It's part of the magazine's body issue And the tick we're talking about is the Lone Star tick. and the syndrome it carries is called the Alpha Gal syndrome and it often produces a very extreme allergy to meat toward the end of your article, You write something I really identified with. You said, After going on this tick research, you thought it would be really good to be back in New York City. You'd feel relatively safe surrounded by brick and concrete But as you turned out, there was a health alert from the city as you got back. What was the health alert? Well, it was it was a health alert. I discovered. I was kind of suddenly worried. I thought, wait a second. And I did a search for Lone Star Ticks in New York and I found a health alert. I mean, from I think a year or two ago saying Yes, the Loneestar tick has settled in Staten Island. It's kind of pretty well established there. and it's in parts of the North Bronx. It's established there. It's all over easastern Long Island And there have been occasional lone stars found in Prospect Park and probably in Central Park There is no established population in Prospect Park or in Manhattan. And there probably will never be a huge one because there aren't deer there. So I don't think the risk is super high. but Essentially, I realized, no, this thing could be in Prospect Park. All it would take is bomb or two tick bombs, you know, a bunch of larvae, and you could have the real risk of getting bitten by a tick three blocks from my house in Brooklyn. So the idea that somehow I'm perfectly protected from nature by being surrounded by stone is kind of a pipe dream. You're not panicking yourself right now No, I'm not. I'm not at all. You know, I do think it's scary. I mean, just being um It was interesting to be at this safe spoon restaurant in Springfield, Missouri because it's a beef growing area. You know, the owner told me, look, vegan is a dirty word around here, but it was just jam packed with people who had alpha gl syndrome, had other kinds of allergies, and it made me feel like, wow, we have somehow gotten to the point in this country where Our bodies are not nearly as resilient as they used to be. and through a combination of diet and chemicals and land use changes Being out in nature and you know changing the ecology by letting deer grow, we have made ourselves more and more vulnerable to things that we used to be more resistant to. So that it gave me a sense of vulnerability that I hadn't had before One more question. So I live in the city There aren't deer in the urban part of the city where I live But there's mice and mice carry Lone Star ticks too, right Yes. So How can you know if you're safe if there's like, you know, mice all over Well to some degree, it's a question of density, right? Like how many ticks are there? I mean I think that's what they're coming up against in Martha's Vineyard too is yeah, you can kill all these deer, but there's still all these mice and shrews and other you know, little mammals around to carry the ticks But the number of ticks they can carry is so much smaller. I mean, a deer can carry five hundred to one thousand ticks in a season You know, a mouse may carry five or six, you know? And so it it's a different level. And I think once you get to the point where Ticks are fairly rare, it's just the risk goes down dramatically. Oh Burkhard buildilder, thank you so much for coming back to Fresh air. Oh, it's been a pleasure. And stay away from the ticks I will. Thank you. You too Berkhard Biler is a staff writer at the New Yorker. His new article is titled The Tick That Hunts downown its hosts, including Us Tomorrow on fresh air, our guest will be romance novelist Kennedy Ryan Her stories focus on people the genre has often left out The black girl, the fat girl, the sick girl, the disabled girl She's the first black author to win the Rita, Romance's highest honor. I hope you'll join us To keep up with what's on the show and get highlights of our interviews, follow us on Instagram at NPR Fresh Air ur Fresh Air's exxecutive producer is Sam Briger. Our technical director and engineer is Audrey Bentham. Our engineer today is Adam Stanishhevsky. Our interviews and reviews are produced and edited by Phyllis Myers, Anie Bolddonado, Lauren Krerenzel, Theeresa Madden, Monique Nazareth, Thea Chalner, Susan Yakkundi, and O Baumman and Nico Gonzaallez Whistler Our digital media producer is Molly Cvie Nesper. Roberta Shherroock directs the show. Our co host is Tanya Moseley. I'm Terry Gross