On a late-summer afternoon in 2024, an airline pilot and father of three named Brian Waitzel ate a hamburger at a barbecue in suburban New Jersey, and four hours later he fell violently ill. By nightfall he was dead. His family was left stunned and confused. What was the cause? Acting on a hunch, a physician friend contacted Dr. Thomas Platts-Mills, an allergist at the University of Virginia School of Medicine and an expert on alpha-gal syndrome, a tick bite-induced allergy to red meat.
When Dr. Platts-Mills studied the sample of Mr. Waitzel’s blood from the autopsy, he saw something familiar: high levels of antibodies specific to alpha-gal, a sugar molecule found most commonly in the saliva of the lone star tick. Another test revealed markers of anaphylactic shock, suggesting Mr. Waitzel had suffered a severe allergic reaction to the hamburger. His wife recalled that after a jog in a park weeks before his death, he had come home with a dozen bites on his ankles.
Mr. Waitzel’s became the first death attributed to alpha-gal syndrome from consuming meat ever documented in a medical journal. His death signaled a shift: Our uneasy relationships with ticks had escalated. It was not enough to worry about Lyme disease; now we could contract a severe allergy that could cause death from foods that many of us have eaten safely all our lives.
The alarming surge in cases of severe tick-borne diseases underscores how quickly the risks of infection are changing. Several species of ticks — the lone star, the Gulf Coast tick and the infamous blacklegged tick (also known as the “deer tick”), which spreads Lyme disease — were once regarded as mere nuisances confined to relatively small regions of the United States. But warming temperatures and changes to landscapes have combined to help them expand their range and bring a host of pathogens with them. Some are manageable; others cause illnesses that are severe and untreatable.
The fastest-growing disease of them all is the best known: Lyme. Cases have more than doubled over the past three decades, and each year, nearly half a million people are treated for the disease. As the blacklegged tick rapidly spreads north, that number is sure to continue rising. While a promising Lyme vaccine is in development, it won’t stop the blacklegged tick from potentially giving us other diseases, such as the flulike anaplasmosis or the rare but sometimes fatal Powassan virus, which can cause inflammation of the brain. The rates of babesiosis, a red blood cell-destroying disease that can lead to organ failure if left untreated, are also on the rise. One researcher has called it “the malaria of developed New England.”
The lone star tick, especially, seems as if it crawled out of a horror flick. With its aggressive approach to hunting and unusually long, barbed mouthparts designed to anchor into our flesh, it resembles a miniature version of the alien in the “Predator” movies. Unlike most other ticks, which take a let’s-see-what-comes-along approach, the lone star will pursue you for several yards. It’s fast, able to crawl up a leg in seconds and is one of the relatively few tick species whose larvae bite humans: Step on a cluster of lone star babies and you will soon find hundreds of poppy-seed-size vampires coating your ankle. They can even push through your socks.
The eastern halves of the United States and Canada are experiencing a sea change in the public health threat posed by ticks. Humans are in retreat from this bloodthirsty enemy. We have pre-emptively surrendered to billions of tiny creatures actively hunting us in our own backyards, choosing resignation over resistance. “There is a clear winner in the ongoing contest between humans and ticks,” Lars Eisen, a veteran research entomologist in the Centers for Disease Control and Prevention’s division of vector-borne diseases, recently wrote. “And it is not us.”
That should change now. We don’t have to let the ticks win.
When I moved to Vermont’s Green Mountains 14 years ago, my neighbors weren’t very worried about ticks. Our winters were too cold, they told me. Vermont has two seasons: winter and the Fourth of July, as one old saw has it. So Vermonters can be forgiven for welcoming the occasional early thaw. But warmer winters have also allowed tick eggs to hatch earlier in the spring and lengthened the window during which ticks are active and hunting for a host. That has allowed the blacklegged tick and American dog tick to become well established in the woods and fields around my home. The lone star tick has been spotted in Vermont as well, although it hasn’t established breeding populations here — yet.
The blacklegged and lone star ticks have been in North America at least since the ice sheets retreated 20,000 years ago, their populations waxing and waning with changes in the climate and the abundance of deer, their favored host. The first-century Roman historian Pliny the Elder described ticks as “the foulest and nastiest creatures that be.” Maybe another subconscious reason we hate ticks so much is that they take us down a peg. They remind us that we, too, are prey — just another blood meal.
