What actually happens when a tick bites you—and how can something so small manipulate the human immune system long enough to feed and potentially transmit disease?
Tick-borne disease researcher Monica Cipriani joins Rich Johannesen, co-founder of Tick Boot Camp Podcast, for an in-depth exploration of the biology of the tick bite, Lyme disease, alpha-gal syndrome, tick saliva, immune modulation, and tick-borne disease transmission.
This conversation was recorded in person at the Tick Boot Camp studio immediately after Monica led our team on a tick-dragging field day across Long Island, where we collected hundreds of ticks from a farm, public trail, and residential environment—including clusters of nearly invisible lone star tick larvae known as “tick bombs,” blacklegged ticks, and an invasive Asian longhorned tick.
See what we found while dragging for ticks on Long Island.
From Lyme Disease Caregiver to Tick-Borne Disease Researcher
Monica’s work is deeply personal.
With bachelor’s and master’s training in microbiology, she transitioned into epidemiology to focus on research, public health, education, advocacy, and policy surrounding tick-borne diseases.
Her mother endured years of unexplained symptoms—including hives, joint pain, brain fog, and cognitive changes—before eventually receiving a Lyme disease diagnosis. Years later, Monica watched her young daughter develop concerning neurological, behavioral, sleep, and physical symptoms while living in Kentucky. After numerous medical appointments, her family traveled to New York, where her daughter was diagnosed with Lyme disease.
Those experiences helped shape Monica’s determination to study why tick-borne diseases can be missed, misclassified, and misunderstood—and how research can help patients receive answers sooner.
How Does a Tick Find and Bite a Human?
Monica takes listeners inside the remarkable biology of ticks.
Ticks are arachnids, not insects, and different species can act as vectors for different pathogens. The episode explores three important species:
- Blacklegged tick ( Ixodes scapularis ) — associated with Lyme disease and other tick-borne infections
- Lone star tick ( Amblyomma americanum ) — strongly associated with alpha-gal syndrome and capable of transmitting several pathogens
- American dog tick ( Dermacentor variabilis ) — another common human-biting tick
Using a specialized sensory structure called the Haller’s organ, ticks can detect environmental signals associated with potential hosts.
Some ticks wait for a host to pass close enough to grab onto, while lone star ticks can be particularly aggressive in seeking hosts.
Once aboard, ticks crawl toward locations where they can establish a successful blood meal.
Tick Saliva: An Evolutionary Tool for Feeding
One of the most fascinating parts of the conversation focuses on tick saliva.
A tick needs to remain attached long enough to complete its blood meal, but the human body has numerous defenses designed to detect an injury or foreign organism.
Monica explains how components of tick saliva can interfere with those defenses.
The discussion explores how ticks can:
- Reduce pain at the bite site
- Suppress itching and histamine-related responses
- Interfere with blood clotting
- Affect blood vessels and platelet activity
- Modulate local immune responses
- Anchor themselves using specialized mouthparts and cement-like substances
- Alter salivary molecules throughout the feeding process
Rather than simply suppressing the immune system completely, Monica describes how ticks can modulate the local immune environment in ways that help preserve viable tissue and allow feeding to continue.
That means a tick bite isn’t simply a tiny wound through which a pathogen enters. The tick itself may help create the biological environment in which transmission occurs.
Why Tick-Borne Disease Is About More Than Lyme
Ticks may acquire microorganisms during earlier blood meals from wildlife and subsequently expose another host during feeding.
The conversation examines the ecological relationship among ticks, wildlife, pathogens, and humans and why understanding the vector is critical to understanding tick-borne illness.
Monica and Rich discuss Lyme disease and Borrelia, along with other tick-associated threats including:
- Ehrlichiosis
- STARI
- Powassan virus
- Bourbon virus
- Heartland virus
- Alpha-gal syndrome
The discussion also explores why the length of attachment matters while emphasizing an important point: people frequently do not know exactly when a tick attached.
Larval and nymphal ticks can be extraordinarily difficult to see. During Tick Boot Camp’s Long Island field work, the team collected larvae so small that hundreds looked almost like specks of pepper.
Alpha-Gal Syndrome and the Lone Star Tick
A major focus of Monica’s current research is alpha-gal syndrome (AGS), sometimes called the red meat allergy.
Alpha-gal syndrome is associated with tick bites—particularly bites from the lone star tick in the United States—and can cause an immune reaction to alpha-gal, a sugar found in most non-primate mammals and mammal-derived products.
For some people, reactions may be relatively mild. For others, exposure can potentially result in severe allergic reactions, including anaphylaxis.
But one of the biggest scientific questions remains:
Why can two people be bitten by similar ticks and have completely different outcomes?
Monica discusses the unanswered questions surrounding individual immune responses, sensitization, demographics, environmental exposures, and the unusual way a tick bite introduces alpha-gal alongside a complex mixture of salivary molecules.
Her research aims to better understand those patterns and the patient experience surrounding this emerging condition.
Learn more about Monica Cipriani’s epidemiology and alpha-gal research.
Lyme Disease, Research, and the Questions Patients Are Asking
The episode also tackles difficult questions that remain important to the Lyme community, including the possibility of congenital transmission of Lyme disease.
Monica explains why researchers must remain willing to investigate unanswered questions rather than dismiss possibilities before adequate research exists.
As both a scientist and a mother whose family has been affected by Lyme disease, she brings a rare perspective to the conversation: understanding the scientific process while also understanding what it feels like when a patient or parent believes something important is being missed.
Why Better Tick Research Matters
Monica argues that improving Lyme and tick-borne disease care requires stronger communication among researchers, public health professionals, clinicians, and patients.
Research ultimately helps create the evidence clinicians can use to recognize disease, improve diagnosis, develop treatments, and establish better standards of care.
For Monica, that work comes back to one goal: helping people feel heard while asking the scientific questions that could lead to better answers.
From the Field to the Tick Boot Camp Studio
This interview capped an extraordinary day of hands-on tick research on Long Island.
Monica, her husband Dr. Andre Ene, Tick Boot Camp co-founders Matt Sabatello and Rich Johannesen, filmmaker Reece Robinson, and the production team dragged for ticks at Malik Farms in Coram, the Rails to Trails path in Rocky Point, and a residential property and nearby groundwater recharge basin.
The team encountered hundreds of lone star tick larvae, blacklegged ticks, multiple “tick bombs,” and an invasive Asian longhorned tick identified by Monica.
The experience made the subject of this interview tangible: ticks capable of affecting human and animal health aren’t only deep in the woods. They can be present where people live, work, walk, farm, exercise, and spend time with their families.
Explore the Long Island tick-dragging field day, photos, videos, species, and findings.
