Black-legged nymphs. Blood meals. Bull’s-eye rashes. Dead-end hosts. Blood-thirsty ticks using deer as “discos.”

There are few things in the natural world that strike more fear into the heart of an East End resident than the tiny parasites lurking in woodlands, gardens and — yes, backyards, even neatly manicured ones.

At their most dangerous, they are smaller than a poppy seed. They can survive winter. They can feed unnoticed for days. Some carry Lyme disease. Others can trigger a severe red-meat allergy.

And the threat is growing more complicated every year, according to Dr. Scott R. Campbell, chief of the Suffolk County Department of Health Services’ Arthropod-Borne Disease Laboratory.

Lyme disease alone has exploded in Suffolk County over the past decade, with suspected cases rising from 654 in 2014 to 3152 in 2024, state records show. Campbell said 2025 saw 3200 suspected cases countywide.

Suffolk County recorded more suspected alpha-gal syndrome cases than any other county in the nation between 2017 and 2022, according to CDC data, although several counties in the South had significantly higher per-capita rates of the disease.

Speaking Monday evening at a Mattituck-Laurel Civic Association event at Veteran’s Beach, Campbell — one of the leading regional experts on tick-borne disease — took residents deep into the hidden ecology of ticks, explaining how the creatures live, feed, reproduce and spread disease across Long Island.

And, yes, it was gross.

But it was fascinating, too.

Campbell translated decades of entomological research into plain language, mixing chilling statistics with memorable observations. At one point, explaining how adult ticks congregate on deer to mate, he said that “it’s kind of like a disco. That’s where they meet.”

The Big Three ticks

Campbell said three species account for nearly all medically significant tick encounters in Suffolk County: Lone Star ticks, American dog ticks and black-legged ticks, also known as deer ticks.  

Each variation progresses through the same basic life cycle — egg, larva, nymph and adult — but each carries different pathogens and presents different risks. And the most dangerous stage isn’t the largest.

The black-legged nymph, roughly the size of a poppy seed, is responsible for more human disease than any other tick stage or species on Long Island, Campbell said. But since it’s so tiny, most people miss it.

Lyme disease remains the biggest threat

The black-legged tick carries Lyme disease, anaplasmosis, babesiosis, Powassan virus disease and Borrelia miyamotoi disease, a relapsing fever infection.

Lyme disease cycles like “ping pong” between two animals: mice and deer, Campbell said. White-footed mice serve as reservoirs for the bacteria that causes Lyme disease. Larval ticks feed on infected mice, acquire the pathogen and carry it into later life stages.

Humans are essentially “dead-end hosts.” We can become infected, but we do not continue the disease cycle. Deer are different. Adult ticks use deer as reproductive hosts. Male and female ticks meet and mate on deer, and females then drop into leaf litter to lay eggs.

One female black-legged tick can produce roughly 2,000 eggs. A female Lone Star tick can produce as many as 6,000.

Among the more unsettling facts Campbell shared was that a single tick can carry more than one disease-causing pathogen. “It’s relatively rare,” he said, estimating co-infection rates at around 10% or less.

Still, it means a person could theoretically contract multiple illnesses from a single bite.

The possibility highlights why physicians increasingly test for more than Lyme disease when patients develop symptoms following tick exposure.

The rise of alpha-gal syndrome

Few tick-related illnesses have captured public attention recently like alpha-gal syndrome, the condition that can leave people allergic to red meat.

A 2023 CDC analysis of alpha-gal testing data identified 3,746 suspected cases in Suffolk County between 2017 and 2022, the highest county total in the nation.

Remarkably, about 4% of all suspected U.S. alpha-gal cases were associated with Suffolk County residents, according to the agency.

Unlike Lyme disease, alpha-gal syndrome is not caused by a bacterium or virus. Instead, it results from an allergic response to a carbohydrate molecule found in tick saliva.

Repeated exposure through tick bites can eventually trigger an immune response that causes reactions when a person eats beef, pork or other meat.

Campbell said the delayed nature of the reaction often confuses patients. People may eat a hamburger for dinner and feel perfectly fine. Hours later, they wake up covered in hives or suffering gastrointestinal distress.