Here in northern New England, the mere presence of ticks has compelled many of my neighbors to alter their daily routines. Lyme disease, for its part, “has transformed mundane domestic objects — like lawns, playgrounds and stone walls — into frightening and difficult‐to‐decipher menaces,” the anthropologist Abigail Dumes has written. A certain amount of anxiety is justified. In the course of writing this essay, I found a blacklegged tick attached to my hip a day after my wife removed one from our daughter’s temple. While reading a journal article about the efficacy of tick checks, I found an American dog tick crawling up my leg.
A mosquito bite itches, annoys and eventually fades away. A tick bite initiates a fraught spiral of uncertainty. Are there red rings developing around the bite? Is my dizziness a sign of dehydration or anaplasmosis? Am I running to the bathroom because I have a stomach bug or a new life-threatening allergy to bacon?
Much as we might despise or fear them, ticks have something to teach us, too. Their abundance signals a broken equilibrium, an ecological rupture. Through our land-use choices, our settlement patterns, our heating of the planet, we have pushed ecosystems — from our backyards to almost the entire eastern half of the United States — way out of balance. And now it’s literally coming back to bite us.
Research suggests that the blacklegged and lone star ticks are returning to areas such as the Mid-Atlantic, the Northeast and the Upper Midwest where they were long ago prevalent, before humans overhunted deer and destroyed much of their habitat. Since the mid-20th century, both forests and deer have bounced back — and so have the ticks. “Suburban sprawl has created huge amounts of this edge habitat,” said Brandon Hollingsworth, an epidemiologist specializing in vector-borne diseases at the University of South Carolina, describing places where forest turns to field. “And that’s where ticks tend to hang out.”
Rodents that serve as the “reservoirs” for tick-borne pathogens have proliferated in large part because humans have displaced their predators with our subdivisions and shopping malls. The deer on which the older ticks feed have also exploded, as their natural predators have mostly disappeared. Having a wider array of species in a given area “dilutes” the pathogens circulating through it. But this broader decline in biodiversity means ticks have fewer species to feast upon and higher odds of getting infected along the way.
The past winter brought an unusual mix of conditions across the eastern United States favorable to ticks: an insulating snowpack, stretches of above-average temperatures and an early spring thaw all combined to boost ticks’ survival rate and accelerate their life cycle. A friend, Dr. Brian Bates, told me that as much as 40 percent of patients’ daily calls this spring to our local clinic in Bristol, Vt., have been about tick bites. Another friend, Dr. John Nesbitt, an emergency physician in Vermont, described the recent surge in the number of tick bite cases he has treated as “astronomical.” Emergency rooms nationwide have been reporting unusually high numbers of tick encounters: Visits for tick bites in April were double the average for the past decade, according to the C.D.C.
And that’s not a sign of mere paranoia: The lone star is surging north and west from its historical stronghold in the Southeast, reaching as far as Maine and Minnesota and running rampant on Long Island and Martha’s Vineyard. After being first spotted on a sheep in New Jersey in 2017, the invasive Asian longhorned tick has now leaped to Oklahoma, Georgia and Massachusetts. The blacklegged tick has made inroads into Ontario and Quebec; studies project that continued warming could expand its overall range by 200 percent, deep into Canada, by 2100.
These ticks are reaching places where people aren’t aware of the risks they pose and many medical providers aren’t prepared to diagnose unfamiliar illnesses. Alpha-gal syndrome is perhaps the most confounding risk of all. Researchers have found a hundredfold increase in positive tests for alpha-gal antibodies from 2013 to 2024. The C.D.C. estimates that as many as 450,000 Americans might already have contracted alpha-gal syndrome since 2010; a vast majority of those cases are undiagnosed because the syndrome can be difficult to differentiate from food poisoning or digestive disorders.
Given all these trends, the tick armies’ conquest of the continent might seem unstoppable. They are hard to see, hard to kill, hard to find. They appear to already have us surrounded. But, in fact, we could be doing so much more to stop them. We’ve done it before.
Consider our endless war on that other major vector of infectious disease: mosquitoes.
In the 1930s, malaria afflicted 30 percent of the people living in the Southeastern United States. The government undertook an ambitious campaign to fight it, and in less than a decade, public health workers dug thousands of miles of ditches, drained half a million acres of swampy mosquito breeding grounds and sprayed four million homes with insecticides.
It worked. Death rates from malaria plummeted, and the disease was eliminated from the country by 1951. As Rachel Carson documented in her 1962 book, “Silent Spring,” that effort led to its own cascading ecological and health crises: mosquitoes developed resistance to the insecticide DDT, which also had disastrous effects on wildlife and proved toxic to humans.
