Solutions Library

Swan’s Island Health Center

Fighting Ticks and Vector-borne Diseases

Although it may be evident that island life often comes with challenges that aren’t experienced on the mainland, one might assume that the danger of ticks and Lyme disease would be universally experienced along the coast of Maine. In actuality, the threat portrays itself with great disparity on Maine’s islands when compared to the mainland. Some islands experience a far more concentrated infestation of infected deer ticks. You are statistically two-and-a-half times as likely to contract Lyme disease on some Maine islands than you are on the mainland of the Midcoast (the mainland region with the highest rates of Lyme). On other islands, however, the threat of Lyme is miniscule or even nonexistent. The geography, ecology, and history of each island creates a different situation for all of the unbridged communities. By that same logic, each island community has grappled with the challenge with varying methods. What has worked for one community may not always work for another, but sharing solutions can often be the quickest route to effective problem solving. Read more to learn about the challenges Lyme disease presents for island communities and the community members on the front lines of the tick conflict.

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Island health centers are assets to their communities for many reasons. They are a place to go for check-ups without needing to take the ferry to the mainland. In the war on ticks, they act as a primary witness to the prevalence of tickborne diseases. They help infected individuals get treatment, but they also help when it comes to prevention. Just like Islesboro’s Tickborne Disease Prevention Committee, Donna Wiegle of Swan’s Island Health Center has the goal of preventing people from contracting Lyme in the first place. Just like other islands, special deer hunts have been pursued in order to reduce the tick population, and there have also been controlled burnings aimed at destroying tick habitats. However, the method with the least controversy and fewest repercussions remains to be educating the public on how to reduce the chances of coming in contact with an infected deer tick.

 

HOW IT WORKS

Beyond helping island patients who are infected with Lyme, Donna has worked in the field with researchers like Chuck Lubelczyck of the Lyme & Vector-borne Disease Laboratory at the Maine Medical Center Research Institute, she has collected samples of deer blood for testing. She played a major role in acquiring permissions from the Maine Department of Inland Fisheries and Wildlife (IFW) for special hunts outside the regular season. Among these responsibilities, she also aims to educate. She’s held educational programs on the island instructing people how to prevent themselves from coming in contact with ticks, what to do if they’re bitten, and what symptoms to associate with a potential case of Lyme disease.

 

Q & A WITH DONNA WIEGLE

Community leader, Donna Wiegle runs the health center on Swan’s Island.

What has been your role in the island’s fight against ticks and Lyme disease?

We have been collecting ticks since the 90s—before my time here as a full time resident. We have a relationship with Maine Medical Center’s Vector-borne Disease Lab. In particular, with Chuck Lubelczyk. Chuck’s been coming out here since the 90s. I came onboard here around 2001 as a full-time resident. I’ve been in contact with Chuck for a long time. He would come out twice a year to collect ticks—Spring and Fall when they’re looking to feed. I’ve been out collecting ticks with Chuck—which is very interesting… you just have a broom handle and attached is a piece of white colored corduroy fabric. You just go along the trails and wave it across the vegetation. You stop every couple of minutes to look at both sides of the flag, remove them with tweezers, and put them in a vial. Chuck has a collection of sites out here that he returns to each season to collect ticks. They take those ticks back to the lab, and they analyze them to see if they are carrying the bacteria for Lyme disease or anaplasmosis or babesiosis or one of the other tickborne diseases that are making appearances here on the coast of Maine. I’ve also done some work with him on our hunting season and collected blood samples from the deer.

How has Lyme impacted the community over time?

I have been working here for more than ten years now, and when I first started we rarely even heard of Lyme disease. One of our earliest cases was a gentleman in the summer population who had Lyme disease, didn’t know it, and ended up with chronic Lyme. Whether he got it here or not, I don’t know. Early on in treating Lyme, physicians in this area just weren’t familiar with it. They didn’t know what it looked like or the best methods for treating it. We had a lobsterman who went to the emergency room with the classic bullseye rash and was misdiagnosed. That wouldn’t happen today. Physicians in this area are now well aware because it’s very prevalent here, but I’m sure if you go up to Washington County and ask them—not so prevalent. But it will be. It’ll just move right up the coast like it has been doing.

What’s the deer situation like on Swan’s Island?

Chuck and his team were trying to assess our deer population by laying out these little grids across the island, and then they’d count deer scat. They must have a formula to assess that we have “x” number of deer per square mile. But in an effort to reduce deer and Lyme disease cases, how many a year do we have to get rid of in a normal hunting season? Is it 30? 50? How many are born each spring? Are we even making a dent in the population at all? We were approved for a special deer hunt very late in the season (winter 2017-2018). We will do it again next year, but we’ll start earlier. We had issues when we started because the doe were already pregnant, and the first deer that was killed was carrying twins. That freaked out the hunters around here—which is too bad. But next year we’ll start in December instead of February which should have a bigger impact, I hope.

What was the process of the special hunt?

A number of years ago, we asked IFW about having a more aggressive hunting season or an extended hunting season, and we were flatly turned down. There was not even any real discussion about it. We just got a “No.” They didn’t want to entertain the idea at all. That might have been five or six years ago. Our problem continued to get worse, so we had a meeting last August here at the clinic with our selectmen and four people from IFW.

