Tick-borne disease

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Tick-borne disease
A feeding tick
SpecialtyInfectious disease

Tick-borne diseases, which afflict humans and other animals, are caused by infectious agents transmitted by tick bites.[1] They are caused by infection with a variety of pathogens, including rickettsia and other types of bacteria, viruses, and protozoa.[2] The economic impact of tick-borne diseases is considered to be substantial in humans,[3] and tick-borne diseases are estimated to affect ~80 % of cattle worldwide.[4]

As of 2020 18 tick-borne pathogens have been identified in the United States according to the Centers for Disease Control[5] and at least 27 are known globally.[6][7][8] New tick-borne diseases have been discovered in the 21st century, due in part to the use of molecular assays and next-generation sequencing.[9]

The occurrence of ticks and tick-borne illnesses in humans is increasing.[10] Tick populations are spreading into new areas, due in part to the warming temperatures of climate change.[6][11] Tick populations are also affected by changes in the populations of their hosts (e.g. deer, cattle, mice, lizards) and those hosts' predators (e.g. foxes). Diversity and availability of hosts and predators can be affected by deforestation and habitat fragmentation.[6]

Because individual ticks can harbor more than one disease-causing agent, patients can be infected with more than one pathogen at the same time, compounding the difficulty in diagnosis and treatment.[2] As the incidence of tick-borne illnesses increases and the geographic areas in which they are found expand, health workers increasingly must be able to distinguish the diverse, and often overlapping, clinical presentations of these diseases.[5]


a) Tick bite mark, ten days old, b) a scarred tick bite mark, c) a recent tick bite mark.


  • Lyme disease or borreliosis
  • Relapsing fever (tick-borne relapsing fever, different from Lyme disease due to different Borrelia species and ticks)
    • Organisms: Borrelia species such as B. hermsii, B. parkeri, B. duttoni, B. miyamotoi
    • Vector: Ornithodoros species
    • Regions : Primarily in Africa, Spain, Saudi Arabia, Asia in and certain areas of Canada and the western United States
    • Symptoms: Relapsing fever typically presents as recurring high fevers, flu-like symptoms, headaches, and muscular pain, with less common symptoms including rigors, joint pain, altered mentation, cough, sore throat, painful urination, and rash[15]
    • Treatment: Antibiotics are the treatment for relapsing fever, with doxycycline, tetracycline, or erythromycin being the treatment of choice.[16]
  • Typhus Several diseases caused by Rickettsia bacteria (below)
  • Rocky Mountain spotted fever
  • Helvetica spotted fever
    • Organism: Rickettsia helvetica
    • Region(R. helvetica): Confirmed common in ticks in Sweden, Switzerland, France, and Laos[17]
    • Vector/region(s)#1: Ixodes ricinus is the main European vector.[17]
    • Symptoms: Most often small red spots, other symptoms are fever, muscle pain, headache and respiratory problems[17]
    • Treatment: Broad-spectrum antibiotic therapy is needed, phenoxymethylpenicillin likely is sufficient.[17]
  • Human granulocytic anaplasmosis (formerly human granulocytic ehrlichiosis or HGE)
  • Bartonella: Bartonella transmission rates to humans via tick bite are not well established [18] but Bartonella is common in ticks. For example: 4.76% of 2100 ticks tested in a study in Germany [19]
  • Tularemia
    • Organism: Francisella tularensis, A. americanum
    • Vector: D. variabilis, D. andersoni
    • Region (US): Southeast, South-central, West, widespread


Isolation of severe fever with thrombocytopenia syndrome virus[20]




  • Alpha-gal allergy - Alpha-gal syndrome caused by immune reaction to the Alpha-gal sugar molecule introduced by ticks. The immune reaction can leave people with an allergy to red meat.

Risk assessment

For a person or pet to acquire a tick-borne disease requires that the individual gets bitten by a tick and that the tick feeds for a sufficient period of time. The feeding time required to transmit pathogens differs for different ticks and different pathogens. Transmission of the bacterium that causes Lyme disease is well understood to require a substantial feeding period.[26] In general, soft ticks (Argasidae) transmit pathogens within minutes of attachment because they feed more frequently, whereas hard ticks (Ixodidae) take hours or days, but the latter are more common and harder to remove.[27]

For an individual to acquire infection, the feeding tick must also be infected. Not all ticks are infected. In most places in the US, 30-50% of deer ticks will be infected with Borrelia burgdorferi (the agent of Lyme disease). Other pathogens are much more rare. Ticks can be tested for infection using a highly specific and sensitive qPCR procedure. Several commercial labs provide this service to individuals for a fee. The Laboratory of Medical Zoology (LMZ), a nonprofit lab at the University of Massachusetts, provides a comprehensive TickReport [28] for a variety of human pathogens and makes the data available to the public.[29] Those wishing to know the incidence of tick-borne diseases in their town or state can search the LMZ surveillance database.[29]