We have since learned how to target vectors of infectious disease without wreaking ecological havoc in the process. And today, local and county health agencies across the country maintain robust mosquito control programs, using proven and safe methods to target breeding sites and keep populations in check.
There are challenges to pursuing tick control on a similar scale. Compared with mosquitoes, ticks are a much less compact target — their life cycles are longer and their breeding sites more dispersed throughout the environment. But we could nevertheless apply lessons learned from mosquito control efforts to confront ticks with greater urgency and ambition.
At each of their life stages, ticks can be foiled by our countermeasures. Most of our proven strategies focus on avoiding encounters or quick removal when bitten. Deer fences and mouse traps can help keep ticks out of your yard. Landscaping that avoids invasive plants such as Japanese barberry that create leafy, humid microclimates can keep tick numbers down. (Ticks hate dry environments.) Wearing long sleeves and tucking pants into socks, applying permethrin to clothes and performing a head-to-toe tick check back at home are all quite effective, too — if they become regular habits. But it takes only one lapse for infection to strike.
Playing defense, while important, won’t be enough. Our war on the ticks should focus on breaking the key links in their chains of reproduction and disease transmission.
Much as we might fantasize about wiping the little bloodsuckers from the face of the earth, eradicating ticks isn’t an option: They are too hardy and the ecological harm would be too great. But diluting the pathogens that ticks carry, and suppressing ticks’ numbers in places where humans are most likely to encounter them, is entirely feasible. This campaign must be waged locally but funded and coordinated by the federal government, the only entity that can marshal the resources and expertise to sustain tick control programs across decades.
One of the biggest success stories in the history of tick control was a C.D.C.-led campaign to counter a deadly epidemic of Rocky Mountain spotted fever afflicting tribal communities in Arizona. In 2012, health officials began putting treated collars on dogs, the primary host of the brown dog tick, and spraying yards with environmentally safe chemicals. After two years, this effort sharply reduced tick numbers and infections.
If we really want to stop the ticks, Dr. Eisen, the C.D.C. scientist, told me, we will have to go after the deer — not with hunting rifles but with a suite of tick-killing drugs and pesticides. Deer are to many tick species what stagnant pools of water are to mosquitoes: breeding grounds. Federal wildlife managers have long used “four posters” — troughs filled with corn and outfitted with paint roller devices that apply insecticides to deer when they stick their heads through to reach bait. These can be highly effective, knocking blacklegged tick populations down by 60 percent or more.
Delivering insecticides to deer orally in a bait — similar to the flea and tick pills that pet owners give their dogs — could also reduce tick numbers while avoiding adverse effects on other wildlife. And companies should develop new, more effective tick-killing products derived from fungi or organic ingredients. Dr. Eisen is hopeful that new approaches combining these different methods, in a kind of coordinated counterassault, could prove effective in the near future.
These promising efforts need government support to overcome the private sector’s reluctance to invest in new solutions, to test innovative control methods at larger scales and to sustain their use. But we aren’t investing nearly enough in them.
In 2019, Congress passed the bipartisan Kay Hagan Tick Act, named for the former senator from North Carolina who died from complications of Powassan virus. The law provided funding for the C.D.C. to set up regional research centers and for local health departments to conduct monitoring and public education on the risks of tick-borne illnesses. It’s up for reauthorization and currently awaiting a full vote in the House of Representatives. That would be a good first step, but lawmakers and federal agencies should go much further than the $27 million called for in the reauthorization bill.
“The funding is not getting any better even though the problem is getting worse,” said Laura Harrington, a professor of entomology at Cornell who runs one of the C.D.C. research centers. “We desperately need multiple strategies for control. It’s an area that really is stagnating.”
Now is the time to curb this silently surging epidemic — one that could affect millions of additional Americans within a few short years and place a significant new burden on the U.S. health care system. People who suffer from chronic tick-borne illnesses can experience debilitating symptoms over many years. One 2022 study by Yale and C.D.C. researchers estimated that Lyme disease alone could be imposing up to $1 billion in costs on society each year. New vaccines — not just for humans, but for deer and rodents, too — could pay for themselves many times over.
Private-public partnerships could be established to help guarantee markets for risk-averse pharmaceutical companies, creating incentives to develop new vaccines and safe insecticides. And the C.D.C. could lead a more aggressive campaign to get out ahead of this threat, which afflicts outdoor workers, hikers, hunters and gardeners in blue and red districts alike. That should include more targeted investments in state, county and municipal health agencies’ efforts to control tick populations in public spaces and, as needed, private residential areas where deer and mice proliferate.
