Tick Borne Disease
Tammara Freimark
Tick-borne pathogens can be passed to humans by the bite of infected ticks. Ticks can be infected with bacteria, viruses, or parasites. Some of the most common tick-borne diseases in the United States include: Lyme disease, babesiosis, ehrlichiosis, Rocky Mountain Spotted Fever, anaplasmosis, Southern Tick-Associated Rash Illness, Tick-Borne Relapsing Fever, and tularemia. Other tick-borne diseases in the United States include: Colorado tick fever, Powassan encephalitis, and Q fever. Lyme disease is the most commonly reported tick-borne disease in the United States. In 2010, more than 22,500 confirmed and 7,500 probable cases of Lyme disease were reported to the Centers for Disease Control and Prevention (CDC).
Outdoor workers are at risk of exposure to tick-borne diseases if they work at sites with ticks. Worksites with woods, bushes, high grass, or leaf litter are likely to have more ticks. Outdoor workers in most regions of the United States should be extra careful to protect themselves in the spring, summer, and fall when ticks are most active. Ticks may be active all year in some regions with warmer weather.
Ticks can spread disease. Not all ticks can cause disease and not all bites will make you sick, but as these diseases become more common it's important to learn how to prevent a bite, how to remove a tick and what to do if you think you could have a tick-borne disease.
Lyme disease is the most common disease spread by ticks in New York but there are other serious diseases transmitted by ticks including babesiosis, anaplasmosis, ehrlichiosis, Rocky Mountain Spotted fever, hard tick relapsing fever and Powassan encephalitis.
Blacklegged ticks (commonly known as deer ticks) live in shady, moist areas at ground level. They will cling to tall grass, brush and shrubs, usually no more than 18-24 inches off the ground. They also live in lawns and gardens, especially at the edges of woods and around old stone walls.
In tick-infested areas, your best protection is to avoid contact with soil, leaf litter and vegetation. However, if you garden, hike, camp, hunt, work or otherwise spend time in the outdoors, you can still protect yourself:
If you develop a rash or flu-like symptoms, contact your health care provider immediately. Although not routinely recommended, taking antibiotics within three days after a tick bite may be beneficial for some persons. This would apply to blacklegged (deer) tick bites that occurred in areas where Lyme disease is common and there is evidence that the tick fed for more than one day. In cases like this you should discuss the possibilities with your doctor or licensed health care provider.
Ticks, and the illnesses they can cause, are of increasing concern in New York. Department of Health staff collect ticks from areas across the state and test them for the agents that cause human illness to determine areas where people are at risk of getting a tick-borne illness.
Diseases most commonly transmitted by ticks in NYS include Lyme disease, anaplasmosis, babesiosis, ehrlichiosis, Rocky Mountain Spotted fever, and Powassan encephalitis. Information on other, less common tick-borne diseases that can potentially be transmitted by ticks in NYS can be found by visiting: Ticks (cdc.gov)
To remove an attached tick, grasp with tweezers or forceps as close as possible to attachment (skin) site, and pull upward and out with a firm and steady pressure. If tweezers are not available, use fingers shielded with tissue paper or rubber gloves. Do not handle with bare hands. Be careful not to squeeze, crush or puncture the body of the tick which may contain infectious fluids. After removing the tick, thoroughly disinfect the bite site and wash hands. See or call a physician if there is concern about incomplete tick removal. It is important that a tick be removed as soon as it is discovered. Check after every two or three hours of outdoor activity for ticks attached to clothing or skin.
Ticks feed on small wild rodents, deer, pets, and humans. When a tick becomes infected and continues to feed on various hosts, the bacteria, virus, or parasite can be transmitted. Ticks that are located in the brush and on tall grasses come into contact with humans as we pass through these environments. The ticks can then crawl up sleeves and bite the skin, typically around warm areas under the hair.
Lyme disease, Anaplasmosis, and Babesiosis are spread by the Deer Tick (Ixodes scapularis). Ehrlichiosis is spread by the Lone Star tick (Amblyomma americanum). Rocky Mountain Spotted Fever is spread by the American Dog Tick (Dercacentor variabilis), Rocky Mountain Wood Tick (Dermacentor andersoni), Lone Star tick (Amblyomma americanum), and Brown Dog tick (Rhipicephalus sanguineus). Powassan virus is spread by the Deer Tick (Ixodes scapularis), Ixodes cookie, and Ixodes marxi. Ixodes cookei and Ixodes marxi rarely bite humans.
