By Andrew Tellijohn
Dr. Brooke Moore’s husband had Lyme disease twice in six years after moving to North Oaks, and her dog had been treated for it as well. So, when she received a notice in 2015 that concerned residents should attend a City of North Oaks public meeting on tick-borne illnesses, it caught her attention.
Moore, a physician with a master’s degree in public health, spoke at the meeting, presenting data and taking questions from the mayor and City Council. Though she had not previously been politically active, she received a phone call later in the week asking her to take part in a North Oaks Tick Task Force.
“There were so many residents there that were concerned that I was excited to be a part of it,” she says.
The Council knew the city had a problem with tick-borne illnesses, but they needed to find out the extent of it and figure out how to solve it. The Tick Task Force eventually came up with the North Oaks Integrated Tick Management Program. The initiative was the winner of a League of Minnesota Cities 2019 City of Excellence Award.
Survey of residents
Seeing a need and an impassioned group of residents, Councilmember Rick Kingston immediately called for the task force to study the tick issue.
“It’s always been my belief that you need to have maximum engagement of your community in order to make something like this work,” Kingston says, “especially when something has been relatively controversial.”
The task force started its work with a survey aimed at benchmarking tick-related infection rates in North Oaks compared with the surrounding communities. Conducted in the spring of 2016, the first survey drew responses from 43% of households in the city.
When it revealed that North Oaks reported five times as many cases of tick-borne illnesses as its neighboring communities like Shoreview, White Bear Lake, Hugo, and Vadnais Heights, the task force began educating itself on what was causing the outbreaks and what could be done to prevent them.
Members collaborated with the public, the Minnesota Department of Health, and the University of Minnesota School of Public Health to create the North Oaks Integrated Tick Management Program. The program includes roles for all those involved in solving the tick problem, including the city government, the North Oaks Home Owners’ Association, residents, and local healthcare providers.
The goal was to study related diseases and develop an action plan to control and reduce tick-borne illnesses in the community. The resulting comprehensive program involved residents, city staff, the local medical community, and others. “What we found in the literature is that it didn’t seem like any one thing was enough,” Moore says. “The communities that had the most success had implemented more than one strategy. We decided to attack it from all angles of the tick lifecycle.”
The task force went into education mode, developing informational materials and sending them to all residents through the local newspaper, the city’s website, email blasts, and the North Oaks Facebook page. The task force also began attending events, such as the community fair in June and Farm Fest in September.
“We didn’t think at the time that citizens were properly informed about not only the risks of tick-borne illness, including Lyme disease, but also with methods that were best practices for dealing with it,” says Kingston, who acted as the task force’s liaison with the city.
The information included tips, such as tucking pantlegs into socks and regularly checking yourself, your children, and your pets for ticks after they spend time outside. Additionally, the task force highlighted the need to have pets treated with flea and tick preventives because they are known to carry infected ticks and spread them to humans.
Dealing with deer
Another strategy was to control the deer population. Previous research indicated that the city had 10 times more deer per square mile than it should have, so the task force asked it to increase its elimination efforts.
“We have the perfect habitat for deer,” says City Administrator Mike Robertson. “There’s woods, but also open areas. That creates an ideal setting for deer.”
Killing excess deer had been controversial with residents in the past, Kingston acknowledged, as nature-loving residents were fond of them. But they were deemed a significant portion of the risk. So, the city and its partners set several traps in new areas until the numbers were in an appropriate range.
“The city has been doing that now for decades,” Robertson says. “We just ramped it up.”
Attacking the ticks directly
The North Oaks Home Owners’ Association, which has responsibility for maintaining all common land and recreation sites in the city, was asked to use pesticide to reduce the prevalence of ticks. Chemical treatment of ticks had not been popular, Kingston says. But his experience as a clinical toxicologist came in handy in educating stakeholders on safer methods of doing it.
The association was also tasked with ensuring that trails are regularly groomed so vegetation is not falling onto paths.
“That’s what happens,” Kingston says. “The deer tick essentially goes onto the long, grassy leaves and as you walk by and brush against it, they attach to your clothing and find their way to your skin.”
The task force also sent letters to local health care officials to inform them of the prevalence of Lyme disease, so they would be aware of the increased risk in the area. They became familiar with what symptoms to look for so they could aid in early diagnosis of Lyme cases, which is vital in eliminating the most serious symptoms. “You’re not going to eliminate Lyme disease,” Kingston says. “What you are going to be able to do is decrease the possibility for Lyme disease to affect the health and safety of our residents.”
The efforts have paid off. Follow-up surveys, which the task force intends to do annually, have subsequently shown decreases in the number of reported Lyme disease cases from 43 in 2016 to 19 in 2018, a reduction of nearly 60%.
Robertson, who is retiring soon, called it one of the most productive task forces he’s been a part of since his career began. “I have never seen a task force or commission get formed and get so much done in such a short time,” he says.
Kingston credits citizen involvement. He was glad to partner with Moore and gratified by how much of the community took part in early meetings.
“There were so many people that showed up,” he says. “The No. 1 thing is they wanted to see something get done.” The task force remains in place, though its meetings are far less frequent. The city has budgeted funding to ensure it has the resources necessary to continue surveying residents on Lyme disease occurrences and to make sure the community plan stays current.
“You have to monitor what the success of the program is,” Kingston says. “You always have new residents moving in and they may or may not be familiar with the challenges of living in a heavily wooded community like ours. It’s really top of mind. It’s a program that will continue, especially with the increased incidents of tick-borne illnesses we’re seeing on a national level.”
Kingston says it’s been rewarding being part of an initiative that has helped city residents and he’s glad that work will continue in the future.
Meanwhile, Moore and Kingston say that while much has been accomplished, city officials and task force members say they want to further their efforts by making them accessible to other communities.
“We want to write something up and get it published,” Moore says. “That’s probably the next step.”
In the meantime, her husband has recovered and is doing well. She, too, says the entire experience has been very gratifying.
“I joke that I’m using my master’s more than anybody ever thought I would,” she says. “It’s been good to be involved in the community and to have seen the response and impact. I definitely would consider participating in something similar in the future.”
Andrew Tellijohn is a freelance writer.