Outflanking the tick hordes will also require some creative thinking. Dr. Platts-Mills speculates that the advent of invisible fences and then local leash laws in the 1980s prevented dogs from chasing deer — and ticks — out of his own Virginia suburb. Tweaking zoning laws to avoid creating a more fragmented habitat that puts people into contact with ticks and deer would help. Land-use policies written to increase biodiversity — for example, by creating wildlife corridors and improving habitat for rodent-hunting predators — can yield dividends, too. Researchers have found that areas where foxes and martens are more abundant have far fewer infected ticks.
In the meantime, experts say it’s essential to better educate the public about the protective measures that work and educate doctors about how to recognize symptoms of lesser-known infections like babesiosis and conditions like alpha-gal syndrome.
Since he established the University of Virginia’s Division of Allergy and Clinical Immunology in 1982, Dr. Platts-Mills, the allergist who helped discover the connection between the lone star tick and the syndrome, has seen patients with all kinds of symptoms. But the risks of alpha-gal syndrome seem to cause a special flavor of anxiety. One person he saw recently had lost 40 pounds just a month after being diagnosed, out of fear of common foods that might trigger anaphylaxis. (Some people with alpha-gal syndrome develop allergies to dairy products, too.) “There’s this sense they are being surrounded by it,” he said of his alpha-gal patients.
Dr. Platts-Mills wants people to know that the syndrome can be managed with careful attention to diet, and the severity of the allergy can fade over time. He should know: He’s contracted the syndrome from lone star bites, too. He avoids red meat. He still goes for walks in Virginia’s Blue Ridge Mountains, recognizing that by locking ourselves indoors, we risk embracing a cure worse than the disease itself.
The first step is simply trying to gain the upper hand. With ticks, we’ve barely begun to fight back. The longer we wait, the more territory they will claim across both our geographic and psychic maps. There is also a real question about whether we could pull off a project with the scale and sustained focus of the 1940s campaign against malaria in today’s America. That effort was made possible by a widespread agreement on the urgency of the threat. In our conspiracy-theory-soaked age, politicians have built careers by sowing distrust of scientists and experts.
Health and Human Services Secretary Robert F. Kennedy Jr., who elevated vaccine skeptics to key C.D.C. positions and once promoted unfounded theories about Lyme disease, has recently taken some encouraging steps to address the problem of ticks. In May, he announced a new initiative that aims to reduce Lyme cases by 25 percent by 2035, compared with 2022 levels. Though it does not mention vaccines, it includes modest new sources of funding for tick control efforts, for clinical research into new products to treat Lyme and combat alpha-gal syndrome, and for a C.D.C. pilot program that “will develop and deploy practical strategies to target and eliminate ticks on wildlife before they can spread disease to humans.”
It’s no moonshot, but it’s a start. And perhaps it’s a sign that getting serious about fighting ticks — much like building more housing or reining in data centers — has the makings of a bipartisan consensus.
As it happens, I’ve known Dr. Platts-Mills ever since I became close friends with his two sons in elementary school. We used to spend hours roaming the Virginia woods around their home, playing our own all-terrain version of “capture the flag.” This game involved hiding in the underbrush, prone in leaf litter, for extended periods of time. Not once did a tick cross my mind or, as far as I can recall, my leg.
That world is long gone. On a recent evening, as I watched my own children race across a forest-rimmed meadow near our Vermont home, ticks were never far from my thoughts.
My kids devised a game in which we pretended we were being pursued by invisible sharks and wolves. We raced through the grass to reach piles of rocks and shrubs that served as safe harbor from our pursuers. While the children shrieked with exhilaration, I eyed the brush, gripped with quiet anxiety about the very real predators we couldn’t see. “We’re safe!” they declared. “Remember, we’re checking for ticks when we get home,” I shouted back, breaking character. They took it in stride; it wasn’t anything they hadn’t heard before.
Deer frequent this particular meadow every night. We avoid it now, when the grass gets too high, but we’ll come back when our neighbor cuts it for hay, pants tucked into socks, both joyful and vigilant. And maybe when my children reach my age, if the country begins to take the threat they pose seriously enough, ticks won’t be the very first and very last thoughts that cross our children’s minds when they venture out on an early summer day.
Graphic by Taylor Maggiacomo.
Jonathan Mingle is the author, most recently, of “Gaslight: The Atlantic Coast Pipeline and the Fight for America’s Energy Future.”
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