People who visit local nature preserves or parks have almost certainly seen the bright yellow signs that warn that black-legged ticks -- the kind that can spread dangerous Lyme disease to humans -- are present in the bushes and grass, and visitors should take precautions.
Even if there are no warning signs, however, hikers, gardeners and those simply playing or recreating outdoors should be aware that tick season has arrived, and after a mild winter, there are plenty of the sesame seed-sized little arachnids.
May is national Lyme Disease Awareness Month, but the ticks have already been active for awhile -- they were even out on the warm days of winter, looking to dine on the blood of humans or other mammals.
The same is true for mosquitos, and if you're headed for the Adirondacks this weekend, black flies, the notorious bane of deep-woods hikers this time of year. The state Department of Environmental Conservation specifically warned this week that both are present, along with cautioning people that the popular hiking trails and parking lots in the High Peaks will be crowded.
Medical professionals are well aware that tick season is underway, following warnings in March that it could be a bad season.
"What we're seeing isn't just that more people are coming in, but the season is starting earlier," said Emily Wright, a registered nurse and site administrator at Malta Med Emergency Care in Saratoga County. "It really started back in April, we are having longer more seasonable temperatures so the ticks are out earlier."
More people are coming into local urgent care centers with either embedded ticks or showing symptoms of tick-borne illness. Wright said it may be because there's more public awareness about the risks of Lyme, but it could also be because the number of ticks has increased.
The ticks are tiny, so hunting them down and picking them off requires careful checking of the body. They often crawl on the host body for a significant length of time before finding a place to bite, meaning a thorough check or a shower can help prevent bites.
The ticks, also known as deer ticks, can also carry other dangerous but treatable illnesses, such as anaplasmosis and babesiosis. The symptoms of anaplasmosis and babesiosis are flu-like, not much different from Lyme's early symptoms, but show up more quickly after someone is bitten than Lyme disease, usually within a week or two.
Medical thinking used to be that the Lyme bacteria takes 36 to 48 hours to transmit from tick to host, but with the other diseases ticks also may carry, current thinking is that time shouldn't be wasted if you feel the kind of itch or irritation that an embedded tick can bring on.
"They want you to come in immediately after being bitten by a tick," Wright said.
Today, Lyme bacteria is found in ticks throughout the Capital Region. The lower Hudson Valley remains the hotspot for the disease, as it has been for years, but ticks carrying the bacteria have slowly spread north and west, and are now found from the Adirondacks to west-central New York. The disease was first identified in 1975 in Old Lyme, Connecticut, leading to its common name.
"If you camp, hike, work, or play in wooded or grassy places, you could be bitten by an infected tick," warns the federal Centers for Disease Control on its website. "People living in or visiting New England, the mid-Atlantic states, and the upper Midwest are at greatest risk."
With more than 4,000 people statewide believed to have contracted the illness each year, there's growing awareness. The state budget this year includes $400,000 to be used for Lyme disease research and public education efforts. The state Senate earlier this month passed a bill that would require health insurance companies to cover long-term Lyme treatments, though the state Assembly has not acted on it.
In 2015, according to the CDC, there were 4,314 confirmed or suspected Lyme cases in New York state. Only Pennsylvania (9,028) and New Jersey (4,855) had more of the 38,000 cases reported nationwide. That's the most recent year for which official numbers are available.
Lyme cases began appearing in small numbers in the Capital Region around the year 2000, and in general the numbers have climbed since then. In 2015, Albany County had 157 cases; Saratoga, 124; Montgomery, 44; Schenectady, 38; Schoharie, 33; and Fulton, 24, according to the CDC.
Many advocates, however, believe there are far more cases than those that the CDC confirms. The CDC tracks Lyme cases by patient county of residence, but there's no guarantee patients contracted the disease in their home county.
Schenectady County's public health staff is seeing about the same amount of Lyme activity this spring as last year, said county spokesman Joe McQueen.
Most of the time, Lyme disease first manifests itself as a fever and rash, and in early stages usually responds well to antibiotics If left untreated, the infection has been known to spread to joints, the heart and the nervous system, and many people have it as a chronic condition.
In general, the health care community recommends people with tick bites go to an urgent or emergent care center for treatment rather a hospital emergency room, since emergency rooms are really set up to deal with critical medical conditions, such as heart attacks and strokes, and tick bites can be treated in a more-routine medical setting.
"It is something we can handle here," Wright said of the Malta Med facility, which is a partnership of Saratoga Hospital and Albany Medical Center.
For people who are going to be outside and want to prevent tick bites, repellant products like DEET work. Wright said for those who want to use a natural product, Eucalyptus oil works, and so does peppermint oil.
Lyme experts recommend that ticks that might be on outdoor clothing can be killed by running the clothing in a hot dryer for 10 or 15 minutes.
Advice from DEC on preventing insect bites, which also applies to ticks, includes wearing light-colored long-sleeved shirts and pants, tucking shirts into pants and pant bottoms into socks, and wearing a head net when flying insects are abundant.