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Duluth Lyme disease researcher seeks public's input

From left: UMD students Emily Hartman, Christopher Little and Jubran Jindeel drag for ticks at a farm in Iron River in the summer of 2017. Photo by Ben Clarke.1 / 6
A deer tick nymph is so small, it's easily missed. Here it's compared to the tip of Clarke's index finger. Bob King / Forum News Service2 / 6
Shannon RedBrook, research assistant in the UMD Medical School, replaces a box of ticks into cold storage. The temperature of the special refrigerator is 80 below Celsius or 112 below Fahrenheit. Bob King / Forum News Service3 / 6
Ben Clarke hands out a free tick kit that includes a tick ID card, tick removal tool, a vial to store the tick and the address to send it to. Bob King / Forum News Service4 / 6
Ben Clarke describes the rapid increase in the number of tick-borne diseases reported in recent years. Clarke has a tick bank at the UMD Medical School to learn everything he can about the several species of critters that populate Minnesota forests and fields. Bob King / Forum News Service5 / 6
Ben Clarke holds two vials, one containing an adult tick (left) and the other a nymph. Each vial in the box at right contains a tick. All are kept in deep freeze at a temperature of 112 below Fahrenheit. Bob King / Forum News Service6 / 6

DULUTH—Benjamin Clarke's bank doesn't make loans, and it doesn't have a drive-through window. He does want deposits, although he's a bit picky about what he'll take.

"I really prefer the deer tick," said Clarke, in his office on the third floor of the University of Minnesota Medical School's Duluth campus. "I'm after Lyme disease. It's very particular about what tick it's in."

Clarke's tick bank is in the locked "minus 80 C room" several corridors away from his office. It's behind two doors inside a large upright freezer that is indeed set at 80 degrees below Celsius, the equivalent of minus 112 Fahrenheit.

One day last week, research assistant Shannon RedBrook pulled a small, plain box out of the freezer and set it on a counter. Lined up inside were tiny vials, each containing, in either the nymph or adult stage, a deer tick, aka blacklegged tick, aka Ixodes scapularis.

It's the early stages of a collection that Clarke hopes will shed light on where blacklegged ticks are thriving in Northeastern Minnesota and how likely they are to carry the bacteria that causes Lyme disease.

"We want to develop a Lyme disease risk map that you can go online to see," he said.

Get a 'tick key'

This is where you come in. If you hike or work outdoors or otherwise spend time in the woods, Clarke would be happy to equip you with a sandwich-sized plastic bag containing a bulb-shaped "tick key," a "tick ID card," and a golf tee-sized plastic vial.

You use the key to safely extract the tick from your skin. You use the ID card to determine if it's a blacklegged tick. If it is, you place it in the vial and bring it or mail it to "Tick Outreach" at the medical school.

Clarke also is happy to bring his kits along and speak to your group about the project. You can find his contact information elsewhere within this article.

Clarke, an associate professor in the school's Department of Biomedical Sciences, is passionate about the tick and the diseases it causes, particularly Lyme disease, which causes flu-like symptoms and can lead to long-term complications.

Everyone agrees it's a growing problem. The U.S. Centers for Disease Control and Prevention reported last week that the number of tick-borne diseases in the U.S. more than doubled from 2004-16, and that Lyme disease comprises more than four out of every five cases. The epicenter of the disease, CDC data show, is in the New England states and in Wisconsin and Minnesota.

Moreover, it has been moving north.

"Back in the mid-'80s, we first saw these ticks in east central Minnesota, between the Twin Cities and Duluth, right along the Minnesota-Wisconsin border," said David Neitzel, an epidemiologist with the Minnesota Department of Health. "And since that time, it really radiated out from that original focus to become established throughout most of the forested part of the state, including ... more and more blacklegged tick populations up in the Arrowhead region all the way up to Grand Marais."

And it's already tick season.

"With the snow melting, the ticks are coming out right away," Neitzel said. "The adult stage of the blacklegged tick is out; the nymphs will be coming soon after."

Nymphs are especially dangerous, Clarke said, because they are so small — about the size of the letter "D" on a dime — and so numerous. And if they carry the bacteria that causes Lyme disease, the human host will get just as sick as if the culprit were an adult tick.

Tick-gathering students

We know the blacklegged ticks are here, but how well-established are they? That's what Clarke is trying to find out. He's doing it by sending teams of students he coordinates with the University of Minnesota Duluth in what's called the Pathways Program. The hands-on program offers an introduction to biomedical sciences to American Indian and other underserved populations through two 10-week-long summer academies.

When he first started sending students out on tick-collecting expeditions a few summers ago, he saw it primarily as a learning tool for the students, Clarke said. It gradually morphed into a legitimate research endeavor.

"It's really strange that 17-, 18-year-olds sent a 60-year-old man down the road on a new project," Clarke said. "When I talk to people on the streets, talk to my dean and the administrators, this is one thing that uniformly catches everybody's attention. Everybody knows somebody who has come down with Lyme disease."

This summer, Clarke will send his students to four collection sites across the Arrowhead. (The state Health Department also has sites in four forested regions of the state, Neitzel said, and plans to add one in St. Louis County, not far from Duluth.)

Clarke hopes to supplement what his students bring in with what comes in to his bank from volunteers. The volunteer need only indicate when and where the tick appeared. Clarke also would appreciate knowing the approximate temperature and humidity.

"With this, we'll be able to generate a map of this area and say: Where are the hot zones?" Clarke explained. "Is it close to the lake, or is it up around in the more swampy areas?"

He's hopeful the map will be online as early as August or September, under the name Ixodes Project.

'They're dangerous'

In his research, Clarke also hopes to develop a more reliable means of diagnosing Lyme disease. The one sure-fire method now is to spot the tell-tale "bull's-eye" rash on the skin. But it's estimated the bull's eye is seen in only about half of the cases, he said.

His research will continue until there's a cure for Lyme disease, Clarke said wryly. But he'd also like to expand to other diseases carried by the same tick.

The second-most common of those is anaplasmosis, Neitzel said. It has a Duluth connection: It first was identified by Dr. Johan Bakken, an Essentia Health physician, in 1994.

"The bottom line is that this tick carries multiple diseases, so they're dangerous," Clarke said. "There's no question."

That's why when Clarke speaks to groups, he also urges them to take fast action if they discover they've been bitten by a blacklegged tick. If you wait to see if you have a bull's eye rash, you've waited too long, he said.

"If you've got a tick that embedded in you, the safest thing is to get yourself in and see a physician and discuss the possibility of getting an antibiotic," Clarke said.

Meanwhile, he's focused on learning everything he can about the blacklegged tick and the diseases it causes.

"It's kind of taken over my life, to tell you the truth," he said.

How to participate

If you're interested in obtaining a tick kit or inviting Benjamin Clarke to speak to your group, you can contact him at bclarke@d.umn.edu or by calling (218) 726-6587.

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