ABERDEEN PROVING GROUND, Md. – For more than 20 years the Army Public Health Center Tick-Borne Disease Laboratory has been offering military clinics and health care providers test kits for free identification and analysis of ticks that have been removed from human patients. This service was known as the DOD Human Tick Test Kit Program, or HTTKP, which is not the catchiest acronym. The program is expanding so that individual Department of Defense beneficiaries who have been bitten by ticks can submit their ticks directly to the Military Tick Identification/Infection Confirmation Kit, or MilTICK, program, without needing to visit a clinic or order a test kit.
“Over the past several years, the MilTICK program has been expanding its capacity to identify and test ticks,” said Robyn Nadolny, APHC biologist and tick testing program coordinator. “We are rebranding to encourage greater participation in the program, with a name that is easier to say and hopefully to remember.”
The purpose of the this program is to expediently provide tick species identification, engorgement level (a relative indicator of attachment duration, i.e. infection potential increases with duration of attachment), and analysis for the pathogens that cause the following human illnesses: Lyme disease, Rocky Mountain spotted fever and related spotted fevers, ehrlichiosis, anaplasmosis, babesiosis, and Powassan virus, said Nadolny.
“Since different tick species transmit different pathogens or groups of pathogens, and since most tick-borne illnesses often exhibit virtually identical early symptoms, tick species and infection status may be useful to the physician in evaluating and monitoring the patient’s health, and in making diagnostic and treatment determinations,” said Nadolny.
May is Lyme Disease Awareness Month and Nadolny says that although tick activity is highest in the summer months, they get very active in the spring and don’t die back down until the fall.
Lyme Disease is the most common vector-borne disease in the U.S., with over 300,000 new cases every year, according to the Centers for Disease Control and Prevention. Most of those new cases arise during the spring and summer months, when tiny nymphal blacklegged ticks (also called deer ticks) are out biting people. It’s important for anyone going outside into tick habitat (brush, woods, tall grass, even yards and lawns) to do a thorough tick check of themselves and any children during tick season.
“Ticks can be very tiny, smaller than a sesame seed, and while the bacteria that cause Lyme disease usually take about 48 hours of tick attachment to transmit from the tick to a person, other pathogens can transmit much faster,” said Nadolny.
Nadolny says it’s always safest to remove a biting tick as quickly as possible. Instructions for how to do this can be found at: https://phc.amedd.army.mil/PHC%20Resource%20Library/HowtoCheckforTicksandRemoval_FS_18-092-0919.pdf.
Last year the lab received nearly 2,800 ticks, more than 200 of which were positive for the agent of a human disease.
“We had participation from 40 states and over 100 installations, and people from all services were participating,” said Nadolny. “We have noticed that participation has plateaued around 2,500-3,000 ticks submitted per year, mostly in the summer, but we have the capacity to identify and test more samples. That is a small percentage of the DOD population we could be supporting, so we want to get the word out that everybody (Active Duty, National Guard, Corps of Engineers, Family, Retired, Civilian, Contractors) can participate in this program, free of charge.”
Nadolny says with concerns about the novel coronavirus, or COVID-19, sweeping the U.S. and the world, it can be easy to forget about other more mundane health risks. However, as spring and summer ramp up, and more and more people are spending their time social distancing outside, it’s important to remember that ticks are becoming more active outside as well.
“With stay-at-home orders in place, and with more people spending time outside while social distancing, expanding the program to individuals as well as providers will allow greater access to the services we provide,” said Nadolny. “We believe this will be a good way to expand the reach of our program, and provide education and peace of mind to a greater proportion of the DOD population.”
The MilTICK program now makes testing that tick even easier. To access the program, any DOD beneficiary with a tick bite simply needs to download the instructions, the form, and the USDA permit (all available online). Beneficiaries then need to place their tick in a resealable bag and mail it in an envelope with the other required documents. All the information they need to participate and mailing instructions are available in one document at this link: https://phc.amedd.army.mil/PHC%20Resource%20Library/MilTICKforms_2020.pdf.
“Different ticks carry different pathogens, so it’s important not to damage your tick before you send it, so that the MilTICK staff can identify your specimen and make sure it is tested appropriately,” said Nadolny. “MilTICK staff will be in touch as soon as the tick is received with the identity of the tick, and results of the test are generally reported within two weeks.”
The MilTICK program also maintains on online data dashboard, where anyone with a CAC card can access and view information about the tick-borne disease risks at their installation, based on the lab’s tick data from the last few years. The Carepoint website can be accessed at https://carepoint.health.mil/sites/ENTO/miltick.
“The more submissions we get, the better our surveillance data is, and the more detailed information we can provide about the risks at a specific military installation,” said Nadolny.
The Army Public Health Center enhances Army readiness by identifying and assessing current and emerging health threats, developing and communicating public health solutions, and assuring the quality and effectiveness of the Army’s Public Health Enterprise.