If you have been bitten by a tick, there is a possibility that have become infected with one of these diseases, but not every tick is a carrier. If you have become infected, symptoms can present themselves between a few days and a few months later, or may not appear at all. The type and severity of symptoms vary with the specific disease, but there are some common symptoms, which include tiredness, body/muscle aches, joint pain, fever, rash, stiff neck, and facial paralysis. Early diagnosis is helpful in successfully treating tick-borne diseases, so it is important to contact your healthcare provider if you are experiencing symptoms.
In Minnesota, there are about a dozen different types of ticks. Not all of them spread disease but it is always best to protect yourself against tick bites. The most common ticks that people come across in Minnesota are the American dog tick (commonly known as the wood tick) and the blacklegged tick (commonly known as the deer tick). The blacklegged tick causes by far the most tickborne diseases in Minnesota. The diseases spread by ticks in Minnesota include:
Minnesota residents who travel to other countries or certain areas of the United States may become sick with one of the tickborne diseases listed above or other tickborne diseases. Avoidance of tick bites and use of tick repellent are recommended when traveling to potential tick habitat within affected areas. For more information on international travel, visit International Travel & Infectious Disease.
Anaplasmosis and ehrlichiosis are two closely related diseases (caused by the bacterium Anaplasma phagocytophilum and Ehrlichia, respectively) that are also transmitted to humans by the bite of an infected tick (a deer tick, in the case of anaplasmosis, or a lone star tick, in the case of ehrlichiosis).
Babesiosis is a malaria-like parasite that infects red blood cells. It typically causes flu-like symptoms but can cause severe and even fatal disease in older people and in those who are immunocompromised.
Rocky Mountain spotted fever is a potentially fatal tick-borne bacterial disease that can be transmitted by the American dog tick, the Rocky Mountain wood tick, and the brown dog tick.
The period of time a tick needs to transmit an infection varies depending on the infectious agent. Powassan virus may be transmitted very quickly. To transmit Borrelia burgdorferi, an infected deer tick needs to feed for at least 36 or even 48 hours before the risk of transmission becomes substantial. Studies have found that about 75% of people who recognize a deer tick bite remove the tick in 48 hours or less.
While patients with Lyme disease may have a headache, fatigue, or joint pain, these are extremely common symptoms of many conditions, such as viral infections or even stress. If a patient has only non-specific symptoms without any signs of Lyme disease, it is far more likely the cause is something other than Lyme disease.
One major sign of Lyme disease is the oval red rash known as erythema migrans. The vast majority of people with Lyme disease (at least 90%) will have this rash. It starts as a flat red spot at the site of the tick bite and gets bigger.
Later-stage signs of Lyme disease can include additional rashes, arthritis with joint swelling (the knee is the joint most commonly involved), facial nerve palsy, an irregular or slow heartbeat (Lyme carditis), or inflammation of the brain or spinal cord.
Many of these illnesses are associated with abnormal results of a standard blood tests (e.g., low white blood cell count and/or platelet count in Anaplasmosis). For many of these tick-borne illnesses, the diagnosis is made based on specific blood tests.
To combat the threat of tick-borne diseases to residents, the Tick-borne Diseases Program of the Monmouth County Mosquito Control Division provides the service of Tick Identification as part of an on-going research program.
Who can use this service?
What will it cost?
How do I remove a tick?
What information can you tell me about my tick?
How long does it take?
Does my tick carry Lyme disease bacteria?
What other diseases could my tick carry?
Will the Tick ID results tell me if I have a disease?
Can I get my tick tested?
How do I remove a tick?
The best way to remove attached ticks is to grasp the tick with fine-tipped tweezers as close to the skin as possible; then pull straight up with a slow, steady force. Try to avoid crushing the tick or destroying it in any way. Clean the area of tick attachment with an antiseptic. Attached ticks should not be removed with noxious chemicals or by burning. This may cause injury to the skin and can increase the risk of transmission by causing the tick to regurgitate disease causing organisms into the body. Removed ticks can be saved in any sealed container to be later identified and tested. Do not place ticks in tape! This makes subsequent identification and testing difficult.
How long does it take?
Tick Identification reports (species, development stage/gender, and engorgement level) are typically sent to you 1-2 days after submitting your tick. However, this can vary based on submission volume and time of year. Please inquire at the time of submission to be sure you have the most up to date information regarding time table.