As Lyme disease Awareness Month draws to a close, levels of some tick-borne illnesses in Missouri are on the rise.

While Lyme infections in Missouri are not as dramatic as they are in northeastern states, officials said there is still cause for concern. Ticks cause a higher number of human diseases than any other insect in the U.S.

The most common tick related diseases in Missouri are Rocky Mountain spotted fever, ehrlichiosis, tularemia, and Lyme, along with newer viruses such as Heartland and Bourbon. Studies show the frequency of infections are increasing.

Dr. Ram Raghavan, associate professor of veterinary pathobiology at the University of Missouri Veterinary Medical School, said there are several reasons why.

"Some of these suburban areas are built around wooded backyards, and people are interacting with the wild more than they used to be in the past," Raghavan explained. "We are also getting very clever and very accurate in the way we detect diseases, there is increased awareness, not only among practitioners, but also patients."

He pointed out climate change is also making winters warmer and extending tick season. When outdoors experts recommend hikers stay in the center of trails and avoid tall grass and brush. Recommendations also include wearing clothing treated with permethrin or insect repellent containing at least 20% DEET, to check clothing for ticks, showering after being outdoors, then conducting a thorough tick check.

Raghavan noted in addition to the many bacterial pathogens transmitted by ticks, there are also threats from emerging viruses.

"Recently, in the past 10 years or so, a couple of new tick-borne viruses emerged in our area here in the central Midwest," Raghavan outlined. "One of them is called Heartland virus, and another one is Bourbon virus. Heartland and Bourbon viruses can actually kill somebody and there have been a few fatalities that have occurred over the years."

The Missouri Department of Health reports the majority of Heartland virus patients required hospitalization to recover. Bourbon virus is named after Bourbon County, Kansas, where the first U.S. incidence of the disease occurred.

A relatively new condition associated with tick-borne illness is Alpha-Gal Syndrome, when people become allergic to red meat. Raghavan said it is transmitted by the most common tick in the state.

"Meat allergy is a significant problem, and it is transmitted by the tick called the Lone Star tick, which is actually the most abundant tick in our region," Raghavan stressed. "Chances are, if someone is ever going to see a tick on them, it's most likely going to be a Lone Star tick. So we need to be watching out for that."

Ticks cannot fly or jump, nor do they drop from trees. They stay relatively close to the ground where they can access soil moisture which they need to stay alive. After rain, the wet conditions and higher humidity will bring ticks out in greater numbers.


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After more than 50 years of use, some Michigan lawmakers say naloxone may not be the best choice in an overdose situation.

Naloxone is sometimes called the "Lazarus drug" because of its powerful ability to seemingly resurrect people after a drug overdose.

Sen. Kevin Hertel, D-St. Clair Shores, and some of his colleagues have introduced a bill which would open the door for what they say are more costly, but more powerful, antidotes.

"Given the prevalence of fentanyl in our communities, and how much stronger some of these drugs that we're now seeing are, we believe -- and in talking with others -- that there should be other tools to respond to an overdose," Hertel explained. "To make sure we're doing everything we can to save somebody's life."

Not everyone is on board with the proposed legislation, Senate Bill 542. Opponents argued the more expensive naloxone alternatives are not necessary, and using them would only increase profits for the pharmaceutical industry.

Jonathan Stoltman, director of the Opioid Policy Institute in Grand Rapids, said while the naloxone alternatives do help in overdose situations, they can also cause nasty side effects.

"The newer approaches, they put people into more severe withdrawal," Stoltman pointed out. "That's a pretty profound negative side effect. The one approach is very inexpensive and works great; the other approach is far more expensive and has this strong negative side effect."

Sponsors of the bill say they're hoping to give Michigan residents a chance to chime in on the issue in a public hearing sometime in June. Michigan saw more than 3,000 opioid overdose deaths in 2021.


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New Mexico saw record enrollment numbers for the Affordable Care Act this year and is now setting its sights on lowering out-of-pocket costs - those not reimbursed by insurance. More than 56,000 New Mexicans are enrolled in a medical health insurance plan on the state exchange - an increase of 12,000 people overall.

Colin Baillio, deputy superintendent with the state's Office of Insurance, said the state has boosted its outreach and made efforts to improve the overall consumer experience.

"We saw a 40% year-over-year increase, and New Mexico saw the biggest percentage increase during the open-enrollment period among all of the state-based marketplaces," he explained

Part of the enrollment increase is due to what's called the "unwinding" - a federal directive that required all states to redetermine Medicaid eligibility following a three-year pause on checks during the COVID pandemic. He said by using expanded tools made available by the federal and state government, 8% of New Mexico's population is now uninsured - down from 23% in 2010.

Following approval by lawmakers in the 2024 legislative session, the New Mexico governor signed seven health care-related bills into law - one of which requires annual reporting of prescription drug pricing. Baililo said the Affordable Care Act built the foundation that has allowed the state to pursue additional affordability initiatives.

"I'm really glad to see that there's so much interest in the next step of health reform, really leaning into these out-of-pocket cost issues and making it easier for people to afford to stay covered and see their doctors," he continued.

Two years ago, the state also passed a one-of-a-kind law that did away with behavioral health co-pays for people in certain insurance plans.

New York's medical aid-in-dying bill is gaining further support. The Medical Society of the State of New York is supporting the bill. New York's bill allows terminally ill people with only six months to live to use this option, with safeguards requiring two physicians' approval.

The bill's Assembly sponsor Amy Paulin, D-Westchester, said despite the growing support, other hurdles lie ahead.

"Now we have what I believe, if it came to the floor, a majority. There's still a hesitation on the part of leadership. You know, we need members to assure leadership that they no longer have reservations," she said.

Other newly resolved concerns center on making sure insurance companies and doctors who don't support this aren't held liable. She's optimistic the bill will pass after nine years in the Legislature. New York would be the 11th state along with Washington, D.C. to have medical aid in dying legislation.

Corinne Carey, senior New York campaign director with Compassion and Choices finds the pandemic drew a vivid picture of a person's end-of-life experience. There were images of people dying on ventilators, apart from loved ones, and unable to communicate. She said people began thinking about a "good death."

"And, what is a good death is being surrounded by loved ones, having some measure of control, experiencing the touch of your loved ones, and being the one in the driver's seat," she explained.

Now people have different options for end-of-life care, each of which presents various challenges. Polls show medical aid in dying has garnered considerable support since being introduced in 2015. A 2022 Compassion and Choices poll finds 57% of nurses support medical aid in dying professionally, although fewer support it personally.