Tick-borne disease

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Tick-borne disease
Other names: Tick-borne illnesses
A feeding tick
SpecialtyInfectious disease
TypesLyme, babesiosis, anaplasmosis, ehrlichiosis, Rocky Mountain spotted fever[2]
CausesCaused by viruses, bacteria, or parasites[3]
Diagnostic methodSymptoms and blood test[4]
Differential diagnosisMeasles, meningococcemia, influenza, enterovirus, mononucleosis, viral hepatitis, typhoid fever, thrombotic thrombocytopenic purpura[5]
TreatmentDoxycycline (among others)[4]

Tick-borne diseases are infections spread by tick bites. They are caused by infection with a variety of pathogens, including rickettsia and other types of bacteria, viruses, and protozoa.[6] The cost is substantial,[7] affecting ~80 % of cattle worldwide.[8]

As of 2020 18 tick-borne pathogens have been identified in the United States[9] and at least 27 are known globally.[10][11][12] New diseases have been discovered in the 21st century, by molecular assays and next-generation sequencing.[13]

Ticks and tick-borne illnesses are increasing.[14] Tick are spreading into new areas, due in part to the warming temperatures.[10][15] 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.[10]

As individual ticks can harbor more than one disease-causing agent, people can be infected with more than one disease at the same time, compounding the difficulty in diagnosis and treatment.[6] Rates of illness are increasing and the geographic areas in which they are found expand.[9]


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


  • Lyme disease or borreliosis[16][17][18][19]
  • Relapsing fever (tick-borne relapsing fever, different from Lyme disease due to different Borrelia species and ticks)[20][21][22]
    • 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
    • Treatment: Antibiotics are the treatment for relapsing fever, with doxycycline, tetracycline, or erythromycin being the treatment of choice.
  • Typhus Several diseases caused by Rickettsia bacteria [23]
  • Rocky Mountain spotted fever[24]
  • Helvetica spotted fever[25][26]
    • Organism: Rickettsia helvetica
    • Region(R. helvetica): Confirmed common in ticks in Sweden, Switzerland, France, and Laos
    • Vector/region(s)#1: Ixodes ricinus is the main European vector.
    • Symptoms: Most often small red spots, other symptoms are fever, muscle pain, headache and respiratory problems
    • Treatment: Broad-spectrum antibiotic therapy is needed, phenoxymethylpenicillin likely is sufficient.
  • Human granulocytic anaplasmosis (formerly human granulocytic ehrlichiosis or HGE)[27]
  • Bartonella: Bartonella transmission rates to humans via tick bite are not well established [28] but Bartonella is common in ticks. For example: 4.76% of 2100 ticks tested in a study in Germany [29]
  • Tularemia[30]
    • 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[31]


Babiesa spp.



  • 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.[45]


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.[46][47]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.[48]

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 . 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 , a nonprofit lab at the University of Massachusetts, provides a comprehensive TickReport and makes the data available to the public.[49][47]

Immunomodulation mechanism

In terms of the mechanism via which infection takes hold we find that ticks upon infestation are able to change systemic immune defenses of their hosts. [50][51]

The ticks saliva induces immunomodulation via downregulation of Th1 cytokines and upregulation of Th2 cytokines, as a consequence the host antibody responses is suppressed. This permits pathogen transmission,[50] which replicate in different skin cells (dermal macrophages, neutrophils and so on).

Mechanism of immunomodulation[50]


In terms of the diagnosis of Tick-borne disease we find that early in the disease course diagnostic test are limited, however the symptoms demonstrated by the individual as well as the possibility of having been exposed to ticks are important diagnostic information. [4][52]


For tick removal grab near the skin. Compressing the body of the tick could cause more toxins to be injected.

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).[53][54]

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.[55]

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.[48]



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 presentation alone.[4]

In terms of the medication- antibiotics depend on the type of bacterial infection (as well as if it is a virus or other type of pathogen) [4]

For example for the treatment of Lyme disease the antibiotic Doxycycline is recommended[56]

See also


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