People always want concrete numbers and statistics to support your case. We don’t have those numbers unfortunately. Not everybody comes here for their healthcare. A lot of people could be diagnosed and treated for Lyme, but they’re going to Ellsworth for medical care. So, when people ask, “How many cases of Lyme do you have?” and I have to say, “I don’t know.”

Based on anecdotal information I get from people, I can only say that I truly believe that each year there are more and more people diagnosed with Lyme disease. We’ve done a survey, but you can’t control what the return rate of the survey is. But I could write a list of probably 40 people in less than five minutes that I know of who have been diagnosed on the island. So, we laid all this out to IFW, and we plead our case that we needed to do something. We could no longer do nothing. We wanted to ask for a special deer hunt again, and they said there were many hurdles to get that approved.

We were finally able to get everything together, and we finally got approval much later than we had hoped. We had hoped to get approval for the hunt in December, and we didn’t get approved until the middle of February. That gave us about four weeks. We were approved to put baiting stations out, and if we could attract the deer, we could kill the deer.

We only killed two deer, which was very disappointing, but I feel like the positive part of it was that we got approved for the special hunt. We’ll be able to have the special hunt next year.

Writers note: The hunt occurred again during the winter of 2018-2019, and over a dozen deer were killed.

Educational materials are posted all around the island’s health center.

What role does education play in combating Lyme?

I think the most important thing is education. And it’s really hard to educate people, but I think patients themselves are becoming more educated about the signs and symptoms of Lyme. You can go to the internet and get that information—you can go to the Centers for Disease Control site. You can come to a public program. I’ve had many public programs here on Swan’s Island over the years with different presenters. The people that generally come to the programs I’ve had over the years are people who have some familiarity with Lyme—they’ve either had it, someone in their family has been diagnosed, or they just really want to learn.

What impact has this had on the summer community?

Because we’re a community with a lot of people from away visiting in the summer, people from Nebraska, Florida, California—they could be from anywhere. They don’t have Lyme disease where they live at home. So, they come to Swan’s Island or any island, and what’s one of the things they want to do? Go hiking. Be outdoors. Maybe they live in the city where they come from—and here’s all this beautiful nature—so they go out, do their thing, and have no knowledge of Lyme disease, ticks, or tickborne diseases. Then they leave the island, go home, become sick, and they go to their primary care doctor who knows nothing about Lyme disease.

I’ll give you a story: I have a friend who comes from the Washington DC area with his family. He was here for a couple weeks, and they’re an outdoors family. They went back home, and he called me up and said, “Donna I’ve been so sick since I left the island. Getting back to Washington DC, I had the worst headache ever. I’ve been to my doctor. I had this terrible rash… my doctor asked me to contact you and ask if you had any knowledge of spider bites. I said, “Send me a picture of the rash.” It was the classic bullseye rash, but his doctor was treating him on 10 days of antibiotics for spider bites because she didn’t know what it was. I actually put his physician in Washington DC in contact with one of our physicians who comes to the clinic on Swan’s Island to go over the protocol on how we’re treating patients here. He went on a longer course of antibiotics, and he got well again. He has no lingering effects of it. He’s a really healthy guy, a runner, a retired military guy, and here he was in DC as sick as could be.

What can be done to make sure that doesn’t happen?

One of the things I think people don’t really want to do is: if you have a rental house, put literature in the rental house. Make people aware. Yeah it might scare some people off, and I think that has happened before. We have a music festival that’s been going on for 25 years, and last year some of the musicians decided not to come. Some had smaller kids and they just didn’t want to put themselves at risk to come out here.

I think if we can’t get a handle on it, it will end up affecting real estate prices out here and also tourism. Just think about this: if you’re planning a week long vacation would you go to a place that was infested with rattle snakes? Well hell no! So are you going to come to a place that has ticks and tickborne diseases?

What about pesticide use?

I have seen pest control companies out here, and I really think it’s something that town governments should be looking into. Because we don’t know—I don’t know—so I’m sure others here don’t really know what products these pest control companies are using. Are these products washing into the water? Is this harmful to clamming? Mussels? Lobsters? Anybody in the fishing industry would be very wary of having anything like that sprayed that could get into the watershed… So I think it’s community problem that I’m seeing more and more of the modern pest company guy driving off the ferry boat—I don’t know where he’s going or what he’s spraying.

So what can someone do?

Be aware there are things you can do to protect yourself. There are sprays you can put on. There are natural products you can put on if you don’t want to use a DEET product. Spray it on the bottom of your pants, tuck your pant legs into your socks, wear light colored clothes. If you’ve been out in a heavily wooded area, go back home and check yourself over. I’ve lived here for almost 20 years now, and I have only had a tick embedded in me twice. Two times in 20 years—I’m outside all the time. I used to do a lot of mowing and weed whacking in tall grass. Hiking through the woods. I have dogs that could bring ticks in. I just think you really need to be aware. Stay on top of it.

The interview above has been edited for length and clarity.

 

RESOURCES

 

Originally Published March 2019

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