How to Protect Yourself from Tickborne Diseases

To protect yourself against illness in the summer, you should avoid ticks. If one of them bites you, here's what you should know about when and how to take action.

Ticks stealthily attack both animals and humans and feed on their victims’ blood. But the dangers these tiny bloodsuckers pose go far beyond a bite. Ticks can spread serious and even potentially fatal diseases. And the risk is growing.

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Milder winters in some parts of the country are one reason ticks have flourished during recent years and, as they’ve increased in numbers and locations, more cases of tickborne diseases have been reported. The Centers for Disease Control and Prevention (CDC) states there are about 30,000 cases of tick-borne Lyme disease in the U.S. annually.

In all, the CDC lists more than a dozen diseases that ticks can be transmit in many parts of the U.S. Some, like Rocky Mountain spotted fever, which was discovered more than 100 years ago, have long been on doctors’ radars. Others, like Lyme and ehrlichiosis, have been recognized and studied for a few decades.

Other tickborne illnesses, including the Heartland virus, were only identified recently, according to infectious disease specialist Henry Wu, MD, assistant professor of medicine at Emory University.

The diseases tick bites can cause range from mild to life-threatening. Sometimes the symptoms are downright bizarre. For example, Lyme disease often produces a rash that looks like a bull’s eye and the Lone Star tick’s bite can trigger ongoing and potentially fatal allergic reactions to meat.

“Many people who are identified with tickborne illness often don’t recall being bitten by a tick,” said Wu, who is director of the Emory TravelWell Center, which provides travel-related healthcare in collaboration with the CDC. “That’s why it’s important for both patients and their doctors to know what tick-spread diseases are present locally and to think about any potential activities that could be related to tick exposure.”

Here are five of the most worrisome tick-borne diseases in the U.S, where people are in most danger of contracting them, and the symptoms that mean you should seek medical help.

Rocky Mountain spotted fever

Rocky Mountain spotted fever (RMSF) is transmitted to humans after the bite of three infected tick species — the American dog tick (Dermacentor variabilis), the Rocky Mountain wood tick (Dermacentor andersoni), and the brown dog tick (Rhipicephalus sanguineus).

People have contracted RMSF throughout most of the country. In most places with RMSF-carrying ticks, the risk is highest during the summer months, especially June and July.

Typical RMSF symptoms include:

• Fever
• Red eyes (conjunctivitis)
• Headache
• Abdominal pain
• Vomiting
• Muscle pain
• Sometimes, a rash

Doxycycline is an effective treatment, but the antibiotic needs to be started before the fifth day of symptoms. “Rocky Mountain spotted fever can have a high fatality rate if not treated in a timely manner,” Wu pointed out.

Lyme disease

The bacterium Borrelia burgdorferi causes Lyme disease. Bites from blacklegged ticks transmit the disease. Blacklegged ticks thrive in the Northeast and Mid-Atlantic States (from northeastern Virginia to Maine), the North central states (primarily Wisconsin and Minnesota), and on the West Coast, especially in northern California.

Most humans are infected through the bites of hard-to-see immature ticks called nymphs that strike mostly during the spring and summer months. Although adult ticks can also transmit Lyme disease bacteria, they are much larger than nymphs — so they’re easier to spot and remove before they make you sick.

If you have any early symptoms of Lyme — including fever, headache, fatigue, and a skin rash that looks like a bull’s eye — seek medical care. Left untreated, the disease can spread to your heart, joints, and nervous system, and it can cause facial paralysis.

Usually, a course of antibiotics can treat Lyme disease. Some patients continue to suffer from symptoms such as fatigue and joint and muscle aches long after the treatment, however, a condition called post-treatment Lyme disease syndrome.

The Heartland virus

Heartland virus is transmitted via the bites of mosquitoes and sandflies as well as ticks. Cases occur in the Southeast and Midwest, as well as some parts of the Northeast, usually during the months of May through September.