“It’s very indicative of the delay,” he said.

The good news, he told the crowd at Veteran’s Beach, is that alpha-gal syndrome is not necessarily permanent. For some people, avoiding further tick bites and reducing exposure allows antibody levels to gradually decline over time.

Tick season never ends

One of Campbell’s most important points challenged a common misconception: that tick season ends with the first frost. Whenever temperatures climb above roughly 40 degrees, adult black-legged ticks become active. That means people can be bitten in January, February or March just as easily as in June.

“Basically all year long in Suffolk County you’re at risk of having a tick bite,” he said, adding that it’s particularly important information for gardeners, dog owners and winter hikers who may let down their guard during colder months.

More bites happen in backyards than in the woods

Perhaps the biggest surprise of the evening involved where most tick encounters occur. Not on hiking trails, or deep in the woods, but in your own backyard — for a simple reason.

When people head into the woods, they typically take precautions. They wear repellents, long pants and protective clothing. When they step outside to weed a flower bed, mow the lawn or pick tomatoes from the garden, they often do not.

“Most people probably get bitten in their yard than anywhere else,” Campbell said.

Hidden tick highways: pachysandra, English ivy

Campbell also talked about landscaping choices that inadvertently create ideal tick habitats, with pachysandra and English ivy at the top of the list. The dense ground cover provides excellent shelter for rodents, particularly mice, which use the vegetation as protected travel corridors beneath the watchful eyes of hawks and owls.

Those rodents, in turn, support tick populations.

“If I show up and there’s pachysandra, all I do is take the flag and walk through it,” Campbell said, referring to the cloth drags scientists use to collect ticks. “I’ve always found black-legged ticks in that.”

Leaf litter, overgrown vegetation and brush piles create similar conditions by trapping moisture and providing cover for hosts.

Ticks come from below, not above

Another widespread myth Campbell debunked involves the belief that ticks drop from above. He said they generally begin at ground level. They climb grasses and low vegetation and wait with their front legs extended in a behavior known as “questing.” When a person or animal brushes past, the tick grabs on.

“Ticks don’t drop from trees,” Campbell said.

Instead, they usually start their journey on shoes, socks and lower pant legs before working upward in search of a feeding site.

And he said they are “active 24/7,” meaning a midnight trip outside can carry the same risk as a morning walk.

Built for the job

Campbell’s most fascinating description involved the mechanics of how ticks actually feed.

Ticks possess barbed mouthparts designed to anchor securely into skin, he said. They secrete a cement-like substance that helps hold them in place. Their saliva contains anesthetics that prevent hosts from feeling the bite and anticoagulants that keep blood flowing.

Despite their tiny brains, Campbell said, “they were made for this.”

The dryer kills ticks

If you’ve spent time outdoors and suspect ticks may be present, Campbell recommends placing clothes directly into the dryer. Not the washing machine.

“Hot water doesn’t kill the ticks, bleach doesn’t kill the ticks, and detergent doesn’t kill the ticks,” he said.

Ten minutes in a dryer, however, will kill them, because they thrive on moisture.

Remove them quickly — and correctly

Campbell urged residents not to panic if they discover an attached tick. He counseled using fine-tipped tweezers to grasp the tick as close to the skin as possible and pull straight upward.

“Don’t twist it, just grasp it and pull straight up,” he said. “All the germs are in the gut  … You don’t want to squeeze it [and] act like a hypodermic needle and squeeze all that those contents into your bite. Just grab it, pull straight up.

“Don’t use gasoline, Vaseline or matches. And don’t use matches and gasoline!” he added with a grin.

Once removed, place the tick in a small container of rubbing alcohol or hand sanitizer, which will kill it. Label it with the date and location of the bite, and monitor for symptoms. The sooner a tick is removed, the lower the risk of disease transmission.

For Lyme disease, Campbell said, transmission generally requires about 36 hours of attachment. That window gives people a critical opportunity to prevent infection through prompt detection and removal.

If you want a tick identified by photo, or have questions about ticks or tick-borne diseases in Suffolk County, email them to: Tick.Prevention@suffolkcountyny.gov