Ticks tend to be more active during warmer months, though this varies by geographic region and climate. Areas with woods, bushes, high grass, or leaf litter are likely to have more ticks. Those bitten commonly experience symptoms such as body aches, fever, fatigue, joint pain, or rashes. People can limit their exposure to tick bites by wearing light-colored clothing (including pants and long sleeves), using insect repellent with 20%–30% N,N-Diethyl-3-methylbenzamide (DEET), tucking their pants legs into their socks, checking for ticks frequently, and washing and drying their clothing (in a hot dryer).[30][31]

According to the World Health Organization, tick-to-animal transmission is difficult to prevent because animals do not show visible symptoms; the only effective prevention relies on killing ticks on the livestock production facility.[32]

Tick removal

Tick removal. Compressing the body of the tick could cause more toxins to be injected into the host.

Ticks should be removed as soon as safely possible once discovered. They can be removed either by grasping tweezers as close to the mouth as possible and pulling without rotation; some companies market grooved tools that rotate the hypostome to facilitate removal. Chemical methods to make the tick self-detach, or trying to pull the tick out with one’s fingers, are not efficient methods.[27]


In general, specific laboratory tests are not available for rapid diagnosis of tick-borne diseases. Due to their seriousness, antibiotic treatment is often justified based on clinical presentation alone.

See also


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  2. 2.0 2.1 Kumar, Manish; Sharma, Aniket; Grover, Prashant (13 February 2019). "Triple Tick Attack". Cureus. 11 (2): e4064. doi:10.7759/cureus.4064. PMC 6464285. PMID 31016091.
  3. Mac, Stephen; da Silva, Sara R.; Sander, Beate (4 January 2019). "The economic burden of Lyme disease and the cost-effectiveness of Lyme disease interventions: A scoping review". PLOS ONE. 14 (1): e0210280. doi:10.1371/journal.pone.0210280. ISSN 1932-6203. PMC 6319811. PMID 30608986.
  4. Rochlin, Ilia; Toledo, Alvaro (1 June 2020). "Emerging tick-borne pathogens of public health importance: a mini-review". Journal of Medical Microbiology. 69 (6): 781–791. doi:10.1099/jmm.0.001206. ISSN 0022-2615. PMC 7451033. PMID 32478654.
  5. 5.0 5.1 Tick-Borne Disease Working Group. 2020 Report to Congress (PDF). Washington, D.C.: U.S. Department of Health and Human Services. 2020. Archived (PDF) from the original on 24 January 2022. Retrieved 4 March 2022.
  6. 6.0 6.1 6.2 Chrobak, Ula (3 February 2022). "Lyme and other tick-borne diseases are on the rise. But why?". Knowable Magazine. doi:10.1146/knowable-020222-1. Archived from the original on 26 February 2022. Retrieved 4 March 2022.
  7. Paddock, Christopher D.; Lane, Robert S.; Staples, J. Erin; Labruna, Marcelo B. (21 September 2016). Changing paradigms for tick-borne diseases in the Americas. National Academies Press (US). Archived from the original on 20 January 2022. Retrieved 4 March 2022.
  8. Zhao, Guo-Ping; Wang, Yi-Xing; Fan, Zheng-Wei; Ji, Yang; Liu, Ming-jin; Zhang, Wen-Hui; Li, Xin-Lou; Zhou, Shi-Xia; Li, Hao; Liang, Song; Liu, Wei; Yang, Yang; Fang, Li-Qun (17 February 2021). "Mapping ticks and tick-borne pathogens in China". Nature Communications. 12 (1): 1075. doi:10.1038/s41467-021-21375-1. ISSN 2041-1723. PMC 7889899. PMID 33597544. Archived from the original on 6 May 2022. Retrieved 4 March 2022.
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  15. Relapsing fever at eMedicine.
  16. Relapsing fever~treatment at eMedicine.
  17. 17.0 17.1 17.2 17.3 Lindblom A, Wallménius K, Nordberg M, Forsberg P, Eliasson I, Påhlson C, Nilsson K (March 2013). "Seroreactivity for spotted fever rickettsiae and co-infections with other tick-borne agents among habitants (sic) in central and southern Sweden". European Journal of Clinical Microbiology & Infectious Diseases. 32 (3): 317–323. doi:10.1007/s10096-012-1742-3. PMC 3569577. PMID 22961007.
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External links

External resources