Symptoms of the virus include:

• Fever
• Extreme fatigue
• Headaches
• Muscle aches
• Diarrhea
• Loss of appetite
• Nausea

The virus can produce changes in the immune system and cause blood clots. Most patients require hospitalization for their illness.

Anaplasmosis

Both adult and nymph blacklegged ticks (Ixodes scapularis) and western blacklegged ticks (Ixodes pacificus) cause anaplasmosis if they are infected with the bacterium Anaplasma phagocytophilum.

Most reported cases occur in New York, Connecticut, New Jersey, Rhode Island, Minnesota, and Wisconsin, although a few people in the Southern states have been infected. Infections with anaplasmosis can occur yearround, but they peak in the summer, especially in June and July.

The typical symptoms — fever, headache, chills, and muscle aches — don’t start until a week or two after a tick bites you. Symptoms and lab tests can determine if you have anaplasmosis, which is treated with the antibiotic doxycycline.

Babesiosis

The extremely tiny (about the size of a poppy seed) nymph form of Ixodes scapularis ticks cause babesiosis. Instead of bacteria or viruses, they transmit microscopic Babesia parasites with their bites. People are most likely to come down with babesiosis during the warm months in the Northeast and upper Midwest states.

Symptoms are usually mild. Some people have no symptoms at all. Some people, however, become extremely ill with:

• Fever
• Nausea
• Fatigue
• Chills
• Sweats
• Headaches
• Low blood pressure
• Body aches

Babesia parasites can destroy red blood cells, resulting in hemolytic anemia that can be fatal, especially in people with a weak immune system — such as cancer patients and those who have liver problems or are elderly.

It takes an examination of blood specimens under a microscope to spot Babesia parasites inside red blood cells. The treatment is a course of multiple antibiotics for several weeks.

Ehrlichiosis

Ehrlichiosis is the name for several bacterial diseases transmitted by both adult and nymph Lone Star ticks. It can occur during any time of the year, but the risk is highest during the summer months, typically in June and July.

Symptoms, which develop within a couple of weeks of a tick bite, include muscle pain, fever, headache, fatigue, and sometimes a rash. Even people who were previously healthy can experience additional severe symptoms, such as breathing difficulties and bleeding disorders, which can be fatal.

Blood tests can identify the infection. The antibiotic doxycycline is usually an effective treatment — if it is given early enough.

Avoiding ticks and what to do if you bitten

Ticks, which are technically invertebrate animals called arachnoids and are related to spiders and scorpions, are typically found in and near wooded and grassy areas. The CDC advises sticking to the center of trails if you hike and avoiding tall bushes and vegetation.

When you go outdoors, apply a repellent with DEET to your skin or clothing. You can also put permethrin on clothing and camping gear to keep ticks away.

You should perform daily tick checks if you’ve been working in your yard or participating in other activities in areas where ticks are common. Most tick bites don’t cause pain, so it’s important to search your entire body for ticks using a hand-held or full-length mirror. Check your children and your pets regularly for ticks, too.

If you find ticks on your clothes, the CDC suggests throwing them in the dryer on high to kill the ticks.

If you find a tick on your body or that of a child or pet, you can remove it safely. “A tool such as tweezers should be used to remove ticks by carefully applying steady, gentle upwards pressure while grabbing them as close to the skin surface as possible,” Wu explained. “The idea is to not squeeze the body (and potentially push more infected fluid into your skin), or to twist the tick (and potentially result in mouth parts breaking off and remaining in the skin).”

After removing a tick, the CDC advises thoroughly washing the bite area and your hands with rubbing alcohol, iodine, or soap and water. If the tick is still alive, drown it in alcohol, place it in a sealed bag or container, wrap it tightly in tape, or flush it down the toilet.

“Note the appearance (size, color) of the tick, as well as the time of likely initial exposure and time of removal,” Wu said. “This might be helpful in case illness develops to determine if the tick might be a source. “

While most tick bites won’t make you sick, contact your doctor if you’ve had a bite and signs of a tickborne illness develop days to weeks later.

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